Tag: Healthcare Policy

Prior Authorization in Medicare Advantage

Prior Authorization in Medicare Advantage : Lawmakers Call for Streamlined Process

CMS has proposed a rule to simplify prior authorization in government-sponsored health insurance programs. However, some lawmakers are urging the agency to do more. A bipartisan coalition of 233 representatives and 61 senators have written a letter to CMS requesting that the proposed rules be expanded and that the changes be finalized quickly to enhance […]
Learn More
Upcoming ICD-11 Codes

ICD-11 Is Coming, Prepare Now

IFHIMA makes the case for ICD-11 adoption with latest whitepaper. As healthcare transformation progresses due to the digitization of data and advancements in medical science and technology, it is increasingly important that nations around the world begin planning for adoption of ICD-11. The International Classification of Diseases (ICD) has a long and valued history of […]
Learn More
Telehealth Challenges

Industry Voices – 3 Challenges Exposed In The New World Of Telehealth

The rapid rise of telemedicine in response to the COVID-19 outbreak has been critical for getting at-risk patients the care they need. In fact, many state governments are working to expand telehealth within their Medicaid programs, while also easing restrictions to allow for faster implementation. And there is evidence that this trend will not be reversed anytime soon. […]
Learn More
Physician Fee Schedule

CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) is proposing changes to the Medicare Physician Fee Schedule (PFS) and the Quality Payment Program as part of its effort to reduce provider burden. “Clinicians are drowning in paperwork and reporting requirements caused by cumbersome government rules and regulations,” said CMS Administrator Seema Verma in a press […]
Learn More
LT/RT Modifiers

Change To RT And LT Modifiers Use

The Durable Medical Equipment Medicare Administrative Contractors (DME MAC) are changing the requirement that medical coders to use the right (RT) and left (LT) modifiers for certain HCPCS codes, and that the modifiers be used when billing two of the same item or accessory on the same date of service and the items are being used bilaterally. The […]
Learn More
Alternative Payment Models

Understanding The New CMS Primary Care Alternative Payment Models

  In April, the U.S. Department of Health and Human Services (HHS) announced five new alternative payment models for primary care, known as the CMS Primary Cares Initiative. The five alternative payment models are: Primary Care First Primary Care First – High Need Populations Direct Contracting – Global Direct Contracting – Professional Direct Contracting – […]
Learn More
Medicare for All Allzone Management Solutions

Healthcare Remains Primary Concern for Voters, with Strong Support For ‘Medicare-For-All’

Healthcare is a top priority for American voters and there aren’t dramatic differences by ideology, according to a new survey. Key Takeaways Thirty six percent of Americans ranked healthcare as the most important policy issue facing the nation’s future. Seventy two percent of Americans responded that they were satisfied with the healthcare they received while […]
Learn More
MEDICARE PAYMENT

CMS Proposes FY 2020 Medicare Payment Updates For Post-Acute Care

Recently proposed rules would boost FY 2020 Medicare payment rates for several post-acute providers, including skilled nursing facilities and hospices. April showers bring May flowers. But, this year, they are also bringing a slew of new Medicare payment rate proposals, including reimbursement and quality reporting updates for several types of post-acute care providers. CMS recently […]
Learn More
x