Tag: Medicare Program


The Future of Digital Health and Healthcare IT Post-Covid

Implementing and pursuing innovation in digital health and healthcare IT should be a priority for all U.S. healthcare providers and payers — especially as the lessons and response to the Covid-19 pandemic become permanently part of our everyday lives. The outbreak of Covid-19 was a “black swan” event that dramatically accelerated the evolution and acceptance […]
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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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Tread Carefully in Medicare Billing

Thanks to new provisions that went into effect for the 2022 calendar year, CMS is no longer necessarily considering “nefarious intent” when determining whether a provider or supplier should be excluded from the Medicare program. The Physician Fee Schedule for the 2022 calendar year is in full effect. The proposals, which were issued in July […]
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AMA Challenges MedPAC Suggestion to Freeze Medicare Physician Payment

The industry group states that Medicare physician payment bump will hinder the delivery of high-quality care as providers face financial burdens. MedPAC, a panel tasked with advising Congress on issues impacting the Medicare program, voted to recommend no increase to 2023 Medicare reimbursement rates for physicians. “Temporary or high variable coronavirus effects are best addressed […]
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The Mississippi’s Medicaid Expansion Could Reduce State Medicaid Spending

Mississippi’s Medicaid program ranks poorly for its access to and quality of care, but Medicaid expansion could increase healthcare coverage along with lowering state Medicaid spending. Mississippi could achieve lower state Medicaid spending over the course of five years by expanding its Medicaid program with the American Rescue Plan boost to federal matching, a Manatt […]
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Medicare Part B premiums are increasing by 14.5%

CMS attributes the increases in part to rising prices and utilization across the healthcare system, as well as Aduhelm. The standard monthly premium for Medicare Part B enrollees will be $170.10 for 2022, an increase of $21.60 from $148.50 in 2021. This represents a 14.5% increase. The annual deductible for all Medicare Part B beneficiaries […]
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CMS Faces Calls to Improve Remote Patient Monitoring Coverage in 2022 PFS

Telehealth advocates are submitting recommendations to CMS to improve coverage for remote patient monitoring services in the proposed 2022 Physician Fee Schedule. With remote patient monitoring projects surging in popularity as a result of the pandemic, telehealth advocates are lobbying the Centers for Medicare & Medicaid Services to improve proposed coverage plans in the 2022 […]
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Leaked CMS Report Targets Medicare Noncompliance at CA Hospital

A leaked CMS report targeting HCA Healthcare-owned Good Samaritan Hospital in California warns the hospital to fix Medicare noncompliance issues or risk termination. A leaked CMS report put HCA Healthcare-owned Good Samaritan Hospital in California at risk of program termination by October if they fail to fix Medicare noncompliance issues that resulted in patient harm. […]
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