Tag Archives:Medicare

DC District Court Holds that Medicare Payment Cuts for 340B Drugs Exceeded Agency's Authority

telemedicine rules in D.C.
上周,联邦地方法院认为,卫生与公众服务部(HHS)的秘书超出了他的权限,因为他减少了医疗保险门诊预期支付系统(OPPS)对医院报销340B计划下购新利18app下载买的大多数单独应18lucknet手机版付药物的近30%。第二次开庭的法院… Continue reading this entry

"Pathways to Success:"CMS Publishes Final Rule Modifying the Medicare Shared Savings Program

government building
医疗保险和医疗补助服务中心(CMS)于12月21日发布了一项最终规则(该规则18lucknet手机版)。2018年,它重塑了医疗保险共享储蓄计划(MSSP)。称为Pathways to Success,"the Rule,among other things,重新设计参与MSSP的选项,Requires accelerated movement to downside risk,旨在增加对…… Continue reading this entry

Some Helpful Managed Care Guidance Provided in Advisory Opinion 18-11

Granston Memo
Practitioners in the Medicare or Medicaid managed care space place heavy reliance on the protection of the Anti-Kickback Statute (AKS) Safe Harbor found at 42 C.F.R.第1001.952(t)一般称为EMCO[合格管理护理组织]安全港,"as they look at incentive arrangements between providers and managed care plans.Although the language of … Continue reading this entry

Understanding Medicare's New Remote Evaluation of Pre-Recorded Patient Information (Asynchronous Telemedicine)

medicaid
从1月1日开始,2019,the Medicare program will cover certain medical 18lucknet手机版services delivered via asynchronous telemedicine technologies.医疗保险和医疗补助服务中心(CMS)刚刚发布了2019年医师收费表的最终规则18lucknet手机版,引入新代码,正式命名”Remote Evaluation of Pre-Recorded Patient Information"(HCPCS code G2010).本文提供了… Continue reading this entry

新利18app下载Health Care Policy Happenings - October 1 - 5,2018年

公共事务
万一你错过了,here are some key 新利18app下载health care policy headlines from the past week.国会立法和委员会活动亚历山大:参议院发送阿片类药物立法地标由麦康奈尔领导致总统——周三,美国参议院以98票对1票通过,《支持病人和社区法》,赞助商… Continue reading this entry

CMS继续加强对医院校外供应商部门的管理。

医院
拥有校外提供者部门(PBD)的医院可能需要重新考虑他们的暑假计划,以集中于医疗保险和医疗补助服务中心(CMS)最近提出的一系列建议性法规,这些法规试图控制门诊医院服务的医疗保险报销,包括例外/有继承权的医疗保险。校外地点……18lucknet手机版 Continue reading this entry

什么时候补偿不合理??

cardiologist
在医疗保险界,合理的补偿并没有明确定义,black and white concept.Instead,在旁观者的眼中,with the parties to each situation where that is an issue seeking to reach out for third party support for their conclusions.But sometimes when the government … Continue reading this entry

新利18app下载Health Care Information Exchanges and Price Transparency Initiatives: CMS Requests Input from Providers

数据挖掘
On July 12,2018年,the Centers for Medicare & Medicaid 18lucknet手机版Services (CMS) issued a proposed rule introducing changes to the Medicare physician fee schedule,and soliciting comments from providers on CMS data sharing initiatives.  In the proposed rule,CMS requests comments on methods to promote the exchange of 新利18app下载health care information between health care providers,… Continue reading this entry

医疗保险提议(并拒绝)2019年的新远程保健服务新利18app下载18lucknet手机版

远程医疗行业很高兴得知CMS最近提议在其医疗保险覆盖的远程医疗服务列表中添加新服务。但更有趣的是,CMS拒绝添加服务,新利18app下载18lucknet手机版以及原因。本文总结了最新提议的添加以及CMS拒绝的服务,18lucknet手机版探索CMS决策的一些原因,而且… Continue reading this entry

Medicare's New Chronic Care Remote Physiologic Monitoring Codes: Everything You Need to Know

remote monitoring
Earlier this year,in a first-of-its-kind move,CMS made remote patient monitoring (RPM) a separately-reimbursable service under Medicare.  Now,CMS已经为RPM服务提出了三个新的代码,18lucknet手机版重新命名”慢性病远程生理监测,"which do a far better job reflecting how providers can more effectively and efficiently use RPM technology to monitor and manage … Continue reading this entry

Tele新利18app下载health Billing Compliance: Medicare Says Goodbye to the GT Modifier

medicaid
For over a decade,Medicare has required providers to append special modifiers to their CPT and HCPCS codes when billing for tele新利18app18lucknet手机版下载health services.The two primary modifiers for tele新利18app18lucknet手机版下载health services were GT (indicating the service was delivered via an interactive audio and video telecommunications system) and GQ (indicating the service was delivered via an asynchronous … Continue reading this entry

根据新的联邦资金法案,最主要的新利18app下载5种远程保健方式将发生变化。

远程医疗行业在得知有利于供应商的立法列入2018年新的联邦两党预算法后一直在热烈讨论,总统于2月9日签署成为法律,2018.  But tele新利18app下载health providers,医院,企业家们需要克服这些炒作,了解这些条款对远程保健的真正作用。新利18app下载 Continue reading this entry

