Just as a point of providing information, please note that CMS has revised its Medicare Learning Network (MLN) booklet for telehealth services. The February 2018 edition is included in this link. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/TelehealthSrvcsfctsht.pdf
The 2019 proposed Medicare Physician Fee Schedule Rule also seeks comments on proposed expansion of telehealth services. That will be the subject of…
On January 11, 2018, CMS announced a new voluntary episode payment model (bundled payments for care improvement advanced–BPCI Advanced) that will test a new iteration of bundled payment for the following thirty-two (32) clinical episodes:
29 Inpatient Clinical Episodes
| Acute myocardial infarction
Back & neck except spinal fusion Cardiac arrhythmia Cardiac defibrillator Cardiac valve Cellulitis |
…
In the January 11, 2018 issue of MLN Connects, CMS has now widely publicized that it issued billing guidance for major joint replacements (hip or knee) in May 2017 at ICN909065.
CMS reports that major joint replacement is one of Medicare’s top volume DRGs and, that due to the high volume of these claims, CMS…
In Robie v. Price, Dr. Robie successfully obtained a temporary restraining order prohibiting CMS from terminating his Medicare billing privileges prior to the exhaustion of his administrative remedies by the U.S. District Court for the Sothern District of West Virginia.
As most realize, exhaustion of administrative remedies is usually a prerequisite to further litigation…
The 2017 Medicare Physician Fee Schedule finalizes the CMS changes for Telehealth reimbursement and coverage for 2017. The CMS fee schedule document also provides a comprehensive explanation of Medicare Telehealth reimbursement and coverage. I have excerpted those 35 pages and linked them as a PDF to this post: Medicare Telehealth Services.
The essential takeaways…
The Centers for Medicare & Medicaid Services (CMS) has finalized the 60-day overpayment rule. I have attached the article I prepared for ACMS Legal Bulletin here.
Mike was published in this month’s Allegheny County Medical Society Bulletin regarding the Medicare reform. You can find the article here.
HHS is gearing up to design and implement a revised Medicare payment system. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) has designated a merit based incentive payment system (MIPS) as a goal. CMS is tasked to design a value based payment system based upon quality, resource use, clinical practice improvement, and meaningful…
The ink was barely dry on the Medicare Physician Sustainable Growth Rate (SGR) fix, and it has already been changed.
One component of the SGR fix, which was just passed in April of this year, was freezing Medicare physician payments from 2019 through 2025, and then allowing a .75% increase for physicians participating in alternative…
The Internal Revenue Code was amended in April 2015 as part of the Medicare Access and CHIP Reauthorization Act of 2015 to increase allowable IRS levies against federal payments, such as Medicare receivables, from 30% to 100% effective October 16, 2015.
CMS has issued MLM Matters – MLM number MM9285, to explain these changes.
