INDUSTRY INSIGHTS YOUR PEERS ARE READING
CMS is proposing to implement several sections of the Bipartisan Budget Act of 2018, including expanding telehealth benefits under Medicare Advantage plans MORE
Medicare patients going for their annual wellness checkups at the Rehoboth McKinley Christian Hospital are now seeing doctors take a whole new approach to their treatment, thanks to a partnership the hospital has made with a Silicon Valley software firm. Gallup Independent. August 27, 2018. MORE
Editor’s Note: Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government. Financial Medicare and Medicaid Medicaid Medicare payment models Value Based Payments MORE
Q: Per Medicare regulations, do the providers at a distant site have to be hospital-based or can they be in a private setting – for example, a group of pulmonologists who want to create a telehealth system on their own? Also, all telehealth services must meet the Medicare established set of criteria for reimbursement. Click here to visit the Medicare Eligibility Analyzer site. To review CCHP information on Medicare, go to: [link]. Medicare MORE
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is new legislation in the United States. In May 2018, the Center for Medicare and Medicaid Services Administration (CMS) released a brief but noteworthy document entitled, Summary of Policies in the … Read more. The post MACRA: New Reimbursement Legislation in the US appeared first on TBH Institute Blog. MORE
Accountable care organizations in the Medicare Shared Savings Programs have saved Medicare $2.7 billion to date, including $859 million in 2016, according to a new analysis commissioned by NAACOS. That's $1.1 billion more than CMS estimates MORE
The possible new mandates, buried in a 479-page Federal Register “Notice of Proposed Rule Making” from the Centers for Medicare & Medicaid Services (CMS), could become part of hospital “conditions of participation” in Medicare. MORE
The article The Political Plausibility of Medicare for All appeared first on electronichealthreporter.com. Editorial Ken Perez Medicare for All OmnicellThis content is copyrighted strictly for Electronic Health Reporter. By Ken Perez, vice president of healthcare policy, Omnicell, Inc. MORE
61 
At HIMSS19, ACT | The App Association's Brian Scarpelli will lay out the details of what he calls a "sea change" in CMS' policy toward remote patient monitoring MORE
Specifically, special attention should be paid to the business’s billing practices, and current Medicare policies and procedures concerning coverage and claims determinations To safeguard your business from payment interruption, providers and suppliers should ensure they have effective compliance measures in place. MORE
40 Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. ” Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. MORE
GALLUP — Medicare patients going for their annual wellness checkups at the Rehoboth McKinley Christian Hospital are now seeing doctors take a whole new approach to their treatment, thanks to a partnership the hospital has made with Zoeticx, a Silicon Valley software firm. MORE
Medicare doesn’t typically provide coverage for continuous glucose monitors (CGMs), as insurors who oversee Medicare coverage have long argued that CGMs are a “precautionary” device rather than a “medically necessary” one. The Medicare-insuring contractor denied the claim. MORE
The Centers for Medicare & Medicaid Services (CMS) released the 2018 Physician Fee Schedule about two weeks ago and there is at least one nugget in there that should speed the adoption of remote patient monitoring. MORE
November 1, 2018 the Centers for Medicare and Medicaid (CMS) made a significant step in overcoming this obstacle. It announced its finalization of “ Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2019 ”. MORE
ACA Affordable Care Act Health Consumers Health costs Health insurance Health politics Health reform Healthcare access Medicaid Medicare“Let’s get this thing f-ing done,” Martha McSally passionately asserted on May 4, 2017. Paul Ryan said, on the floor of the U.S. MORE
The need for Medicare marketing regulations was crystal-clear 10 years ago. But a slew of changes to CMS' Medicare marketing guidelines this year expanded what plans can do at educational events, in providers' offices and more. Do these revisions create room for growth or opportunities for manipulation MORE
57 Federal prosecutors have intervened in a newly unsealed whistleblower lawsuit accusing Sutter Health of submitting unsupported diagnosis codes to Medicare Advantage plans, which inflated payments. The lawsuit comes weeks after DaVita's medical group paid $270 million to resolve similar allegations MORE
65 Payers are rapidly becoming educated in telehealth and are keen on closing telehealth gap, but need to be mindful of Medicare requirements. Almost a third of telemedicine claims sampled by HHS’ Office of Inspector General did not meet Medicare requirements, resulting in an estimated $3.7 MORE
The Centers for Medicare and Medicaid Services (CMS) is a government agency within the US Department of Health and Human Services (HHS). CMS oversees insurance billing code sets in the United States.1 HCFA 1500 Form More precisely, as part of … Read more. MORE
Medicare Related Topics Electronic Health Reporter
NOVEMBER 28, 2018
The article The Political Plausibility of Medicare for All appeared first on electronichealthreporter.com. Editorial Ken Perez Medicare for All OmnicellThis content is copyrighted strictly for Electronic Health Reporter. By Ken Perez, vice president of healthcare policy, Omnicell, Inc.
