Tag: CMS final Rules

: Final Rule for Streamlining Prior Authorization Processes

Final Rule for Streamlining Prior Authorization Processes Unveiled

In an effort to streamline prior authorization processes, provider bunches, including the American Medical Association (AMA) and the Medical Group Management Association (MGMA), have asserted that the ultimate goal of the new regulations will assist in facilitating a more efficient and effective prior authorization workflow. Provider bunches are commending CMS for finalizing understanding data-sharing approaches […]
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CMS Issues Contract Year 2023 Final Rule for Medicare Advantage Organizations and Prescription Drug Sponsors

  On April 29, 2022, the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”).  CMS promotes the Final Rule as advancing “CMS’ strategic vision of expanding access to affordable health care […]
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The 4 key issues for the revenue cycle in 2022

Taya Moheiser, CMPE, CMOM, owner of ITS Healthcare, and Kem Tolliver, CMPE, CPC, CMOM, president of Medical Revenue Cycle Specialists to share the top trends they’re following right now. KEY TAKEAWAYS Mental health billing will continue to evolve. Billing directly to Medicare for physician assistants will take center stage. Be sure to educate your revenue […]
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The 2022 OPPS/ASC Final Rule Finalizes 2% Boost in Payment Rates

CMS dramatically increases financial penalties for noncompliance with hospital price transparency rules. On Nov. 2, 2021, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule, finalizing payment rates and policy changes affecting Medicare services furnished […]
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CMS Repeals Final Rule on Digital Therapeutics in A Year of Shifting Guidance

  The absence of an established, repeatable, and scalable path to commercialization and prescription of DTx has bottlenecked broader uptake, says one physician leader. Key Takeaways The Centers for Medicare & Medicaid Services has repealed its Medicare Coverage of Innovative Technology final rule. The action leaves multiple unanswered questions for digital therapeutic reimbursement, with payers […]
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The CMS repeals rule allowing coverage of breakthrough technologies for Medicare patients

CMS is exploring a new rule due to concerns raised and operational challenges. The rule that would have allowed access to Food and Drug Administration-designated and -approved technologies for Medicare patients suffering from illnesses and conditions that existing treatments and technologies are unable to address. CMS is exploring a new rule due to concerns raised […]
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CMS Unveils 2022 Final Rules for Four Provider Types

Medicare payment policies and rates are set to be adjusted for the 2022 fiscal year as a result of the moves. The Centers for Medicare & Medicaid Services (CMS) brought a four-pack of final rules to the backyard barbecue as the dog days of summer continue. The federal agency unveiled the plans on Thursday, noting […]
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CMS Releases PCS Codes Final Rule

The final rule contains 78,220 code changes, up by 117 from FY 2021. The Centers for Medicare & Medicaid Services (CMS) has released the final ICD-10-PCS codes and guidelines for the 2022 fiscal year (FY). The files included in the release include the Addenda File, Code Tables and Index file, FY 2022 PCS Version Update […]
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