Tag: Medicare Beneficiaries

cms-seeks-to-improve-healthcare-outcomes-and-drive-down-costs

CMS Seeks to Improve Healthcare Outcomes and Drive Down Costs

CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity. On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) announced new proposed actions to address the health equity gap, decrease mounting healthcare costs, and increase medical accessibility and patient quality of care. […]
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unitedhealthcare-loses-medicare-advantage-overpayment-suit.

UnitedHealthcare loses Medicare Advantage overpayment suit

Dive Brief: A federal appeals court has ruled against UnitedHealthcare, the biggest private payer in the U.S., and reversed a 2018 decision overturning Medicare’s overpayment rule requiring insurers to refund reimbursement to CMS within 60 days if they learn a diagnosis lacks medical record support. UnitedHealthcare argued in court in November the overpayment rule was […]
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New Medicare Rule

New Medicare Rule Will Cut Payments to Hospitals for Some Surgeries

A cost-cutting change in Medicare policy will reduce payments to hospitals for some surgical procedures and increase costs for patients, according to a March 21 report from the The Washington Post. Before the change, CMS categorized 1,740 surgeries and other services as eligible for Medicare payments only if they were performed on beneficiaries who were admitted […]
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Medicare Beneficiaries of Innovative Technology

CMS Accelerates Medicare Beneficiaries’ Access to Innovations

Medicare beneficiaries now have immediate access to innovative medical technology approved by the U.S. Food and Drug Administration (FDA), rather than having to wait for it to clear additional bureaucratic hurdles before coverage is approved. The Medicare Coverage of Innovative Technology (MCIT) final rule issued this week eliminates the time and cost innovators were formerly […]
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2021 OPPS Final Rule

OPPS Final Rule Eliminates Inpatient Only List

The 2021 OPPS final rule seeks to increase patient choice and lower out-of-pocket costs. On Dec. 2, 2020, the Centers for Medicare & Medicaid Services (CMS) released the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule for calendar year (CY) 2021. The final rule aims to provide Medicare recipients […]
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2021 Medicare Physician Payment Schedule

Final 2021 Medicare Pay Schedule: What Physicians Need to Know

The 2021 Medicare physician payment schedule finalized an AMA-developed approach for less burdensome coding and documenting of office and outpatient evaluation and management (E/M) services. The Centers for Medicare & Medicaid Services (CMS) also extended Medicare payment for many services delivered via telehealth at least until the end of calendar year 2021, but indicated that […]
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Medicare Reimbursement or Telehealth

CMS Provides Medicare Reimbursement for More Telehealth During PHE

CMS recently added 11 new services to the Medicare telehealth services list, qualifying the services for Medicare reimbursement through the COVID-19 public health emergency (PHE). The new telehealth services cover some cardiac and pulmonary rehabilitation services, as well as certain neurostimulator analysis and programming services. The additions to the Medicare telehealth list were made in […]
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Medicare 2021 Fee Schedule

AMA Calls For Modifications To The Proposed Medicare 2021 Fee Schedule

The American Medical Association (AMA) says the proposed Medicare 2021 fee schedule should be modified to reflect changes brought on by the ongoing COVID-19 coronavirus pandemic. In detailed comments submitted to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, the AMA warned that some proposed regulations in the fee schedule would hurt many practices already […]
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Rehab in Covid-19 Recovery

The Critical Role of Rehab In Covid-19 Recovery

  Further, the study underscored that inpatient rehab plays a unique and positive role in treating patients recovering from COVID-19. Discover key strategies hospitals can use to improve outcomes through rehabilitation for patients recovering from COVID-19. Importance of Rehab for Patients Recovering from COVID-19 At least 700,000 Americans recovering from COVID-19 will require inpatient rehabilitative […]
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