Stay on top of the latest in diagnosis coding by reviewing this chapter-by-chapter summary of the changes effective October 1. Highly anticipated, the Centers for Medicare & Medicaid Services (CMS) released the ICD-10-CM code descriptions, tables and index, and addendum for fiscal year 2022. Although still pending are the 2022 Official Guidelines for Coding and […]
It would lengthen the annual open enrollment period, expand the role of navigators and nix Trump-era guidelines for waivers that were criticized for allowing states to skirt coverage requirements. The Biden administration is planning to restore key parts of the Affordable Care Act that were pared back by the Trump administration as the current HHS […]
Dive Brief: CMS does not have adequate authority to ensure that hospitals will be ready for the next pandemic, and wasn’t able to regulate them well enough to know whether they were maintaining quality and safety during the COVID-19 crisis, according to a new HHS Office of Inspector General report. As COVID-19 first emerged […]
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 […]
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 […]
CMS will increase Medicare payments by $35 per dose to administer at-home COVID-19 vaccines in an effort to increase the vaccination rate among beneficiaries. Medicare payments will increase by $35 per dose for providers who administer at-home COVID-19 vaccinations for Medicare beneficiaries, CMS announced today. In alignment with President Biden’s goal of ensuring vaccine […]
The COVID-19 pandemic has blown the doors wide open on telehealth, especially with new reimbursement parity policies. But value-based contracts can support the growing interest in remote patient monitoring and other virtual care services beyond the pandemic, according to telehealth experts at the Revenue Cycle Management Summit. “Remote patient monitoring programs are growing,” Andrew […]
Previously delayed from March 15th to May 15th, the final rule will now be codified on December 15th, giving CMS time to tackle issues raised by stakeholders. CMS announced that it will delay the effective date of a final rule updating the definition of “reasonable and necessary” and the guidelines surrounding the Medicare Coverage of […]
After three years of policy proposals, the American Medical Association Current Procedural Terminology (CPT) panel responses, and substantial guidance from gastroenterology and other specialty societies, changes to the office/outpatient evaluation and management (E/M) codes became effective as of January 2021. Some aspects of these revisions took effect for telehealth services since spring 2020 for Medicare, […]
At first glance, it appeared that hospitals were complying with the Centers for Medicare & Medicaid Services’ (CMS) price transparency requirement, which became effective January 1, 2021. Upon a closer look; however, multiple deficiencies were found. CMS previously advised that it would begin auditing compliance with the rule this past January. Interestingly, it was the […]