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) [1]. The PFS Final Rule contains a number of significant changes, including: • providing for reimbursement for communication technology-based services and expanding access […]
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 includes reimbursement for a variety of […]
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 members enrolled in Medicare Advantage plans. […]
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 Medicare & Medicaid Services (CMS) took […]
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 urban enrollees, as well as in-home […]
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.) introduced the Home Health Payment Innovation […]
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 Medicaid, private insurers such as Blue […]
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 its latest proposed rule focused on […]
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, they’ll have to make themselves invaluable […]
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 health services in an effort to […]
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 are responsible for managing to a […]
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 go live January 1, 2019. CMS’ […]
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 program is called “Pathways to Success.” […]
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 additions as well as the services […]
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 the final rule, announced last Thursday, […]