The Centers for Medicare and Medicaid Services (CMS) finalized material changes to the overpayment rules for Medicare Parts A, B, C, and D effective January 1, 2025. These changes create new ambiguity and practical challenges for organizations dealing with a potential overpayment. Organizations shoul...
Among the changes cited are physician e-prescribing bonuses, prompt payment to pharmacies, use of prescription drug event (PDE) data by agencies, states, and researchers, and weekly pricing updates to pharmacies. It is noted that the Centers for Medicare & Medicaid Services (CMS) released ...
The pilot projects and public comments resulted in changes to the proposed TCET pathway. CMS has clarified eligibility, created a mechanism to predict TCET demand through letters of intent, established an equitable and operational quarterly review process, and developed a real-time platform ...
The prior authorization changes, announced this week, are part of the Centers for Medicare & Medicaid Services' (CMS')2024 update of policy changesfor Medicare Advantage and Part D pharmacy plans Medicare Advantage plans' business practices have raised significant concerns in recent years. More than...
(CMS) has used a single normalization factor as a basis to calculate payment rates for both Medicare Advantage Prescription Drug plans (MA-PDs) and standalone Part D plans (PDPs – the Medicare Prescription Drug Benefit). (A normalization factor is used to account for changes in the health ...
Questions for States As They Turn to Medicaid Managed Care Forty-nine states now rely on some form of Medicaid managed care plan. This brief examines several critical questions states must answer as they design Medicaid managed care programs aimed at reducing costs and increasing access to care.....
Dry eye disease is common but it's not always simple. If eye drops aren't helping, you'll want to see an eye doctor to determine the root cause. Barbara SadickFeb. 12, 2025 2025 Best Ambulatory Surgery Centers The second edition of the ASC ratings will feature several methodological refin...
Find out about the different imaging test types, when you may need them and how to prepare. Vanessa CaceresJan. 31, 2025 How to Assess Your Heart Health A healthy heart can help you live a long and happy life. Christine ComizioandElaine K. HowleyJan. 31, 2025 ...
Composition and Monthly Changes of the Volatile Constituents in the Sour Hetsuka-daidai Citrus Peel Sour citrus are prized for their flavor and fragrance. This work identified the components of the peel oil of Hetsuka-daidai (Citrus sp. hetsukadaidai), a ... H Toshiyuki,H Kanako,N Rino,...
The U.S.Social Security Administration (SSA)announces its annual changes to theSocial Securityprogram for the following year every October. The2025 changesconsist of a 2.5% cost-of-living adjustment (COLA) to the monthly benefit amount, an increase in the maximum earnings subject to the Social ...