Category: Blog

medicare-patients-in-metro-areas-more likely to report-telehealth-use

Medicare Patients in Metro Areas More Likely to Report Telehealth Use

Additionally, those who were younger than 75, lived in the west and had internet connectivity were more likely to use video or voice calls to interact with their physicians. Medicare beneficiaries living in metropolitan areas were more likely to report that they used telehealth services, a new study revealed. Published in the Journal of Evaluation […]
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Beware: Proportion of Medicare Fee-for-Service Beneficiaries is Shrinking

The volume of Medicare beneficiaries has been slowing growing while the distribution of Medicare plans is quickly changing. Medicare provides federal healthcare coverage for Americans 65 or older, or anyone with end-stage renal disease, regardless of age, as well as certain people with disabilities under the age of 65 who often also have Medicaid benefits […]
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cms-repeals-final-rule-digital-therapeutics-year-shifting-guidance

CMS Repeals Final Rule on Digital Therapeutics in A Year of Shifting Guidance

  The absence of an established, repeatable, and scalable path to commercialization and prescription of DTx has bottlenecked broader uptake, says one physician leader. Key Takeaways The Centers for Medicare & Medicaid Services has repealed its Medicare Coverage of Innovative Technology final rule. The action leaves multiple unanswered questions for digital therapeutic reimbursement, with payers […]
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The Millions of Patients Receive Healthcare Data Breach Notifications

Utah Imaging Associates began notifying nearly 600K of a healthcare data breach, and Eskenazi Health began notifying over 1.5 million individuals. Covered entities must post a notice on the home page of its website for at least 90 days if there are more than 10 individuals with out-of-date contact information to ensure that impacted individuals […]
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The CMS Expands Medicare Coverage for Remote Patient Monitoring

  CMS has been incrementally expanding coverage for remote patient monitoring since first recognizing the platform in 2019. Through RPM, healthcare providers can use digital health tools and telehealth platforms to improve care management for patients at home, especially those with chronic conditions or who’ve been recently discharged from a hospital. The platform has the […]
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A Snapshot of Telehealth Payment Policies Across States

Telehealth policies vary from state to state but in the past few months there have been some common regulation changes across the country. Specifically, states modified their Medicaid reimbursement policies for telehealth services, the Center for Connected Health Policy’s (CCHP) State Telehealth Laws and Reimbursement Policies Fall 2021 report revealed. CCHP gathered data from state […]
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New ICD-10-CM/PCS Codes Released

  The implementation of the new codes is April 1, 2022. The new ICD-10-CM/PCS codes for implementation on April 1, 2022, were recently released by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC). The CMS v39.1 version of the MS-DRG grouper will be released in February […]
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Newly expanded supplemental benefits in Medicare Advantage grew 43% for 2022

Along with that growth, the number of plans offering more than one benefit increased 15%, from 175 to 202. The findings show that under the Centers for Medicare and Medicaid Services’ reinterpretation of “primarily health-related” benefits, supplemental benefit offerings in Medicare Advantage – such as home-based palliative care, in-home support services, caregiver support and therapeutic […]
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The Steps You Can Take to Defend Against Exclusion of Zero-Paid Claims

Zero-paid claims are defined as any claims submitted by healthcare providers that are not paid. The problem is that when performing statistical extrapolations, auditors (ZPICs, or Zone Program Integrity Contractors, and others) routinely screen out zero-paid items when they extract the claims from a sample. This is a violation of at least 12 parts of […]
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Reporting COVID-19 Vaccination Status in 2022

Three new diagnosis codes for reporting COVID-19 vaccination status will go into effect April 1, 2022. The codes were presented by the National Center for Health Statistics (NCHS) at the Sept. 14-15, ICD-10 Coordination and Maintenance Committee meeting, so they are not listed in the 2022 ICD-10-CM code book. The new ICD-10-CM codes for reporting […]
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