The Centers for Medicare & Medicaid Services (CMS) issued its2025 Physician Fee Schedule (PFS) proposed ruleearlier this month. Alongside a2.8 percent payment cutfor physicians, the rule includes numerous proposals directed at virtual care, including brand new codes for certain digital th...
The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule (CMS-1809-P), which includes proposals to update payment rates, policies and regula...
Additionally, the proposed rule for the CY 2025 ESRD Prospective Payment System would update the outlier policy, the low-volume payment adjustment (LVPA) and the bundle payment as it relates to oral-only drugs. First, the proposed rule would expand the list of ESRD outlier services to...
New CMS Proposed Rule: Comprehensive Care for Joint ReplacementJonesDay
The proposed rule would allow CMS to revoke a provider’s or supplier’s Medicare enrollment if convicted of a federal or state misdemeanor within the previous 10 years. For exclusion to apply, CMS would have to determine that the misdemeanor in question is detrimental to the best interest...
On December 10, 2024, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule with technical changes for the Medicare Advantage (MA) Program and the Medicare Prescription Drug Benefit Program for Calendar Year 2026 (Proposed Rule). Citing the growing use...
CMS proposed reducing its Medicare Physician Fee Schedule conversion factor from $33.29 to $32.36 in 2025. However, the proposed rule also aims to strengthen primary care and maintain telehealth flexibilities. CMS has released its proposed 2025 MedicarePhysician Fee Schedule, or PFS, which incl...
Along with the proposed rule, CMS is issuing the 2025 benefit year premium adjustment percentage index and related payment parameters in guidance before January 1, 2024, consistent with policy finalized in the 2022 Payment Notice. WHY THIS MATTERS ...
proposed a rule that would change how organizations that participate in Programs of All-Inclusive Care for the Elderly (PACE) respond to complaints and address PACE participants' requests for services, while modifying CMS’ monitoring of PACE organizations' corrective actions in contract year 2025. ...
The proposed rule also authorizes CMS to calculate 2023 Part C Star Ratings for the three Healthcare Effectiveness Data and Information Set measures based on the Health Outcomes Survey. The agency claims that, without this technical change, it would be unable to calculate 2023 Star Ratings for th...