Tag: Medicare Beneficiaries

IVIG Medicare Payment Update

Medicare Updates IVIG Demonstration Payment for 2023

Healthcare providers submitting claims for services, supplies, and accessories ordered under the Medicare Intravenous Immune Globulin (IVIG) Demonstration can expect to see an approximate 2.1 percent payment increase over last year. The calendar year 2023 rate for HCPCS Level II code Q2052 is $392.56, compared with $384.59 in 2022. What is the Medicare Intravenous Immune Globulin Demonstration? […]
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10 Areas That Will Impact Healthcare Organization in 2023

In an era of resource scarcity for many, it’s imperative for healthcare organizations to strategically identify areas of concern unique to them and on a broader spectrum. Healthcare business professionals and clinicians from entry-level departments to the C-suite should have at minimum a risk assessment in these areas and, ultimately, put in place policies and […]
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CMS Aims To Streamline Prior Authorization To Reform MA

The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]
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The Successful Alternative Payment Models from CMMI, To Date

The Center for Medicare & Medicaid Innovation (CMMI) has launched more than 50 alternative payment and care delivery model tests, with 33 models now or still operational, according to CMMI’s sixth report to Congress on its progress. These model tests have impacted the lives of millions of patients. In the two-year period covering the report, […]
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Patient Care Could be Affected by 8.5% Cut on Medicare Payments

An 8.5% cut to Medicare payments could affect patient care in medical practices across the country. Reducing charity care, new Medicare patients, staff, and locations all are among the effects projected if Congress does not act on 2023 reimbursement levels, according to a new study by the Medical Group Management Association (MGMA). The findings came […]
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How are Medicare patients using interstate telehealth visits?

Opponents of the loosened interstate telehealth restrictions that were instituted at the start of the COVID-19 pandemic argued that it would result in out-of-state doctors luring patients away from their current physicians. But a new study finds that most out-of-state telehealth is used for continuity of care, not acquiring new patients. The study compares interstate […]
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Updates on End-Stage Renal Disease Prospective Payment copy

Updates on End-Stage Renal Disease Prospective Payment

CMS issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease Prospective Payment System for renal dialysis services furnished to Medicare beneficiaries on or after Jan. 1, 2023. Here are four takeaways from the proposed rule: Under the proposed rule, Medicare expects to pay $8.2 billion to approximately 7,800 facilities […]
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Medicare, Beneficiaries Saw Higher Prices at Provider-Based Facilities

The Medicare program and Medicare beneficiaries could have saved a combined $1.6 billion if provider-based facilities charged the same payment rate as freestanding facilities, OIG found. Medicare and its beneficiaries paid significantly higher prices at provider-based facilities than they would have paid to freestanding facilities for the same services, according to a report from the […]
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CMS aims to eliminate delays in new Medicare coverage, expand special enrollment periods

The Biden administration wants to close the gap before new Medicare beneficiaries can get coverage and expand use of special enrollment periods. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule Friday that updated Medicare enrollment and eligibility rules. One of the key proposals is to provide Medicare coverage a month immediately […]
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