FierceHealthIT
DECEMBER 11, 2018
Accountable care organizations in the Medicare Shared Savings Programs have saved Medicare $2.7 billion to date, including $859 million in 2016, according to a new analysis commissioned by NAACOS. That's $1.1 billion more than CMS estimates
Mobi Health News
DECEMBER 5, 2018
At HIMSS19, ACT | The App Association's Brian Scarpelli will lay out the details of what he calls a "sea change" in CMS' policy toward remote patient monitoring
Mobi Health News
NOVEMBER 1, 2018
CMS Administrator Seema Verma said that the remote monitoring change and others would promote care innovation and reduce provider burden
BHM Healthcare Solutions
OCTOBER 2, 2018
Editor’s Note: Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government. Financial Medicare and Medicaid Medicaid Medicare payment models Value Based Payments
The cHealth Blog
NOVEMBER 16, 2017
The Centers for Medicare & Medicaid Services (CMS) released the 2018 Physician Fee Schedule about two weeks ago and there is at least one nugget in there that should speed the adoption of remote patient monitoring.
FierceHealthIT
NOVEMBER 19, 2018
Medicare Advantage enrollment is expected to increase from 34% of the Medicare population in 2018 to 42% in 2028. Yet CBO forecasts that spending on those enrollees will grow from $200 billion to $580 billion over the same time period
BHM Healthcare Solutions
JUNE 26, 2018
Editor’s Note: The growth of Medicare Advantage as a program (it accounts for a third of Medicare enrollees and spending), and the 9.3% The growth of Medicare Advantage as a program (it accounts for a third of Medicare enrollees and spending), and the 9.3%
Insulin Nation
AUGUST 27, 2014
Unfortunately, Medicare policy hasn’t kept up with evolving diabetes technology, and policymakers have left out CGMs from the list of reimbursable diabetes devices. There have been several petitions circulating to pressure lawmakers to make Medicare cover CGMs.
Healthcare Informatics
OCTOBER 29, 2018
CMS is proposing to implement several sections of the Bipartisan Budget Act of 2018, including expanding telehealth benefits under Medicare Advantage plans
FierceHealthIT
DECEMBER 11, 2018
Federal prosecutors have intervened in a newly unsealed whistleblower lawsuit accusing Sutter Health of submitting unsupported diagnosis codes to Medicare Advantage plans, which inflated payments. The lawsuit comes weeks after DaVita's medical group paid $270 million to resolve similar allegations
BHM Healthcare Solutions
APRIL 10, 2018
Editor’s Note: Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government. Financial Medicare and Medicaid Medicaid Medicare payment models Value Based Payments
BHM Healthcare Solutions
AUGUST 7, 2018
Editor’s Note: The growth of Medicare Advantage as a program (it accounts for a third of Medicare enrollees and spending), and the 9.3% CMS data showed Medicare spending for hospice care rose 81 percent between 2006 and 2016, from $9.2.
Healthcare Guys
OCTOBER 26, 2018
Specifically, special attention should be paid to the business’s billing practices, and current Medicare policies and procedures concerning coverage and claims determinations To safeguard your business from payment interruption, providers and suppliers should ensure they have effective compliance measures in place.
BHM Healthcare Solutions
JUNE 5, 2018
Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Total Medicare reimbursement for all brand-name drugs ballooned 77 percent from 2011 to 2015.
eVisit
NOVEMBER 19, 2018
November 1, 2018 the Centers for Medicare and Medicaid (CMS) made a significant step in overcoming this obstacle. It announced its finalization of “ Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2019 ”.
FierceHealthIT
DECEMBER 4, 2018
Nearly half of Medicare patients in long-term-care facilities have experienced some type of harm as the result of their care, endangering their health and increasing Medicare costs, according to a report from a government watchdog
BHM Healthcare Solutions
AUGUST 7, 2018
Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. ” Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries.
FierceHealthIT
DECEMBER 5, 2018
Medicare is only supposed to pay inpatient facilities for durable medical equipment used during patient stays. Yet OIG found $34 million that Medicare channeled directly to suppliers of such equipment between 2015 and 2017
FierceHealthIT
NOVEMBER 30, 2018
Although CMS' new lab fee schedule was designed to cut Medicare payments to labs, GAO says its implementation could authorize expensive unbundled lab payments
FierceHealthIT
NOVEMBER 14, 2018
A nuanced legal battle over Medicare Advantage overpayments rages on. CMS will appeal a September ruling invalidating a 2014 rule with huge implications for insurers, including UnitedHealth
Telehealth Blog
MAY 24, 2018
Q: Per Medicare regulations, do the providers at a distant site have to be hospital-based or can they be in a private setting – for example, a group of pulmonologists who want to create a telehealth system on their own? Also, all telehealth services must meet the Medicare established set of criteria for reimbursement. Click here to visit the Medicare Eligibility Analyzer site. To review CCHP information on Medicare, go to: [link]. Medicare
Insulin Nation
MAY 10, 2016
Medicare doesn’t typically provide coverage for continuous glucose monitors (CGMs), as insurors who oversee Medicare coverage have long argued that CGMs are a “precautionary” device rather than a “medically necessary” one. The Medicare-insuring contractor denied the claim.
