Tag: CMS

CMS COVID-19 Vaccination Rule

Centers for Medicare & Medicaid to Enforce Its COVID-19 Vaccination Rule, Sets New Deadlines

The 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 enforcing its COVID-19 vaccination rule in the other 25 states, which are involved in a case challenging its […]
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Medicare Advantage Plans and the Two-Midnight Rule

Medicare 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 performs endless chart reviews for observation status determinations, medical necessity reviews, peer-to-peer conversations with payors, […]
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beware-proportion-of-medicare-fee-for-service-beneficiaries-is-shrinking

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-expands-medicare-coverage-remote-patient-monitoring

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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new-icd-10-cm-pcs-codes-released

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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improper-medicare-payments-down-20b-since-2014-cms-data-shows

Improper Medicare payments down $20.7B since 2014, CMS data show

  The 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 considerable progress toward the Biden-Harris Administration’s goal of protecting CMS programs’ sustainability for future generations. We intend to build on this success […]
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cms-releases-2022-physician-fee-schedule-final-rule

CMS Releases 2022 Physician Fee Schedule Final Rule

The Centers for Medicare & Medicaid Services (CMS) has finalized 2022 payments and policies under the Medicare Physician Fee Schedule (MPFS). The rule includes updates to payment rates for physicians and other healthcare professionals for calendar year (CY) 2022; expands the use of telehealth for mental health; clarifies policies related to split (shared) visits, critical […]
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