If you have Medicare, you probably have minimum essential coverage (MEC) as defined by the Affordable Care Act (also known as Obamacare or ACA). Learn more about which Medicare coverage does and doesn't count.
Updated January 26, 2023. Accessed March 15, 2023. https://www.ahcancal.org/Survey-Regulatory-Legal/Emergency-Preparedness/Documents/COVID19/3-Day Waiver FAQ.pdf 7. The Medicare Payment Advisory Commission Policy. March 2022 report to Congress: Medicare payment policy. March 15, 2022. Accessed...
Our Medicare monthly payment is going up around $20 more in 2022. He has been on a State assisted pharmacy plan, so I guess he shouldn’t have to pay a penalty? Is Medicare trying to push seniors who’ve paid into the system their whole lives, in a debt situation? If you have a ...
The Comprehensive Care for Joint Replacement (CJR) model is an alternative Medicare payment model for joint replacement that mandated participation by hospitals in randomly selected Metropolitan Statistical Areas (MSAs). On average, the program decreased inpatient length of stay and increased home discharg...
(MPNs) when available, or, if unavailable, other OPAIS fields, such as names and addresses. CMS will also exclude units in all professional claim lines for 2023 dates of service that were billed with the “JG” or “TB” modifiers, which indicate that the...
A Medicare appeal is a formal request made by a Medicare beneficiary or their representative to challenge a decision made by Medicare regarding coverage, payment, or denial of a specific healthcare service, item, or prescription drug. The appeal process allows individuals to seek a review and pot...
Effective Dates Please note that this rule is effective as of 60 days following the date of publication (December 11, 2023), but is only applicable one year after publication (October 10, 2024). RREs are expected to be compliant with their Section 111 Mandatory Insurer Reporting requirements ...
Payment for Specimen Collection for Purposes of COVID-19 Testing Who can bill for the Medicare specimen collection fee? Independent laboratories can bill Medicare through their MAC for the specimen collection fee. The specimen collection fee applies if the specimen is collected by trai...
The Secretary has the option to delay the reporting to manufacturers for the 2023 payment year by up to one year (to September 30, 2025). Other changes Other key changes proposed in the Build Back Better Act include: Point-of-sale (POS) rebates: The BBB would indefinitely delay ...
Finally, on July 12, CMS also announced a new hospice audit pilot program using its Supplemental Medical Review Contractor (SMRC), Noridian, to conduct post-payment reviews of hospice routine home care claims with dates of service between January 1, 2021 to Decem...