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CMS Issues Final Medicare PFS Rule for CY 2019

On November 1, 2018, the Centers for Medicare and Medicaid Services (CMS) released in pre-publication form the Medicare Physician Fee Schedule (PFS) Final Rule for Calendar Year (CY) 2019 (PFS Final Rule) . The PFS Final Rule contains a number of significant changes, including: • providing for reimbursement for...

November 12, 2018 Dr. M Telehealth Medicare, Reimbursement, Telehealth.

Medicare Telehealth Coverage—Ten Things

Health Update November 07, 2018 Recognizing significant changes in healthcare practice, especially innovations in the active management and ongoing care of chronically ill patients, and patients’ desire to avoid unnecessary doctor visits, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on November 1, 2018 that...

November 7, 2018 Dr. M Telehealth Medicare, Reimbursement, Telehealth.

CMS Proposes Telehealth Expansion for Medicare Advantage Plans

CMS is proposing to loosen reimbursement and access restrictions on the use of telehealth and telemedicine in Medicare Advantage plans, giving providers more opportunities to use connected care technology. By Eric Wicklund October 29, 2018 – The Centers for Medicare & Medicaid Services is looking to expand telehealth access for...

October 30, 2018 Dr. M Telehealth Legislation, Medicare, Remote Patient Monitoring, Telehealth.

CMS Proposes to Modernize Medicare Advantage, Expand Telehealth Access for Patients

CMS Proposes to Modernize Medicare Advantage, Expand Telehealth Access for Patients Proposed rule would strengthen the popular system for private health insurance plans to provide Medicare coverage, increase plan flexibility to offer telehealth benefits, and improve coordination for dual-eligible beneficiaries In a proposed rule issued today, the Centers for...

October 26, 2018 Dr. M Telehealth Legislation, Medicare, Reimbursement, Remote Patient Monitoring, Telehealth.

CMS Moves to Expand Telehealth Coverage Under Medicare Advantage

The Centers for Medicare & Medicaid Services on Friday unveiled a proposal that the agency says will expand telehealth coverage to enrollees in Medicare Advantage plans. Under the proposed rule, which would take effect in calendar year 2020, Medicare Advantage plans could cover telehealth services for both rural and...

Dr. M Telehealth Medicare, Reimbursement, Telehealth.

New Senate Bill Seeks to Loosen Homebound Requirements for Home Health Services

By Kaitlyn Mattson | October 7, 2018 The home health industry has won another victory in Washington, D.C., in its battle against certain parts of the Patient-Driven Groupings Model (PDGM) and shift toward a more pre-acute care identity. Sens. Susan Collins (R-Maine), Bill Nelson (D-Fla.) and Debbie Stabenow (D-Mich.)...

October 8, 2018 Dr. M Telehealth Medicare.

Telehealth and the law: the challenge of reimbursement

Technological advances continue to expand the healthcare delivery marketplace. Through technology, more and more providers are trying to cash in on telehealth. As with any other business, the healthcare industry is driven by profitability. In healthcare, profitability is generally driven by reimbursements from government payers such as Medicare and...

September 21, 2018 Dr. M Telehealth Legislation, Medicare, Reimbursement, Telehealth.

New CMS Proposal Would Save Home Health, Hospice $137M Annually

By Robert Holly | September 17, 2018 Federal policymakers are again taking aim at costly administrative and paperwork burdens for the home health and hospice industries in order to help providers save tens of millions of dollars annually. The Centers for Medicare & Medicaid Services (CMS) on Monday announced...

September 18, 2018 Dr. M Telehealth Legislation, Medicare.

ACO Announcements Add to Existing Skilled Nursing Pressures

By Maggie Flynn | September 10, 2018 Value-based arrangements generate much of their savings by shifting spending away from the post-acute setting, according to recent government announcements. That ups the already-high pressure on skilled nursing facilities to lower patient length of stay while maintaining quality of care. To cope,...

September 10, 2018 Dr. M Telehealth Medicare.

AMA Adds Connected Health CPT Codes, Pushes for Medicare Payment

The 2019 CPT code set includes new remote patient monitoring and internet consulting codes to encourage innovative care delivery and Medicare payment for connected health. September 07, 2018 – The American Medical Association (AMA) updated the Current Procedural Terminology (CPT) code set in 2019 to include new codes for connected...

September 7, 2018 Dr. M Telehealth Medicare, Reimbursement, Remote Patient Monitoring.

ACOs taking risk in innovative payment model generate savings for patients and taxpayers

Aug 27, 2018 Today, the Centers for Medicare & Medicaid Services (CMS) released an evaluation report for the first performance year of the Innovation Center’s Next Generation Accountable Care Organization (ACO) Model showing promising early results. Results demonstrated the positive outcomes in terms of quality and costs when providers...

August 27, 2018 Dr. M Telehealth Medicare, Reimbursement.

2019 Medicare Physician Fee Schedule and Quality Payment Program – CMS Proposed Rule – CPT Codes 990X0, 990X1, and 994X9 – Everything You Need to Know

CMS has proposed three new codes for RPM services, retitled “Chronic Care Remote Physiologic Monitoring,” which do a far better job reflecting how providers can more effectively and efficiently use RPM technology to monitor and manage patient care needs, including chronic care management. If finalized, these three codes would...

August 23, 2018 Dr. M Telehealth Medicare, Reimbursement, Remote Patient Monitoring, Telehealth.

CMS Proposes “Pathways to Success,” an Overhaul of Medicare’s ACO Program

Today, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would overhaul the Medicare Shared Savings Program, which is the program established by the Affordable Care Act and launched in 2012 under which the vast majority of Medicare’s Accountable Care Organizations (ACOs) operate. The redesigned...

August 9, 2018 Dr. M Telehealth Medicare, Reimbursement.

Medicare Proposes (and Rejects) New Telehealth Services for 2019

Medicare Proposes (and Rejects) New Telehealth Services for 2019 Wednesday, August 8, 2018 The telemedicine industry was pleased to learn CMS recently proposed adding new services to its list of Medicare-covered telehealth services. But what may be more interesting are the services CMS declined to add, and why. This article summarizes the newly-proposed...

August 8, 2018 Dr. M Telehealth Medicare, Reimbursement, Telehealth.

Final rule pushes interoperability, reduced reporting burden

The Centers for Medicare & Medicaid Services (CMS) has finalized a rule it says will improve interoperability, reduce the reporting burden under meaningful use, and allow healthcare providers to spend more time with their patients while saving hospitals and other medical facilities millions of dollars each year. CMS said...

August 6, 2018 Dr. M Telehealth Medicare, Reimbursement, Telehealth.