Tag: CMS rules

Prior-Authorization Issue

Prior authorization issues with Medicare Advantage plans

A new final rule from the Centers for Medicare and Medicaid Services (CMS) will make it harder for Medicare Advantage (MA) plans to require prior authorizations for their coverage The rule comes in the wake of a 2022 report from the Office of Inspector General of the US Department of Health and Human Services that […]
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CMS pitches inpatient payment rule for 2023: 10 things to know

CMS released its annual Inpatient Prospective Payment System proposed rule April 18, which proposes a reimbursement boost for acute care hospitals. Here are 10 things to know about the 1,786-page proposed rule: Payment rate update. Under the proposed rule, acute care hospitals that report quality data and are meaningful users of EHRs will see a […]
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Healthcare Tech Company Launches Online Price Transparency Tool

Through the online price transparency tool, users can view hospital service prices and assess machine-readable file completeness. A healthcare technology company has launched an online price transparency tool that allows consumers to compare hospital costs before seeking care. Turquoise Health’s Price Transparency Scorecard lets consumers find prices by searching for specific services or providers. The […]
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CMS COVID-19 Vaccination Rule

Centers for Medicare & Medicaid to Enforce Its COVID-19 Vaccination Rule, Sets New Deadlines

The Centers for Medicare & Medicaid Services (CMS) will enforce its COVID-19 vaccination requirement in 25 states, the District of Columbia, and other territories, according to an update released on December 28, 2021. CMS is enjoined from enforcing its COVID-19 vaccination rule in the other 25 states, which are involved in a case challenging its […]
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The CMS Vaccination Mandate Rule Blocked

If you’re leaning toward pausing your vaccination requirement process, be ready to crank it back up on a dime, legal experts stress. After the Biden administration issued two COVID-19 vaccination regulations on Nov. 5 — one from the Centers for Medicare & Medicaid Services and one from the Occupational Safety and Health Administration — states […]
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