New Funding Legislation's Impact on 新利18app下载Health Care Programs

Congress passed a funding bill early this morning just after the February 8th deadline.The new legislation will make several changes to the Medicare program,推迟削减比例失调的共享医院,为社区卫生中心提供两年的资金,新利18app下载更新某些过期或过期的医疗保健计划。新利18app下载The legislation increases government funding caps … Continue reading this entry

CMS宣布了一个高级的替代支付模式-BPCI高级

1月9日,2018年,The Centers for Medicare & Medicaid 18lucknet手机版Services (CMS) announced a new voluntary bundled payment model program – Bundled Payment for Care Improvement Advanced (BPCI Advanced).The episode payment model,这是BPCI程序的第二代版本,将有资格成为一个先进的替代支付模式(APM)下的质量… Continue reading this entry

New OIG Project Expands Telemedicine Audits to State Medicaid Programs

medicaid
Following on the heels of its plans to review Medicare payments for tele新利18app18lucknet手机版下载health services,美国卫生与公众服务部(HHS)的联邦监察长办公室(OIG)刚刚宣布了一个新的项目,该项目旨在审查州政府为远程医疗和其他远程服务支付的医新利18app下载疗补助金。18lucknet手机版Accordingly,为远程医疗提供国家医疗补助计划的提供者,… Continue reading this entry

Medicare Payments for Tele新利18app下载health Increased 28% in 2016: What You Should Know

远程保健新利18app下载提供者可以庆祝另一个成功的增长年,as CMS reported a 28% increase over total 2016 payments for tele新利18app18lucknet手机版下载health services under the Medicare program.Providers continue to successfully integrate tele新利18app18lucknet手机版下载health services into their traditional health care delivery approaches,并且正在实现医疗保险FFS计划和其他来源的支付机会… Continue reading this entry

第九巡回胜利为基于平等准入要求的医疗补助报销挑战打开了大门。

reimbursements
The Ninth Circuit held August 7 that the Department of 新利18app下载Health a18lucknet手机版nd Human Services Secretary erred in approving a Medicaid State Plan Amendment (SPA) that cut reimbursement for outpatient hospital services in California by 10% for eight months in 2008-2009.The Hoag Memorial decision sided with the 57 hospitals that challenged the SPA under the … Continue reading this entry

医疗保险索赔上诉:哥伦比亚特区Circuit Reverses and Remands in Case Seeking Relief From Processing Delays

医院
Summary of AHA v.Price,2017年美国应用程序。Lexis 14887(哥伦比亚特区Cir.八月。11,2017)   On August 11,2017,哥伦比亚特区Circuit reversed the district court and held that the district court abused its discretion by ordering the Secretary of HHS to clear the backlog of administrative appeals of denied Medicare reimbursement claims within … Continue reading this entry

OIG to Audit Medicare Tele新利18app18lucknet手机版下载health Services: What You Need to Know

远程医疗保健新利18app下载
For what may be the first time,the Office of Inspector General (OIG) at the Department of 新利18app下载Health18lucknet手机版 & Human Services (HHS) recently announced a new project to review Medicare payments for telehealth services.Accordingly,providers who bill the Medicare program for tele新利18app18lucknet手机版下载health services may expect to have those claims reviewed to confirm the patient … Continue reading this entry

DOJ and OIG Focus on Opioid Abuse: Medical Professionals Who Overprescribe May Be Targets

受管制物质
最近的两个公告反映了美国政府正在采取积极措施解决类阿片滥用问题,确定并瞄准医疗专业人员参与促进涉及联邦医疗保健计划受益人的类阿片滥用。新利18app下载司法部7月13日宣布,2017 fraud charges involving 412 defendants in 41 federal districts across … Continue reading this entry

What To Know 18luck电脑版About New HHS OIG Exclusion Regs

Regulatory-Developments
1月12,2017,the Office of Inspector General of the U.S.Department of 新利18app下载Health a18lucknet手机版nd Human Services issued the third and final installment of its recent three-part rulemaking effort — a final rule updating its exclusion regulations,82美联储。Reg.4100 (Jan.12,2017年)。这一最终规则遵循了其他两项于12月公布的规则,更新了OIG的民用货币…… Continue reading this entry

CMS撤销竞争性投标供应商的计费特权

The Centers for Medicare and Medicaid 18lucknet手机版Services (CMS) has demonstrated that it will not hesitate to use one of its most crippling administrative enforcement tools—the revocation of Medicare billing privileges—against one of its largest suppliers,正如其对阿瑞娃医疗公司的指控所表明的那样,有限责任公司医疗保险收费特权可针对任何一个(或… Continue reading this entry

在新的一年里OIG环与新的反回扣法令安全港

Just in time for the New Year,the Office of Inspector General (OIG) of the U.S.卫生及公众服务部发布了最终条新利18app下载例(最终条例),18lucknet手机版修订了现有的两个反回扣条例安全港,added two regulatory safe harbors to complement existing statutory safe harbors,创造了一个全新的安全港… Continue reading this entry

CMS最终确定强制性心脏病护理捆绑支付模式等

On December 20,2016,医疗保险和医疗补助服务中心(CMS)发布了一项最终规则(最终规则),其中18lucknet手机版包括三项新的强制性心脏病治疗分期付款计划。as well as the expansion of the Comprehensive Care for Joint Replacement Model (CJR).模型由CMS创新中心实施。在权威下… Continue reading this entry