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Category: Reimbursement

Government / Reimbursement

CMS Website Finally Recognizes ICD-10 Delay

Weeks after the President signed the temporary Sustainable Growth Rate (SGR) “doc fix” bill that included a one-year extension to ICD-10 implementation, the Centers for Medicare and Medicaid Services (CMS) …

Industry / Regulations / Reimbursement

Industry ‘ready’ for prior auths

Industry stakeholders support CMS’s plans to expand the PMD demo—with a few tweaks. “I’m all for it,” said Peggy Walker, billing specialist at VGM. “I’m ready for more prior auths.” …

Reimbursement

OIG Issues Report on Limited Compliance with Medicare’s Face-to-Face Requirement for Home Health Services

On April 9, 2014, the US Department of Health and Human Services Office of the Inspector General’s (OIG) Office of Evaluation and Inspections (OEI) issued a report (OEI-01-12-00390) entitled “Limited …

Payor / Reimbursement

Medicare Advantage plan sponsors weigh reimbursement increase

The region’s two biggest Medicare Advantage plan sponsors say they are reviewing government reimbursement rates for next year before making any decision about member benefits. The Centers for Medicare and …

Payor / Reimbursement

U.S. insurers still expect cuts in 2015 Medicare payments

U.S. health insurers said on Tuesday they still expected cuts in government reimbursements for privately managed Medicare health plans for the elderly next year even after the White House administration …

Reimbursement

Sweeping Changes to Medicare Payment for Clinical Laboratory Services

On March 31, 2014, the Senate gave final approval to the Protecting Access to Medicare Act of 2014 (the Act), which includes significant reforms to the way Medicare pays for …

Reimbursement

HME News: Capped-rental rule takes effect

Although providers hoped to hear “April Fools,” the rule transitioning certain complex rehab items to capped-rental status went into effect Tuesday as planned. “This change in regulation is so ridiculous, …

Government / Reimbursement

AAHomecare PR Spurs CMS to Action

Back in January, AAHomecare issued a press release about Leonce Pierre-Lewis, a patient in New Jersey who was having trouble getting a replacement wheelchair from Medicare. This week, the Association …

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