Tag: Medicare Reimbursement

Permanent Payment Adjustment for Home Health

Permanent Payment Adjustment for Home Health

The federal agency released the Home Health Prospective Payment System Rate Update proposed rule for CY23, which aims to permanently adjust Medicare payment based on PDGM. CMS proposes updated Medicare payment for home health agencies CMS is looking to apply a permanent prospective payment adjustment to the home health 30-day period payment rate to account […]
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Medicare, Beneficiaries Saw Higher Prices at Provider-Based Facilities

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, HHS Finalize 2023 Notice of Benefits, Payment Parameters

CMS, HHS Finalize 2023 Notice of Benefits, Payment Parameters

  CMS and the Department of Health and Human Services (HHS) released the 2023 Notice of Benefits and Payment Parameters Final Rule, which includes standardized plan options, changes to network adequacy reviews, refinements to the Affordable Care Act’s essential health benefits nondiscrimination policy, and other changes. “The recent Open Enrollment Period demonstrated the demand for […]
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Barostim Heart Failure Treatment: Coding Training

Barostim Heart Failure Treatment: Coding Training

The Centers for Medicare & Medicaid Services (CMS) has begun covering a portion of the device cost for Barostim Neo, a neuromodulation device for treating chronic heart failure. In late 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it would begin covering a substantial portion of the cost of implantable heart failure […]
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Revenue Cycle Leaders Experience Price Transparency Rule Burden

Key Advantages of Medicare Advantage Plans Versus FFS Medicare

Medicare Advantage plans draw a more diverse beneficiary population and can result in lower healthcare spending for low-income beneficiaries. Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on behalf of Better Medicare Alliance (BMA). “Medicare Advantage […]
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AHA Requests Additional COVID-19 Financial Support from Congress

AHA Requests Additional COVID-19 Financial Support from Congress

During the Delta and Omicron surges, hospitals and health systems faced significant challenges, prompting AHA to ask Congress for additional COVID-19 financial support. The American Hospital Association (AHA) has urged Congress to provide hospitals and health systems with additional COVID-19 financial support, including more Provider Relief Funds and an extension on the Medicare sequester relief. […]
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AMA Urges Congress to Update Medicare Physician Payment System

AMA Urges Congress to Update Medicare Physician Payment System

The American Medical Association urged congressional leaders to lift the freeze on Medicare physician payments and provide updates that reflect inflation and practice costs. Following a recent Medicare Payment Advisory Commission (MedPAC) report, the American Medical Association (AMA) has asked Congress to update the Medicare physician payment system to include a stable annual payment rate […]
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Hospitals Saw Substantial Underbilling for Medicare Telestroke Services

Hospitals Saw Substantial Underbilling for Medicare Telestroke Services

One-third of hospitals across the country offered telestroke services, but less than 40 percent submitted Medicare telestroke claims in the year before the COVID-19 pandemic. Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial underbilling from hospitals with […]
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Telehealth Update: New Bill Could Provide Much Needed Certainty to Providers and Patients

Telehealth Update: New Bill Could Provide Much Needed Certainty to Providers and Patients

On Monday, February 7, 2022, U.S. Senators Catherine Cortez Masto, D-Nevada, and Todd Young, R-Indiana, introduced the Telehealth Extension and Evaluation Act, which if passed, would extend several of the telehealth waivers for two years after the end of the federal public health emergency (PHE).  See our previous coverage of telehealth during the COVID-19 pandemic. […]
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New Senate Bill Aims to Extend Medicare Telehealth Waivers By 2 Years

New Senate Bill Aims to Extend Medicare Telehealth Waivers By 2 Years

The bill proposes extending Medicare reimbursement for a range of telehealth services, including substance abuse treatment, for two years after the public health emergency has ended. A new piece of bipartisan legislation has been introduced in the US Senate that aims to extend access to telehealth for Medicare beneficiaries after the COVID-19 pandemic has ended. […]
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