Month: September 2021

AHA Pens Oppositions to 2022 Physician Fee Schedule Proposed Rule

AHA Pens Oppositions to 2022 Physician Fee Schedule Proposed Rule

The organization is concerned about policies in the 2022 Physician Fee Schedule proposed rule, ranging from telehealth worries to apprehension about MIPS. The AHA agreed with certain aspects of the rule but also voiced various problems and recommendations for CMS to consider. The AHA opposed several telehealth policies that CMS included in the rule. The […]
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Affordable Care Act Marketplace Sees Boost in Diversity, Savings

Affordable Care Act Marketplace Sees Boost in Diversity, Savings

HHS has announced that 2.8 million people gained health insurance coverage through the Affordable Care Act marketplace during the special enrollment period. This influx of enrollees raised marketplace enrollment to 12.2 million, the highest enrollment level that these marketplaces have ever seen. “It’s clear that when health coverage is accessible and affordable, people sign up, […]
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COVID-19 AHA_AHIMA FAQ Revisions Made

COVID-19 AHA/AHIMA FAQ Revisions Made

  The implication of an incorrect COVID-19 diagnosis can be profound. I made a mistake last week. I was told that the joint American Hospital Association/American Health Information Management Association (AHA/AHIMA) frequently asked questions (FAQ) regarding ICD-10-CM coding for COVID-19 had been updated, so I checked the website (https://www.codingclinicadvisor.com/faqs-icd-10-cm-coding-covid-19). On the introduction page, it stated, […]
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5 Steps To Revenue Cycle Succession Planning Success

5 Steps To Revenue Cycle Succession Planning Success

It’s more important than ever for revenue cycle leaders to think seriously about succession planning as baby boomers begin to retire and the revenue cycle increasingly requires more specialized skills, says PeaceHealth’s senior enterprise director of HIM, coding, and CDI. “Everyone’s replaceable,” says Cassi Birnbaum, senior enterprise director of HIM, coding, and CDI at PeaceHealth […]
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CMS to Tie Vaccine Mandate to Medicaid, Medicare Participation

CMS to Tie Vaccine Mandate to Medicaid, Medicare Participation

  A COVID-19 vaccine mandate for healthcare workers will be tied to Medicaid and Medicare Conditions of Participation (CoP), the Biden-Harris Administration recently announced. The announcement made via CMS yesterday said the Administration will require COVID-19 vaccination of staff in all Medicaid and Medicare-certified facilities by October. The emergency regulation, when it is released, will […]
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The Biden Administration Drug Plan Includes Value-Based Payment Ideas for Medicare

The Biden Administration Drug Plan Includes Value-Based Payment Ideas for Medicare

The administration said it would make the results of its drug price negotiations with manufacturers, as well as its approach to value-based care models, open to a variety of payers. The Biden administration Thursday released its plan to reduce prescription drug prices, which would include the use of models to test value-based payments in Medicare […]
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The CMS provides additional ARP funding to states to promote insurance affordability

The CMS provides additional ARP funding to states to promote insurance affordability

The Centers for Medicare and Medicaid Services and the Biden Administration have earmarked $452 million in federal funding through the ARP  funding to Health insurance program for efforts to lower costs and improve health insurance access in 13 states. Due to the changes made to the ARP, states with 1332 reinsurance waivers will have more […]
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AMA Updates CPT Codes for COVID-19 Vaccines

AMA Updates CPT Codes for COVID-19 Vaccines

The updates include unique CPT codes for a new formulation of the COVID-19 vaccine developed by Pfizer and new codes for booster doses expected to roll out later this month. The American Medical Association (AMA) has announced updates to the Current Procedural Terminology (CPT) code set to account for changes to COVID-19 vaccines, including booster […]
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How Ambulatory Surgery Centers Lower Payer Outpatient Spending

How Ambulatory Surgery Centers Lower Payer Outpatient Spending

Payers can reduce surgical costs by 59 percent by shifting eligible members from the hospital outpatient setting to ambulatory surgery centers. Ambulatory surgery centers are care sites that offer surgical procedures, diagnostics, and preventive care services, according to the Ambulatory Surgery Center Association. These sites are not provider offices, rural healthcare clinics, or urgent or […]
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