Tag: Medicare Beneficiaries

Surprise Medical Billing

President’s Efforts to Limit Surprise Medical Bills and Reduce Health Care Expenses

The President administration has announced its intention to restrict the sale of “junk” insurance policies, including short-term plans that may not provide adequate coverage for individuals who are in-between jobs and require temporary health care coverage. These policies have been known to deny basic coverage to policyholders. On Friday, President announced a set of fresh […]
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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 […]
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IVIG Medicare Payment Update

Medicare Updates IVIG Demonstration Payment for 2023

Healthcare providers submitting claims for services, supplies, and accessories ordered under the Medicare Intravenous Immune Globulin (IVIG) Demonstration can expect to see an approximate 2.1 percent payment increase over last year. The calendar year 2023 rate for HCPCS Level II code Q2052 is $392.56, compared with $384.59 in 2022. What is the Medicare Intravenous Immune Globulin Demonstration? […]
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CMS-Aims-To-Streamline-Prior-Authorization

CMS Aims To Streamline Prior Authorization To Reform MA

The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]
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how-are-medicare-patients-using-interstate-telehealth-visits

How are Medicare patients using interstate telehealth visits?

Opponents of the loosened interstate telehealth restrictions that were instituted at the start of the COVID-19 pandemic argued that it would result in out-of-state doctors luring patients away from their current physicians. But a new study finds that most out-of-state telehealth is used for continuity of care, not acquiring new patients. The study compares interstate […]
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Updates on End-Stage Renal Disease Prospective Payment copy

Updates on End-Stage Renal Disease Prospective Payment

CMS issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease Prospective Payment System for renal dialysis services furnished to Medicare beneficiaries on or after Jan. 1, 2023. Here are four takeaways from the proposed rule: Under the proposed rule, Medicare expects to pay $8.2 billion to approximately 7,800 facilities […]
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