Tag: Medicare Policy

Prior Authorization in Medicare Advantage

Prior Authorization in Medicare Advantage : Lawmakers Call for Streamlined Process

CMS has proposed a rule to simplify prior authorization in government-sponsored health insurance programs. However, some lawmakers are urging the agency to do more. A bipartisan coalition of 233 representatives and 61 senators have written a letter to CMS requesting that the proposed rules be expanded and that the changes be finalized quickly to enhance […]
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Medical-Necessity-Code-Changes-ICD-10-CM

NCDs Affected by ICD-10-CM Medical Necessity Code Changes

When ICD-10-CM is updated Oct. 1, so are these National Coverage Determinations. Are you wondering which National Coverage Determinations (NCDs) will be affected by the thousands of diagnosis code changes going into effect Oct. 1? Centers for Medicare & Medicaid Services (CMS) transmittal tells all. CMS Transmittal 11546, issued Aug. 4, is a one-time notification […]
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Biden Administration Shares Latest Round of HHS Staff Appointments

Today the Biden Administration announced its latest group of appointments to the Department of Health and Human Services. The new appointees join tens of thousands of career officials throughout the agency at a time when expertise is critical to tackling the ongoing COVID-19 pandemic. WHAT’S THE IMPACT? Kristina Schake will serve as HHS Secretary Xavier Becerra’s […]
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New Medicare Rule Will Cut Payments to Hospitals for Some Surgeries

A cost-cutting change in Medicare policy will reduce payments to hospitals for some surgical procedures and increase costs for patients, according to a March 21 report from the The Washington Post. Before the change, CMS categorized 1,740 surgeries and other services as eligible for Medicare payments only if they were performed on beneficiaries who were admitted […]
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AMA Calls For Modifications To The Proposed Medicare 2021 Fee Schedule

The American Medical Association (AMA) says the proposed Medicare 2021 fee schedule should be modified to reflect changes brought on by the ongoing COVID-19 coronavirus pandemic. In detailed comments submitted to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, the AMA warned that some proposed regulations in the fee schedule would hurt many practices already […]
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