CMS has released a proposed rule for the Home Health Prospective Payment System in CY22, which aims to expand value-based purchasing and address health equity. CMS has released the proposed rule for the Home Health Prospective Payment System next year. The rule seeks to expand the Home Health Value-Based Purchasing (HHVBP) Model and address […]
New codes are effective Oct. 1, 2021. Highly anticipated, the fiscal year 2022 ICD-10-CM codes have been released by the Centers for Disease Control and Prevention (CDC), although still pending are the 2022 Official Coding and Reporting Guidelines which were not included in the package of new codes. We are still waiting for the release […]
HHS recently extended the deadline to use COVID-19 relief funds to the end of the month, but some providers say they still need more time. The American Hospital Association (AHA) is seeking more time for healthcare providers with unspent COVID-19 relief funds. The deadline to use COVID-19 relief funds is approaching for many providers. According […]
The Supreme Court’s decision in California v Texas ended one lawsuit against the Affordable Care Act but may have left room for future legal action. Since the Supreme Court dismissed California v Texas on June 17, payers and healthcare leaders have vocalized their support for the decision, their readiness to continue building on the Affordable […]
The pandemic has only made the trend worse, as 33% of hospital executives report average claims denial rates of 10% or more. Hospital claim denial rates have hit new highs, with a 20% increase in those rates over the past five years, suggesting that better claims denial management processes are necessary, finds a new […]
Merging the two health systems would create the largest system in Michigan, operating 22 hospitals and 305 outpatient centers, as well as a health plan. Michigan-based Beaumont Health and Spectrum Health have announced that they plan to merge to create the largest health system in the state. The announcement dropped yesterday said the two […]
MACPAC’s June 2021 report to Congress included findings about non-emergency medical transportation benefits in Medicaid programs that could prove useful for benefits design. A small fraction of the Medicaid population utilizes non-emergency medical transportation (NEMT) benefits, but for that community of beneficiaries NEMT programs can be indispensable, a MACPAC report recently found. It has been […]
The code 99417 is invalid for Medicare and MA reimbursement. When the CPT® Guidelines were updated for 2021, one of the options for leveling an office or other outpatient evaluation and management (E&M) service was to use time as the leveling agent. The time thresholds for each E&M office visit were also changed from “typical” […]
HHS recently updated Provider Relief Fund reporting requirements, extending the period of availability of funds and reporting periods. The update to the Post-Payment Notice of Reporting Requirements states that clinicians now have a period of availability of funds based on the date they received the payment, rather than the original deadline of June 30, 2021. […]
The US could see a physician shortage of 37,800 to 124,000 doctors by 2034, including shortfalls in both primary and specialty care, according to the latest numbers from the Association of American Medical Colleges (AAMC). Primary care will see a shortage of 17,800 to 48,000 physicians between 2019 and 2034, while specialty care is slated […]