Author: The PMB Pulse

CMS Announces New Model Opportunity for Medicaid Managed Care Organizations Serving Beneficiaries Dually Eligible for Medicare and Medicaid

The Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare & Medicaid Innovation is announcing a new opportunity to enable Medicaid Managed Care Organizations (MCOs) to better serve enrollees who are dually eligible for Medicare and Medicaid. This new Model opportunity is the first CMS initiative designed to harness the power of Medicaid MCOs […]

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Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2021

On December 1, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates on policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, on or after January 1, 2021. The calendar year (CY) 2021 PFS final rule is one of several […]

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Permanent Expansion of Medicare Telehealth Services and Improved Payment for Time Doctors Spend with Patients Finalized

The Centers for Medicare & Medicaid Services (CMS) released the annual Physician Fee Schedule (PFS) final rule, prioritizing CMS’ investment in primary care and chronic disease management by increasing payments to physicians and other practitioners for the additional time they spend with patients, especially those with chronic conditions. The rule allows non-physician practitioners to provide […]

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UPDATED: Emergency and Disaster Instructions

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 […]

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CMS Announces Historic Changes to Physician Self-Referral Regulations

On November 20, the Centers for Medicare & Medicaid Services (CMS) finalized changes to outdated federal regulations that have burdened health care providers with added administrative costs and impeded the health care system’s move toward value-based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 […]

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Preview 2021 Plans and Prices Ahead of the Upcoming Federal Health Insurance Exchange Open Enrollment Period

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 […]

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Lawmakers Introduce New Bill Paving the Way for Home Health Telehealth Reimbursement

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 […]

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CMS Announces New Repayment Terms for Medicare Loans made to Providers during COVID-19

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 […]

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PMB listed as one of the healthcare revenue cycle companies to know in 2020 from Becker’s Hospital Review

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 […]

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Major Changes Are Coming to E/M Visits in 2021: Will You Be Ready?

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, […]

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