The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract. CMS does not construe this as a change to the MAC Statement of Work. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract...
Today, the Centers for Medicare & Medicaid Services (CMS) released afinal ruleimposing new price transparency requirements on hospitals, including online posting of negotiated rates for all services. In addition, CMS, in conjunction with the Departments of Health and Human Services (HHS), Labor, an...
The Centers for Medicare & Medicaid Services (CMS) finalized its Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payment rates on Nov. 2 for calendar year (CY) 2024. TheFinal Rulewill be effective on Jan. 1, 2024. The Final Rule updates Medicare pay...
CMS is requesting specific feedback on the potential new Medicare Plan Finder Drug Pricing measure for the Part D Star Ratings, noting limitations of the current Medicare Plan Finder Price Accuracy measure that is part of the Part C and D Star Ratings, including concerns that plans may b...
“Medicare may also refuse to pay for future medical expenses related to the WC injury until the entire settlement is exhausted.” “The WCMSA amount review process is the only process that offers both Medicare beneficiaries and Workers’ Compensation entities a finality, with respect to obligation...
Earlier this year, the United States Centers for Medicare and Medicaid Services (CMS)announcedthat it plans to delay the enforcement of certain provisions of the Transparency in Coverage Final Rules by six months – from January 1, 2022, to July 1, 2022. CMS notes that the ru...
In mid-June 2020, the United States Centers for Medicare and Medicaid Services (CMS)released a proposed rule(NPRM), “Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Reba...
After years of declining reimbursement, the US Centers for Medicare & Medicaid Services (CMS) has proposed an increase in the amount paid to hospitals and outpatient clinics for cardiac computed tomography angiography (CCTA). Current CMS reimbursement for CCTA—included in a class 1 recommendation ...
calendar year 2014, the last year that these statistics were compiled.1 In Table 1, I have ranked the top 10 retina procedures in the BESS files in order of highest utilization (allowed services) and then by the amount of dollars allowed (allowed charges) by Medicare for those same ...
“You can pass through in a hospital environment and get a higher reimbursement if you could get Medicare to start paying higher amounts for an IOL,” Mr. Michaels said. Brette McClellan, director of health policy and government relations ...