Reports on the information that the Centers for Medicare and Medicaid Services (CMS) has increased Medicare rate for partial hospital providers in the U.S. Recalculation of the hospital and community mental health center cost-to-charge ratios; Analysis of the data resulted in reduced cost per ...
-- Final CMS rule concludes iovera is a qualifying device for separate payment under the NOPAIN Act -- -- BeginningJanuary 1, 2025, providers can receive additional Medicare payment when they use EXPAREL or iovera°via product-specific reimbursement codes -- ...
CMS Updates Scope of Providers Subject to Provisional Period of Enhanced Oversight McDermott Will & Emeryon1/8/2025 The Centers for Medicare & Medicaid Services’ (CMS) 2025 Home Health Prospective Payment System final rule (Final Rule) expanded the scope of providers subject to a provisional peri...
Medicare Parts A & B On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a rule finalizing changes for Medicare payments under the PFS and other Medicare Part B policies, effective on or after January 1, 2025.The CY 2025 PFS final rule is one of several final...
Providers that bill Medicare Advantage or Medicare Part C (“MA”), and most particularly capitated provider groups, should carefully watch a recent lawsuit Providers that bill Medicare Advantage or Medicare Part C (“MA”), and ...
CMS's commentary indicates that this Final Rule reflects its attempt to better balance the government's interest in promptly recovering Medicare overpayments against providers' and suppliers' need to be able to thoroughly investigate and quantify potential overpayments before re...
For providers, the final rule encourages the adoption of electronic prior authorization processes by adding a new measure for Merit-based Incentive Payment System (MIPS) eligible clinicians under the Promoting Interoperability performance category of MIPS, as well as for eligible hospitals andcritical acc...
CMS has announced plans to test an alternative payment model (APM) to support Medicare beneficiaries with dementia and their unpaid caregivers.
Eligible health care settings would also be able to add a new Electronic Prior Authorization measure via the Medicare Promoting Interoperability Program and for Merit-based Incentive Payment System. According to CMS, the new rules would support higher quality patient care while requiring providers...
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...