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...
More InfoBrain illness and injury, with a focus on dementia-related diagnoses, occupy a high volume of the 1,495 proposed changes to the ICD-10-CM diagnosis code set by CMS in the fiscal year (FY) 2023 inpatient prospective payment system (IPPS) proposed...
More InfoCMS encouraged Medicare Advantage plans to waive prior authorizations during the public health emergency, but AHA urged the agency to make it a requirement instead of a suggestion. The American Hospital Association (AHA) has asked CMS to work...
More InfoCMS is proposing a new rule that aims to cut prescription drug costs, increase contract vetting and improve health equity, according to a Jan. 6 news release. The proposed changes primarily target Medicare Advantage and Part D plans. CMS also...
More InfoThe Centers for Medicare & Medicaid Services (CMS) will enforce its COVID-19 vaccination requirement in 25 states, the District of Columbia, and other territories, according to an update released on December 28, 2021. CMS is enjoined from...
More InfoMedicare Advantage plans hold up their end of the contract with CMS, and provide, at a minimum, a fair reimbursement for services delivered. The physician advisor is a fast-growing specialty that has evolved into so much more than someone who...
More InfoFor most readers the results of this analysis will be amazing but true. Longtime RACmonitor contributor and R1 Physician Advisory Services Vice President Dr. Ronald Hirsch recently pointed site Publisher Chuck Buck in the direction of something...
More InfoAdditionally, 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...
More InfoThe 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...
More InfoCMS 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...
More InfoThe 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...
More InfoThe number of improper payments made under Medicare fee-for-service declined by $20.72 billion since 2014, according to new figures from the Biden administration. “The continued reduction in Medicare fee-for-service improper payments represents...
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