Hospital groups are digesting the 863-page CY 2022 OPPS proposed rule, but many are already commenting on new hospital price transparency penalties and other policies. The newly proposed Medicare Outpatient Prospective Payment System (OPPS) rule for calendar year (CY) 2022 is causing a stir with new hospital price transparency enforcement rules and other policies. The […]
The Health Resources and Services Administration (HRSA) has paid over 5 million claims for COVID-19 vaccinations of uninsured Americans, according to a recent announcement. The claims were paid through the HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured, a program funded by pandemic-related legislation […]
HHS will designate $4.8B from the American Rescue Plan to COVID-19 testing reimbursement under the HRSA COVID-19 Uninsured Program. Under the Health Resources and Services Administration (HRSA), HHS announced it will allocate $4.8 billion to COVID-19 testing reimbursement for the uninsured as part of the American Rescue Plan. There are currently approximately 29 million uninsured […]
Claims management is a multi-step process that provides ample opportunity for errors and delays, but if payers modify their approach to certain steps in the process it could have a positive impact overall. In the most concise language, claims management starts with a provider sending a claim or prior authorization request to a payer. The […]
New and innovative home dialysis machines will soon qualify for additional Medicare reimbursement, according to the latest End-Stage Renal Disease (ESRD) Prospective Payment System (PPS)Â final rule. CMS released the final rule yesterday, which introduced the new transitional add-on payment for dialysis machines used in patient homes and also included an update to Medicare reimbursement rates […]
Providers are increasingly using chronic care management (CCM) codes to address care fragmentation issues for patients with multiple chronic conditions. However, utilization patterns among providers could indicate some unaddressed challenges, according to a new study. The study recently published in the American Academy of Family Physicians examined publicly available Medicare data from 2015 to 2018. The data captured all […]
The AMA’s new Category I CPT code will allow for COVID-19 coding and billing of antigen tests performed on patients suspected of being infected by the novel coronavirus. The American Medical Association (AMA) recently updated Current Procedural Terminology (CPT) to enable proper COVID-19 coding and billing of antigen tests performed on patients suspected of being infected with […]
With telehealth reimbursement flexibilities set to expire following the public health emergency period, providers are calling on HHS and policymakers to continue payment parity beyond COVID-19. Telehealth use has increased dramatically in a matter of weeks, enabling providers to continue seeing patients despite social distancing and shelter-at-home restrictions due to COVID-19. But these advancements could […]
CMS is boosting Medicare payment to $100 for coronavirus lab tests that can process more than 200 specimens a day effective April 14 through the duration of the national emergency. CMS is nearly doubling Medicare payment for high-production coronavirus lab tests in efforts to boost COVID-19 testing capacity and monitoring in nursing home communities and […]
A healthcare lawyer advises providers to thoroughly document care delivery to prevent medical billing and payment issues likely to arise from the COVID-19 pandemic. Clinical documentation is critical to serving patients with COVID-19, but also avoiding medical billing and payment issues in the months and years following the pandemic, according to healthcare lawyer Delphine O’Rourke. “There’s […]