Tag Archives: CMS

Medicare Bundled Payments for Orthopedic and Cardiac Care to Proceed, HHS Says

A final rule by the Department of Health and Human Services (HHS) that establishes several cardiac and orthopedic bundled-payment models under Medicare was recently delayed; however, recent reports clarified that the launch date of the bundled-payment mod Continue reading

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Reminder: BFCC-QIOs have Resumed Two-Midnight Reviews

Given the resumption of BFCC-QIO short-stay reviews, providers should be prepared for BFCC-QIO review of claims that fall within the six-month look back period and were not formally denied. Continue reading

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Two Midnight rule helped slash improper payments for inpatient hospital claims by 58 percent, CMS says

said the overall Medicare fee-for-service improper payment rate dropped from 12.1 percent in 2015 to 11.0 percent in 2016. Moreover, improper payments for inpatient hospital claims alone dipped by 58.3 percent, from 9.2 percent in 2014 to 3.8 percent in 2 Continue reading

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Medicare outpatients risk higher bills for some procedures

You pay less for outpatient treatment than for a hospital admission, right? Not necessarily in the topsy-turvy world of Medicare billing, according to a government report. Continue reading

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Proposed Mandatory Medicare Cardiac Bundles:  The Pushback Begins

CMS’s October 3 deadline for comments on the proposed mandatory Medicare cardiac bundle was greeted with hundreds of comments – many of a highly technical nature that will get worked out (or ignored) in the final regulations. Continue reading

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MedPAC discusses draft 2018 payment recommendations for post-acute care

The Medicare Payment Advisory Commission this week discussed draft recommendations that would forgo increases in or reduce Medicare payment rates in 2018 for home health agencies, skilled nursing facilities, inpatient rehabilitation facilities and long-te Continue reading

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Slavitt Offers Value-Based Care Steps Post MACRA Implementation

As CMS gets ready for MACRA implementation in the new year, CMS Acting Administrator Andy Slavitt urged healthcare and political leaders to carry on value-based care progress made under the Affordable Care Act. Continue reading

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Consultant: Trump’s choice for HSS, CMS leadership spells trouble for hospitals

With Tom Price leading HHS and Seema Verma at the CMS helm, hospitals should brace for value-based pullback, problems accessing capital. Continue reading

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Push Comes to Shove in the World of Meaningful Use

Over the past decade, Medicare reimbursement has been affected by a combination of MU, e-prescribing and quality reporting programs. All those are now coming together in the unified MACRA/MIPS Quality Payment Program. Continue reading

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“Finally Friday!” ALJ Training Given by OMHA, CMS and MAC

FRIDAY December 2, 2016: “ALJ Training Given by OMHA, CMS and MAC” or We finally get a peek behind the curtain and… maybe this is how Dorothy felt? Get the Handouts Sponsored by The Health Law Partners and ZirMed THIS … Continue reading

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