CMS proposes to clarify and modify its process for making changes to the Medicare Telehealth List. In previous years services were added on a Category 1, Category 2 or Category 3 basis. Now that the COVID-19 public health emergency (PHE) is over, CMS proposes to clarify and mo...
On June 15, 2022, the Supreme Court held, among other things, that absent a survey of hospitals' drug acquisition costs, the U.S. Department of Health and Human Services (HHS) may not vary the reimbursement rates only for 340B hospitals. Therefore, the court determined that ...
inpatient-only listtotal hip arthroplastyoutpatientcostshealth policyStarting in 2020, Centers for Medicare and Medicaid Services (CMS) removed total hip arthroplasty (THA) from the inpatient-only list, resulting in an average of $1637 per case reduction in facility reimbursement. The purpose of this...
Yet, audio-only was not universally embraced as a permanent covered service with separate reimbursement. In the final rule, CMS elected to discontinue such coverage post-PHE, and did not permanently add these services to the Medicare Telehealth Services List. With the exception of certain telementa...
“Second, in addition to patient safety concerns that some hospital groups raised, there were also concerns about the decrease in hospital reimbursement for procedures removed from the IPO list under OPPS,” Shah adds. “For those who felt and continue to feel strongly that ...
(RA) as documentation to evidence the state’s liability for dual eligible beneficiaries’ deductible and/or coinsurance amounts. If a provider does not bill the state and submit the Medicaid RA to Medicare with its claim for bad debt reimbursement for dual eligible beneficiaries, the result is...
This does not provide significant dollars for an ASC to do the Medicare case—in fact, the implant may cost the ASC more than the total reimbursement amount. This device offset value attributed to the implant is based on hospital reporting data; ASCs may not have the buying power of a ...
Families who send their children to private schools argue thatthey are reducing the strain on public school resources. They note that they arenot asking for a total reimbursement[meaning total payback of private tuition] but rather a deduction, which would reduce their tax bill by some percentage...
Therefore, we do not intend, nor should clients expect, for this payment to be an exact reimbursement of any excess tax cost. *Please refer to the "Loan Consent" section of your Account Agreement which states that no compensation is due in connection with such loans and that Schwab "is ...
(Mo-99), the precursor to Tc-99m, CMS proposes a new $10 add-on payment per dose, beginning Jan. 1, 2026, for radiopharmaceuticals using Tc-99m derived from domestically produced Mo-99. This initiative aims to ensure equitable reimbursement for providers, reflecting the higher costs of...