In CMS
Dec 28th, 2016
The Centers for Medicare & Medicaid Services (CMS) is creating a next generation risk adjustment model that will: (1) account for the number of individuals who had a Marketplace plan for less than 12 months; (2) better account for the risk of high-cost patients; (3) improve compensation for healthier members; and (4) use prescription drug ...
Dec 18th, 2016
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update fiscal year (FY) 2017 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). The proposed rule, which CMS says would apply to approximately 3,330 acute care hospitals and ...
Dec 6th, 2016
President-elect Donald Trump has selected Tom Price, MD, a six-term Republican congressman from Georgia and an orthopedic surgeon, as the next Secretary of the U.S. Department of Health and Human Services (HHS). Price is chairman of the Committee on the Budget in the House of Representatives. He also serves on the House Ways and Means ...
In CMS
Oct 13th, 2016
On Oct. 13, the Centers for Medicare & Medicaid Services (CMS) announced its effort to relieve some of the administrative burdens of Advanced Alternative Payment Models (APMs) on physicians. While implementing new healthcare delivery system reforms stemmed from the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), CMS wants clinicians ...
In Billing
Feb 16th, 2016
A final rule, issued by the Centers for Medicare & Medicaid Services (CMS) on Feb. 12, clarifies reporting and repayment obligations for providers and suppliers who receive a Medicare overpayment. The final rule explains, “a person has identified an overpayment when the person has or should have, through the exercise of reasonable diligence, determined that the ...