When a natural disaster, extreme weather or emergency occurs that affects providers and the Medicare beneficiaries that they serve, special emergency-related policies and procedures may be implemented. For detailed information on these policies and procedures, please see the following resources: For information when an applicable 1135 waiver (PDF, 346 KB) has been granted For information on […]
On November 20, the Centers for Medicare & Medicaid Services (CMS) finalized changes to outdated federal regulations that have burdened health care providers with added administrative costs and impeded the health care system’s move toward value-based reimbursement. The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a physician from making referrals to […]
The Centers for Medicare & Medicaid Services (CMS) announced that starting today consumers can preview 2021 healthcare plans and prices on HealthCare.gov. This is an opportunity for consumers to compare coverage options ahead of Open Enrollment for the Federal Health Insurance Exchange, which officially kicks-off on November 1. As in previous years, window shopping allows […]
Home health providers are one step closer to getting the No. 1 thing they’ve been asking for since the COVID-19 pandemic began: reimbursement for telehealth-driven visits. On Friday, U.S. Senators Susan Collins (R-Maine) and Ben Cardin (D-Md.) introduced the Home Health Emergency Access to Telehealth (HEAT) Act, a bipartisan bill to provide Medicare reimbursement for […]
The Centers for Medicare & Medicaid Services (CMS) announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program as required by recent action by President Trump and Congress. This Medicare loan program allows CMS to make advance payments to providers and are typically used in emergency situations. Under the Continuing Appropriations […]
Published: September 2020 Healthcare revenue cycle companies to know | 2020 List Hospitals, health systems, physician practices and healthcare organizations are experiencing increasingly complex revenue cycles, working with government and private payers as well as patients to collect. Precision Medical Billing was launched in 1995 and is dedicated to helping physicians, home health agencies and […]
The documentation guidelines set forth by the Centers for Medicare & Medicaid Services (CMS) for evaluation and management (E/M) services, established 20 years ago, do little to support patient care. Instead, they serve more as a scoring system to justify a level of billing (e.g., level 3, 4, or 5), rather than helping physicians diagnose, […]
The Quality Improvement and Evaluation System (QIES), which providers and vendors use to submit assessment data, is being upgraded to make the system more reliable, scalable, secure, and accessible. The enhancements will occur in phases (by provider type) and began with Long- Term Care Hospitals (LTCHs) in March 2019, followed by Inpatient Rehabilitation Facilities (IRFs) […]
Recently the House of Representatives’ Small Business Committee convened for a hearing on utilization management and barriers to care in small medical practices. In particular this hearing focused on the application of prior authorization within Medicare Advantage (MA) plans and the associated challenges faced by patients and providers of services due to prior authorization requirements. […]
This is the first major update to rules for the Stark law since 1989, according to HHS. An HHS press statement explained that the new rules would give providers in value-based arrangements “greater certainty” and “ease the compliance burden for healthcare providers across the industry,” while maintaining protections against fraud and abuse. Clinicians and hospital […]