Category: Medicare
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Medical Association of Alabama Advancing Prior Authorization Reforms – Launches Website ALFixPriorAuth.com
Prior authorization (PA) processes have become a significant challenge for physicians, leading to delays in necessary treatments and increased administrative burdens which negatively affect patient care. Recognizing these challenges, the Medical Association of Alabama is committed to supporting comprehensive and meaningful PA reforms, both in Alabama and Washington, D.C., which build on the success seen…
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Congress Considers Expanding Medicare Coverage for Prescription Weight Loss Medications
By: Jessie Bekker, Burr & Forman LLP Some Congressional leaders voted to expand Medicare coverage for prescription medications to treat obesity. The House of Representatives Ways and Means Committee voted in late June to pass the Treat and Reduce Obesity Act of 2023. If passed, the bill would approve Medicare Part D coverage for glucagon-like…
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Medical Association Endorses Prior Authorization Bill Reintroduced in Congress
On June 12, bipartisan lawmakers introduced an updated version of the Improving Seniors’ Timely Access to Care Act in both the House (H.R. 8702) and Senate (S. 4532). The Medical Association is supporting the latest version of this legislation that was introduced, once again, by Senators Roger Marshall, MD (R-KS), Krysten Sinema (I-AZ), John Thune (R-SD), and Sherrod…
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Inside the massive proposed 2023 Medicare physician pay schedule
The Medical Association of the State of Alabama is working with the AMA and national specialties to analyze CMS’s proposed physician fee schedule for 2023 to determine its impact on physician practices. The Medical Association in partnership with these other medical organizations will provide appropriate comments to CMS once the full impact of the proposal…
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American Rescue Plan Offers $940 Million for Medicaid Expansion and Other Benefits for Healthcare
The American Rescue Plan Act of 2021, signed by President Biden on Thursday, includes a number of key provisions that strengthen both public and private health insurance coverage. Among its Medicaid and the Children’s Health Insurance Program (CHIP) provisions, the American Rescue Plan encourages states to finally take up the Medicaid expansion by offering even…
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Summary of Telehealth Waivers as of April 1, 2020
By: Jim Hoover, Burr & Forman, LLP The changes made to the requirements for telehealth services since the start of the COVID-19 pandemic have been swift and substantial. For the first several weeks, it seems changes were made almost daily. As time has passed, the changes to telehealth have stabilized enough that a summary of…
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Families First Coronavirus Response Act (HR6201) Summary
Last night President Trump signed what is being called the second coronavirus stimulus bill. It provides for free coronavirus screening, $1 billion in additional unemployment insurance funding to all states, a bump in Medicaid FMAP, $1 billion in food aid, and two provisions to provide paid sick leave to employees. Emergency Paid Sick Leave This…
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Telehealth in Alabama during COVID-19 Public Health Emergency (PHE)
prepared by Kim Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC March 19, 2020 The most important thing to remember is that payers have differing definitions of what they consider telehealth. I recommend checking with the applicable insurer for the most up-to-date information affecting requirements for coding and billing of telehealth services. A few things…
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Appropriate Use Criteria for Advanced Diagnostic Imaging
Contributed by: Gregg Everett, Gilpin Givhan The Protecting Access to Medicare Act (PAMA) was passed in 2014. PAMA required the Centers for Medicare and Medicaid Services (CMS) to establish a program that promotes “Appropriate Use Criteria” (AUC) for advanced diagnostic imaging. AUC’s are evidence-based criteria that assist professionals who order and furnish certain imaging services…
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CMS Releases Physician Fee Schedule Final Rule
The Centers for Medicare and Medicaid Services (CMS) released its final rule for the CY 2020 Physician Fee Schedule. The Medical Association and the AMA will continue to review the rule and analyze these policies in the coming weeks. Attached is a summary of some of the policies CMS finalized in the rule. Some of…