Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Medicare Part B

Potential Medicare Reimbursement Demo to Lower Part B Drug Prices

October 26, 2018 - In an effort to control prescription drug prices, HHS is proposing a mandatory demonstration that would test a new Medicare reimbursement model for certain physician-administered drugs payable under Part B. The proposed International Pricing Index (IPI) payment would use private-sector vendors to procure, distribute, and bill Medicare for certain physician-administered drugs. Medicare...


More Articles

How Part B Drug Changes Could Impact Provider Reimbursement

by Jacqueline LaPointe

Healthcare industry experts are warning the Trump Administration that its proposal to transfer some drugs covered by Medicare Part B to Part D would have a negative impact on provider reimbursement and care quality. In the Trump...

85% of Hospitals to See Part B Increase Despite 340B Payment Cuts

by Jacqueline LaPointe

EDITOR'S NOTE: This article has been updated with a statement from the American Hospital Association. Approximately 85 percent of hospitals will receive a net increase in their total Medicare Part B reimbursements despite recent...

AMGA: Align Medicare Advantage, APMs to Promote Value-Based Care

by Jacqueline LaPointe

If CMS moves forward with relaxing Medicare Advantage benefit requirements, then the federal agency should offer the same flexibilities to providers and beneficiaries in Medicare Part B alternative payment models, such as accountable care...

Orgs Argue MIPS Adjustments for Drug Payments Harm Patient Access

by Jacqueline LaPointe

Applying Merit-Based Incentive Payment System (MIPS) adjustments to Medicare Part B drug payments will restrict patient access to critical treatments, 11 medical societies recently told congressional leaders. The medical societies,...

Oncologist Org Opposes MedPAC Medicare Reimbursement Changes

by Jacqueline LaPointe

The Community Oncology Alliance (COA) recently expressed concerns that proposed Medicare reimbursement changes for Part B services from the Medicare Payment Advisory Commission (MedPAC) would drive cancer care to more higher-cost...

CPC Initiative Improves Care Delivery But Not Medicare Spending

by Catherine Sampson

Although the Comprehensive Primary Care (CPC) initiative lead to progress in primary care delivery, it has not caused improvements in Medicare spending, patient experience or quality of care, researchers from The New England Journal of...

Could More Competition Reduce Rising Prescription Drug Costs?

by Vera Gruessner

Prescription drug costs seem to be higher than ever before. Merrill Matthews, Resident Scholar at the Institute for Policy Innovation, wrote about some of the reasons behind these high prices and the solutions that could lower prescription...

How Value-Based Care Payment Improves Patient Outcomes

by Vera Gruessner

Last month, the Centers for Medicare and Medicaid Services (CMS) released a new value-based care payment system for Medicare Part B drug prescribing protocols of physicians. Medicare Part B is a program in which decisions are reimbursed...

CMS Rule Addresses Medicare Fraud, Overpayment Compliance

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) published a final rule this week focused on improving Medicare compliance, reporting, and self-identified overpayments to ultimately combat Medicare...

CMS’s Medicare Drug Spending Dashboard Notes Spending Spike

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has released a Medicare Drug Spending dashboard to address prescription drugs’ affordability. CMS aims to make drug spending trends more transparent for healthcare...

CMS Confirms More Affordable 2016 Medicare Part B Premiums

by Jacqueline DiChiara

Healthcare consumers’ wallets will apparently be a tad fuller next year. 2016 will not see a cost of living increase for those under Social Security, according to an announcement from the Centers for Medicare & Medicaid...

NAMD Pens Medicare Part B Letter Urging Congress to Act Now

by Jacqueline DiChiara

The National Association of Medicaid Directors (NAMD) penned a letter yesterday to various leaders of the Senate Committee on Finance, House Committee on Ways and Means and House Energy and Commerce Committee "respectfully" urging Congress...

CMS Puts Medicare Part B Claims on Two Week Hold

by Ryan Mcaskill

Because of an issue with the 2015 Medicare Physician Fee Schedule, CMS has put a temporary hold on claims while it’s fixed. Hospitals and other healthcare providers that submitted Medicare Part B claims at the start of the year may...

HHS Announces 2015 Medicare Premiums and Deductibles

by Ryan Mcaskill

Medicare Plan B premiums, deductibles and copays will be largely unchanged in 2015. Earlier this month, the Department of Health and Human Services (HHS) announced the premiums and deductibles for Medicare programs in 2015. Revealed by...

TrailBlazer Health Claimed $1.3M in Unallowable Medicare Costs

by Ryan Mcaskill

TrailBlazer claimed $137K in Medicare Part B termination costs and $1.1M in potentially unallowable severance pay termination costs. Earlier this month, the Office of Inspector General (OIG) of the Department of Health and Human Services...

Are Part B Rx drug rates higher than other gov’t programs?

by Elizabeth Snell

Medicare Part B lost millions of dollars in 2011 because certain fees were not aligned with the rates that Part D and state Medicaid programs paid, according to a recent Office of Inspector General (OIG) report. Specifically, if Part B...

X

Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy


no, thanks

Continue to site...