The Centers for Medicare & Medicaid Services (CMS) published aFinal Ruleon April 4, 2024, that makes a number of changes to regulations governing the Programs of All-Inclusive Care for the Elderly (PACE). Among other things, the Final Rule gives CMS additional grounds on which to deny PACE ...
The article discusses the final rule issued by the U.S. Centers for Medicare and Medicaid Services (CMS) for providers and suppliers who qualify for a National Provider Identifier (NPI). The CMS requires the providers and suppliers to include the NPI on any enrollment applications to Medicare ...
CMS hasfinalizedpolicies to increase access to marketplace coverage and expand essential health benefits (EHBs) in the HHS 2025 Notice of Benefit and Payment Parameters final rule. “Access to affordable, quality health care options remain a concern across the country and ...
(OPPS)/Ambulatory Surgery Center (ASC) Payment System final rule (OPPS Final Rule),1in which the agency finalized several of the policies it proposed in the 2022 OPPS/ASC Payment System proposed rule (OPPS Proposed Rule).2In summary, in the OPPS Final R...
Section 4124(b) of the Consolidated Appropriations Act of 2024 established coverage for IOP services effective Jan. 1, 2024. CMS finalized the payment and program requirements for the new IOP benefit. The Final Rule includes the scope of benefits, physician certification requirements, coding and bil...
The CMS 2025 Hospice Final Rule was released on July 30, 2024. Catch our summary and links to helpful resources.
CMS said in the final rule that it continues to believe that the Radiation Oncology Model “would address long-standing concerns related to RT delivery and payment, including the lack of site neutrality for payments, incentives that encourage volume of services over the value of services, and cod...
It says that the final rule will address consumer notices, quality reporting and enrollee satisfaction surveys, and Small Business Health Options Program (SHOP). It mentions the possible implication of the final rule to state laws and insurance companies....
Fierce Healthcare reportsthat Humana is weighing its options to challenge the rule. Humana CEO Bruce Broussard said the company is still reviewing the rule but that it was “disappointed” with exclusions in the final regulation. “We are considering all of our options to address or...
2 April 2024 Registration Link: CMS Final Interoperability and Prior Authorization Rule: Impacted Parties, API Implementation, Reporting Requirements Impacted payers include Medicare Advantage/Medicare Part D plans, state Medicaid and Children's Health Insurance Program (CHIP) fee-for-service programs...