New Medicare rules to simplify billing; more IVDs exempt from FDA premarket review. (in vitro diagnostics)Szabo, Joan
” he notes. “If it’s not clinically necessary, it makes more financial sense for physicians to see new patients of their own instead of doing several split visits. We don’t count on split visits for a big chunk of our reimbursement.” While the new billing rule will have some impact...
On April 1, 2006, new Centers for Medicare and Medicaid Services (CMS) rules for billing erythropoietin (EPO) for dialysis patients went into effect. Two key provisions of the rules were to cap the dose for a single patient at 500,000 IU/month and to mandate a 25% reduction in...
On July 31, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule entitled,Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year...
Long-standing concerns in DME (Durable Medical Equipment) known for unquestionable billing practices, led the government to take action for tackling fraud in the insurance industry. Medicare, the nation’s largest health insurance program, regulates the billing structure of the maximum number of health...
Reports that the federal government has handed hospitals the Medicare billing compliance model which is voluntary and can be tailored to fit various types of institutions. Purpose of the model; Guidelines offered by the model; Information about the model plan. INSET: Highlights of HHS' model hospit...
The policies will require states to submit an annual payment analysis comparing managed care plan payment rates for certain services as a proportion of Medicare payment rates and comparing payment rates for community-based services to those of the state’s Medicaid plan. ...
“good faith effort” exemptions, which provided an additional year to implement EVV and iron out any issues. Some of these efforts were hampered by COVID-19, but the Centers for Medicare & Medicaid Services (CMS) hasn’t reextended the deadline. So some states are still scrambling to ...
https://www.kff.org/medicare/issue-brief/medicare-advantage-2017-spotlight-enrollment-market-update/ 17. Gottlieb JD, Shapiro AH, Dunn A. The complexity of billing and paying for physician care. Health Aff (Millwood). 2018;37(4):619-626. doi:10.1377/hlthaff.2017.1325...
Gore. When Medicare relaxed its rules, did that make a big change for you in an academic setting? Gore: It absolutely did. Personally, about 55% of my practice is Medicare patients. In recognition of the pandemic, personally in my own practice, I had made a decision to large-scale ...