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

Medicare Spending

HHS: Medicare Part B Premiums, Deductibles Staying the Same

by Elizabeth Snell

Healthcare costs are often a top concern for providers and patients. However, one expense is remaining the same for the second year in a row. Next year’s Medicare Part B premiums and deductibles will remain the same as the last two...

Outpatient Costs Higher for Rural Hospital Medicare Patients

by Ryan Mcaskill

A new report from the inspector general at the Department of Health and Human Services (HHS), found that medicare beneficiaries treated at primary rural “critical access” hospitals (CAHs) pay more for outpatient services than those...

How Easily Can Seniors Access Medicare Preferred Pharmacies?

by Elizabeth Snell

Regardless of whether older Americans live in small towns or rural areas, the majority of them are still able to find access to preferred pharmacies in Medicare, according to a recent survey. Specifically, 9 in 10 seniors from urban, suburban,...

Medicare Readmission Penalties Hit 2,610 Hospitals

by Elizabeth Snell

Medicare fined 2,610 hospitals across the nation for readmission penalties, according to a report released last week. This is a record number of hospitals being fined for having patients returning within one month for additional treatment. In...

CMS Releases First Set of Open Payments Data

by Elizabeth Snell

The Centers for Medicare & Medicaid Services (CMS) released the first round of Open Payments data this week. The move is part of a larger effort to help consumers understand the financial relationship between the health care industry, and...

Will integrated Medicare and Medicaid benefits save money?

by Elizabeth Snell

Individuals who are disabled, under the age of 65 and qualify for both Medicare and Medicaid benefits are known as disabled dual-eligible beneficiaries. In 2009, the Medicare and Medicaid programs spent an estimated $103 billion on those...

ACO payment reform proposed in new legislation

by Elizabeth Snell

Two state representatives introduced legislation earlier this month in an effort to further advance the progress of Accountable Care Organizations (ACOs). Representatives Diane Black (R-TN) and Peter Welch (D-VT) explained in a joint statement...

CMS releases FY2013 RAC report to Congress

by Elizabeth Snell

The Center for Medicare & Medicaid Services (CMS) released its Medicare fee-for-service Recovery Audit Program’s report to Congress for fiscal year 2013. The report found that Recovery Audit Contractors (RACs) identified and corrected...

Safeguards possibly ineffective on some copayment coupons

by Elizabeth Snell

Pharmaceutical manufacturers’ current safeguards may not prevent all copayment coupons from being used for drugs paid for by Part D, according to a recent Office of Inspector General (OIG) report. The coupons are typically offered to reduce...

Texas legislator asks Medicare to retract billing settlement

by Elizabeth Snell

Typically, settling disputed inpatient billing claims is seen as a positive thing. However, the chairman of the House Ways and Means Committee’s health panel believes that Medicare’s current plans to do so could result in the...

Medicare ACOs improve care, save $372M in healthcare costs

by Elizabeth Snell

Medicare Accountable Care Organizations (ACOs) improved patient care and generated over $372 million in total program savings, according to the Center for Medicare & Medicaid Services (CMS). The Medicare Shared Savings Program (MSSP) and...

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 rates...

Research finds higher Medicare spending in unhealthy states

by Elizabeth Snell

Socioeconomic factors that affect the need for medical care, along with interactions between the Medicare system and other parts of the health system are main reasons why there is variation in Medicare health spending between states, according...

2015 proposed physician fee schedule, Part B revisions

by Elizabeth Snell

On Friday, July 11, 2014, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule for its “Revisions to Payments Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B” policy. The...

2015 proposed outpatient PPS policy changes, payment rates

by Elizabeth Snell

On Monday, July 14, 2014, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that would update the payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments...

2015 inpatient psychiatric facility PPS final rule

by Elizabeth Snell

On Wednesday, August 6, 2014, the Centers for Medicare & Medicaid Services announced its final rule for updating the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs). The...

Summary of FY 2015 Hospice Payment Rate Update

by Elizabeth Snell

On Friday, August 22, 2014, the Centers for Medicare & Medicaid Services (CMS) released the 2015 Hospice Payment Rate final rule, which covers hospice payment rates and the 2015 wage index. The overall economic impact of this final rule is...

Proposed 2015 home health PPS refinements, rate update

by Elizabeth Snell

On Monday, July 7, 2014, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule for the home health prospective payment system (HH PPS) refinements and refine update for the calendar year (CY) 2015. The proposed rule...

2015 skilled nursing facility PPS, consolidated billing

by Elizabeth Snell

On Tuesday, August 5, 2014, the Center for Medicare & Medicaid Services announced its final rule updates for the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2015. ...

CMS falls behind on regulating rural health clinics

by Elizabeth Snell

The Centers for Medicare & Medicaid Services (CMS) has not issued final regulations to a portion of Rural Health Clinics (RHCs) that would enable those facilities to be considered an essential healthcare provider, according to a recent report...

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