Hall Render

AUGUST 10, 2023

On August 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its Final Hospital Inpatient Prospective Payment System (“IPPS”) and Long-Term Care Hospital (“LTCH”) PPS rule for fiscal year (“FY”) 2024 (“Final Rule”). The Final Rule increases the rate for IPPS payments by 3.3%

Hospitals 40

Hospitals Medicare Medicare Medicaid 40

Physician Credentialing Company

OCTOBER 25, 2024

Insurance Verification And Pre-Authorization Before delivering services, it’s very important for healthcare providers to check whether the patient’s insurance includes mental health services under the 90834 code or not. Medicare and Medicaid may have different payment systems from those of the private health insurance plans.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

C&M Health Law

AUGUST 3, 2023

Under the final rule, enforcement of the information blocking penalties will begin September 1, 2023. This means, OIG will not impose penalties on conduct occurring before September 1, 2023. Other than the information blocking penalties, the rest of the final rule’s provisions are effective August 2, 2023.

Fraud 52

Fraud HIPAA Governance Compliance 52

Health Care Law Brief

JULY 25, 2023

On June 27, 2023, the Office of Inspector General (“ OIG ”) for the U.S. Department of Health and Human Services (“ HHS ”) released its final rule (“ Final Rule ”) implementing penalties for information blocking. 1] See 21st Century Cures Act, Pub.

HIPAA 52

HIPAA Payment Systems Compliance Licensing 52

C&M Health Law

DECEMBER 23, 2022

The regulations impact CMS-regulated payers and provide incentives for providers and hospitals that participate in the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS). The deadline to submit comments is March 13, 2023. Our initial takeaways are summarized below.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting “reasonable and customary charges” requiring physicians to collect data to negotiate reasonable contracts. Hospital reimbursement also changed.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting "reasonable and customary charges" requiring physicians to collect data to negotiate reasonable contracts. Hospital reimbursement also changed. AIHC is a non-profit organization.

Medicare 52

Medicare Medicare Medicaid Medicaid 52