As many hospitals near capacity during another surge of COVID-19, CMS is allowing some healthcare providers to participate in a new hospital at home program that allows them to deliver acute care...
Come January 1, 2021, CMS will implement 21 new ICD-10 procedure codes for COVID-19 vaccines and therapeutics for the novel coronavirus, including baricitinib and monoclonal antibody treatments.
The...
Aggressive corrective actions aimed at reducing Medicare fee-for-service (FFS) improper payments have resulted in less healthcare fraud, waste, and abuse, as well as $15 billion in savings, according...
Just a day after the FDA approved the emergency use of a new COVID-19 antibody drug, CMS updated Medicare payment and billing policies to ensure providers have access to the new treatment for...
UPDATE 11/20/2020: CMS has extended the deadline to update billing information for APM incentive payments to December 13, 2020.
Eligible clinicians who CMS has notified as having missing billing...
CMS recently announced that 51 organizations will take part in a new directing contracting opportunity that will test what the agency calls the “next evolution of risk-sharing...
CMS has finalized a 1.9 percent, or $390 million, increase in Medicare home health reimbursement in 2021.
The boost in reimbursement is significantly less than the 2.6 percent increase proposed by CMS...
The majority of facilities participating in the Hospital Readmissions Reduction Program (HRRP) in fiscal year (FY) 2021 have been penalized for readmitting too many patients according to CMS...
New and innovative home dialysis machines will soon qualify for additional Medicare reimbursement, according to the latest End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final...
Eligible clinicians overwhelmingly participated in the Quality Payment Program despite facing challenges caused by the COVID-19 pandemic, according to preliminary data from CMS.
CMS announced in a...
A new interim final rule with comment period ensures Medicare reimbursement for the administration of a COVID-19 vaccine and provider use of innovative treatments for the novel coronavirus.
The rule...
A new proposed rule from CMS is seeking to streamline how the agency determines if durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) qualify for Medicare reimbursement and...
CMS recently announced via email that it intends to delay the start of the Radiation Oncology Model after receiving feedback from stakeholders.
“CMS has received feedback from a number of...
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...
UPDATED 10/14/2020 CMS recently announced new repayment terms for payments issued to providers under the Accelerated and Advance Payment Programs at the start of the COVID-19 public health...
New guidance from CMS shares how the agency plans to implement a recent interim final rule that makes COVID-19 data reporting a condition of participation (CoP) in Medicare for hospitals.
The guidance...
CMS is seeking to expand COVID-19 testing by streamlining Clinical Laboratory Improvement Amendments (CLIA) certification and compliance.
In an announcement late last week, the agency provided a...
CMS is expanding a program integrity payment model that saved Medicare $650 million by targeting inappropriate overuse of ambulance services using prior authorizations.
In an announcement yesterday,...
CMS is transitioning more specialty care to value-based reimbursement with two new alternative payment models for end-stage renal disease and cancer care.
A final rule released late last week unveiled...
In a new letter to Medicaid directors, CMS called for multi-payer alignment in value-based care arrangements run by the state healthcare programs.
The Sept. 15th letter providers guidance to the...