Health Populi
NOVEMBER 5, 2018
ACA Affordable Care Act Health Consumers Health costs Health insurance Health politics Health reform Healthcare access Medicaid Medicare“Let’s get this thing f-ing done,” Martha McSally passionately asserted on May 4, 2017. Paul Ryan said, on the floor of the U.S.
Healthcare Guys
NOVEMBER 18, 2018
Medicare patients going for their annual wellness checkups at the Rehoboth McKinley Christian Hospital are now seeing doctors take a whole new approach to their treatment, thanks to a partnership the hospital has made with a Silicon Valley software firm. Gallup Independent. August 27, 2018.
FierceHealthIT
SEPTEMBER 19, 2018
Recovery audit contractors (RACs) returned $214 million to the Medicare program in fiscal year 2016. of Medicare expenditures, and one organization says the program is hampered by limits on documentation requests But that represents less than 0.1%
FierceHealthIT
DECEMBER 4, 2018
Almost half of online Medicare Advantage directories contained incorrect or out-of-date information, CMS found in a recent investigation
TeleMental Health blog
SEPTEMBER 24, 2018
The Centers for Medicare and Medicaid Services (CMS) is a government agency within the US Department of Health and Human Services (HHS). CMS oversees insurance billing code sets in the United States.1 HCFA 1500 Form More precisely, as part of … Read more.
Morning eHealth
APRIL 27, 2018
FDA draws strong, mixed reaction — U.S. Digital Service hands QPP back to CMS
Insulin Nation
JULY 17, 2015
Despite the committee’s title, much of the testimony came from young people affected by Type 1 diabetes as part of a lobbying effort to get Medicare to cover continuous glucose monitors (CGMs). Two months later, a Medicare appeals council reversed the judge. The U.S.
Health Populi
MARCH 27, 2018
The latest data on health care costs in retirement was published by EBRI earlier this year in their report , Savings Medicare Beneficiaries Need for Health Expenses: Some Couples Could Need as Much as $370,000, Up from $350,000 in 2016.
FierceHealthIT
OCTOBER 17, 2018
Medicare Plan Finder frustrates many seniors, and there's a lot of confusion over what star ratings mean, said multiple speakers at AHIP's National Conference on Medicare
Society for Participatory Medicine
JUNE 27, 2018
The possible new mandates, buried in a 479-page Federal Register “Notice of Proposed Rule Making” from the Centers for Medicare & Medicaid Services (CMS), could become part of hospital “conditions of participation” in Medicare.
FierceHealthIT
OCTOBER 1, 2018
will pay $270 million to resolve claims it provided inaccurate information that caused Medicare Advantage plans to receive inflated Medicare payments A medical care group that is part of dialysis giant DaVita Inc.
FierceHealthIT
NOVEMBER 30, 2018
The need for Medicare marketing regulations was crystal-clear 10 years ago. But a slew of changes to CMS' Medicare marketing guidelines this year expanded what plans can do at educational events, in providers' offices and more. Do these revisions create room for growth or opportunities for manipulation
FierceHealthIT
NOVEMBER 15, 2018
A New York judge says Anthem must release testimony to federal prosecutors as part of a fraud investigation into the insurer’s Medicare Advantage plans.
Healthcare Guys
OCTOBER 17, 2018
GALLUP — Medicare patients going for their annual wellness checkups at the Rehoboth McKinley Christian Hospital are now seeing doctors take a whole new approach to their treatment, thanks to a partnership the hospital has made with Zoeticx, a Silicon Valley software firm.
FierceHealthIT
OCTOBER 2, 2018
Of the nearly $7 billion Medicare paid to inpatient rehab hospitals in 2013, $5.7 billion was deemed improper. The watchdog agency recommended that CMS revamp its payment structure for rehab hospitals
FierceHealthIT
NOVEMBER 16, 2018
Improper payments in Medicare have been on the decline since Congress passed the Improper Payments Elimination and Recovery Act of 2010. They reached an eight-year low of 8.12% in the Medicare fee-for-service program this year, according to CMS
FierceHealthIT
OCTOBER 3, 2018
Humana's Medicare Advantage HMO base in southern California will be able to spend more time with providers and receive more robust preventive care as a result of a collaboration with Heritage, the insurer said
TeleMental Health blog
SEPTEMBER 24, 2018
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is new legislation in the United States. In May 2018, the Center for Medicare and Medicaid Services Administration (CMS) released a brief but noteworthy document entitled, Summary of Policies in the … Read more. The post MACRA: New Reimbursement Legislation in the US appeared first on TBH Institute Blog.
BHM Healthcare Solutions
MAY 1, 2018
Payers are rapidly becoming educated in telehealth and are keen on closing telehealth gap, but need to be mindful of Medicare requirements. Almost a third of telemedicine claims sampled by HHS’ Office of Inspector General did not meet Medicare requirements, resulting in an estimated $3.7
FierceHealthIT
OCTOBER 3, 2018
CMS Administrator Seema Verma took another swipe at calls for a “Medicare for All” healthcare system this week, saying expanding those benefits to every American would “dilute” the program
Let's personalize your content