Tag: Medicare
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What’s Behind the Curtain? Federal Agencies Seek Transparency Regarding Health Provider Ownership
By: Jessie L. Bekker, Burr & Forman LLP Market analysts reported a decline in mergers & acquisitions in the health care industry in2023 as compared to pre-pandemic trends—a perhaps unsurprising development amid 7% orhigher interest rates. The federal government, however, is now taking notice of who’s behind theongoing trend toward health care consolidation. On March…
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Proposed 2023 physician pay schedule deepens Medicare’s instability
The Medical Association is working with the AMA and many national specialty societies to analyze and comment on CMS proposed 2023 fee schedule. The following article was prepared by the AMA and outlines efforts to address problems that have been identified with the proposed fee schedule: After a thorough analysis, the AMA has weighed in with…
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Medical Association Endorses Refinements to Improve MACRA
Since the enactment of the Medicare Access and CHIP Reauthorization Act, many organizations have worked with Congress and the Centers for Medicare and Medicaid Services to promote a smooth implementation of the two payment models. Although MACRA is an improvement over the flawed sustainable growth rate payment model, its implementation has been flawed. The Medical…
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Medical Association Signs on to Letter Targeting PA Requirements
The Medical Association recently joined the American Medical Association and 85 other national medical groups and state medical associations in sending a letter to the Centers for Medicare & Medicaid Services to urge CMS to provide guidance to Medicare Advantage plans on prior authorization processes through its 2020 Call Letter. In the jointly signed letter,…
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Navigate the New Medicare ID Transition in Nine Steps
Due to a legislative mandate in MACRA passed in 2015, Medicare will no longer use Social Security numbers to identify individuals. Instead, a new randomly generated Medicare Beneficiary Identifier (MBI) will be assigned to all 58 million Medicare recipients. New Medicare ID cards containing the MBI are currently being sent to recipients. The MBI replaces…
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Brookwood Baptist Medical Center Medicare Certification Extended
Brookwood Baptist Medical Center, the second largest hospital in the metro Birmingham area, received an 11th-hour reprieve Thursday night with regulators from the Centers for Medicare and Medicaid Services accepted the facility’s action, thus allowing the hospital to continue its Medicare and Medicaid billing privileges. However, the facility is not out hot water just yet.…
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CMS Publishes 2019 Physician Fee Schedule
UPDATED JULY 27, 2018: CMS Overhauls Office Visit Pay In Proposed 2019 Physician Fee Rule CMS is proposing to overhaul how Medicare pays for office visits and how doctors document those visits in what Administrator Seema Verma said would be “one of the most significant reductions in provider burden ever taken by any administration.” The change,…
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Trump Administration Releases Drug Pricing Blueprint
On May 11, The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs, along with a request for information. The Blueprint was framed as advancing four specific goals: Reducing list prices; Improving government’s ability to negotiate better prices; Encouraging competition through rapid entry to market of generics and…
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CMS Issues Final Rule on 2018 Medicare Reimbursement
The Centers for Medicare & Medicaid Services has issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2018. Background on the Physician Fee Schedule Payment is made under the PFS for services furnished by…
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STUDY: Patients Prescribed Opioids in the ER Less Likely to Use Them Long Term
WASHINGTON – Compared to other medical settings, emergency patients who are prescribed opioids for the first time in the emergency department are less likely to become long-term users and more likely to be prescribed these powerful painkillers in accordance with The Centers for Disease Control and Prevention guidelines. A paper analyzing 5.2 million prescriptions for…