The organization released new CPT codes for Pfizer’s pediatric COVID-19 vaccine once FDA grants emergency use authorization for children between six months and five years of age. The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include a new code for administering pediatric doses of Pfizer’s COVID-19 vaccine in […]
The Provider Relief Fund payments are part of the Phase 4 General Distribution announced in December. HHS, through the Health Resources and Services Administration (HRSA), is doling out another $2 billion in Provider Relief Fund payments to healthcare providers impacted by the COVID-19 pandemic. More than 7,600 providers across the country will get the payments […]
CMS has issued interpretative guidance on its healthcare worker vaccine mandate following the Supreme Court’s decision to allow the mandate to be enforced while some states challenge it in courts. The guidance released a day after the Supreme Court ruling states that facilities participating in Medicare and Medicaid in 24 states must ensure their employees […]
Small group coverage did not pursue the trends that many experts anticipated after the Affordable Care Act went into effect. From 2013 to 2020, small group coverage has maintained a fairly stable environment, researchers from the Urban Institute found. The researchers used the Medical Expenditure Panel Survey Insurance Component (MEPS-IC) in order to assess changes […]
CMS 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 noted that the proposed changes come with “modest costs” that should not affect bidding, premiums […]
Medicare Part B spending on laboratory tests ticked up to $8 billion in 2020, driven largely by new COVID-19 diagnostics reimbursements, even while spending on other types of tests declined, according to a new report released by the U.S. Department of Health and Human Services’ Office of the Inspector General. In total, there was $1.5 […]
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 […]
Break out your pen and paper because if you haven’t already started your list of new year’s resolutions, the past 12 months have given us plenty of ‘New Year, new me’ examples to take note of. From ratified legislation and appointed government officials to trending cyberthreat tactics (and binge-worthy Netflix series), there have been plenty […]
COVID-19 continued to affect the industry, which has plowed forward with expanded offerings, digital transformation and other bold moves. It was difficult to predict trend lines for the payer and health insurance industry in 2021, largely because of persistent uncertainties due to the COVID-19 pandemic. Consumer behavior has become more unpredictable, care models and […]
On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued its Calendar Year (CY) 2022 Physician Fee Schedule (“PFS”) Final Rule. In this post, we sample some key highlights from the Final Rule. For more detail, take a look at our previous post, in which we highlight the PFS’s changes to the […]