Medisys Compliance

FEBRUARY 9, 2024

Several significant updates affecting wound care billing took effect in January 2024. Here’s a breakdown of three key wound care billing updates for 2024 that you need to know: 3 Key Wound Care Billing Updates for 2024 1. This change aims to improve transparency and ensure appropriate reimbursement for these devices.

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Medisys Compliance

JULY 19, 2024

Introduction The landscape of Medicare and Medicaid billing for behavioral health services has undergone significant changes recently. Expanded Telehealth Services One of the most notable changes in Medicare/Medicaid billing for behavioral health is the expanded coverage for telehealth services.

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Medisys Compliance

APRIL 11, 2024

A New Era for Mental Health Access The landscape of mental healthcare in the United States underwent a significant change on January 1, 2024. The Centers for Medicare & Medicaid Services (CMS) website offers a comprehensive guide, including FAQs, enrollment instructions, and billing manuals specifically tailored for MFTs and MHCs.

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HealthIT Answers

JANUARY 31, 2024

The Centers for Medicare & Medicaid Services opened data submission for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2023 performance year of the Quality Payment Program. ET on April 1, 2024. Data can be submitted and updated until 8:00 p.m.

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Hall Render

MARCH 4, 2025

On November 20, 2024, the Office of Inspector General (OIG) for the U.S. Nationally, violations under this regulation were cited 36 times in 2024 and 27 times in 2023. SNF services covered by the Medicare Part A Skilled Nursing Prospective Payment System (PPS) payment are not designated health services (DHS) for purposes of the PSL.

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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%

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Healthcare IT Today

SEPTEMBER 19, 2024

However, the Centers for Medicare and Medicaid Services (CMS) took an important step to accelerate the adoption of the model in the U.S. where healthcare systems have traditionally operated under a fee-for-service framework, there’s a growing interest in exploring and implementing value-based care models. In the U.S.,

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Hall Render

JULY 14, 2023

On Friday, June 20, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update (“PPS Rule”), which has since been published in the Federal Register and is currently open for comment.

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Hall Render

NOVEMBER 28, 2023

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. or $140 million in 2024.

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Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. These changes become effective on January 1, 2024.

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Medisys Compliance

APRIL 18, 2022

An Alternative Payment Model (APM) is a payment approach that gives added incentive payments to provide high-quality and cost-efficient care. Many states are taking advantage of Medicaid program flexibility and federal financing to implement APMs in a variety of ways. Types of Alternative Payment Models.

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Compliancy Group

JUNE 28, 2024

On June 24, 2024, the Department of Health and Human Services (HHS) released a final rule establishing disincentives for healthcare providers who have engaged in information blocking. The 2024 rule provides a different penalty for provider information blocking. What Disincentives Does the 2024 Final Rule Establish?

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HIPAA Journal

MARCH 29, 2024

HHS Issues Guidance for Providers Affected by Change Healthcare Ransomware Attack The Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), and the Administration for Strategic Preparedness and Response (ASPR) have issued guidance to help entities impacted by the Change Healthcare ransomware attack.

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Ransomware US Department of Health and Human Services HIPAA Hospitals 97

HIT Consultant

JULY 15, 2024

– The Centers for Medicare & Medicaid Services (CMS) released a proposed rule outlining changes to Medicare payments under the Physician Fee Schedule (PFS) for services furnished and other Medicare Part B issues on or after January 1, 2025. RFI on additional payment policies recognizing advanced primary care services.

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Hall Render

NOVEMBER 6, 2024

Effective Date The Final Rule is scheduled to be published on November 7, 2024, with an effective date of January 1, 2025. CMS took regulatory action through the Calendar Year 2022 Home Health Prospective Payment System rule to extend those requirements through December 31, 2024. Revised 42 CFR Section 483.80(g)

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Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Taking effect on October 1, 2024, the Final Rule confirms CMS will adopt updated market area delineations based on the 2020 census.

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Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Taking effect on October 1, 2024, the Final Rule confirms CMS will adopt updated market area delineations based on the 2020 census.

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Hall Render

APRIL 12, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”). The Proposed Rule is scheduled to be published in the Federal Register on May 2, 2024.

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Health Law Attorney

DECEMBER 18, 2020

The Centers for Medicaid & Medicare Services ( CMS ) recently released the 2021 Outpatient Prospective Payment System ( OPPS ) and Ambulatory Surgical Center ( ASC ) Final Rule, which may be accessed here. CMS will be phasing the IPO list out over the next three years, with the IPO being completely phased out by CY 2024.

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HIT Consultant

DECEMBER 12, 2024

Accessed April 9, 2024.[link] Accessed March 7, 2024. In collaboration with The US Oncology Network, Erin spearheaded the development of McKessons Practice Insights Qualified Clinical Data Registry (QCDR) and custom oncology-specific quality measures. References 1. Traditional MIPS Overview. Learn About MVP Reporting Option.

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Compliancy Group

OCTOBER 5, 2023

Under MACRA, the Centers for Medicare and Medicaid Services (CMS) created regulations to encourage healthcare providers to use secure health information technology. One of these incentives is the Merit-Based Incentive Payment System, or MIPS, program.

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Hall Render

SEPTEMBER 5, 2024

On August 1, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the Fiscal Year 2025 Hospital Inpatient Prospective Payment System Final Rule (“Final Rule”), finalizing the proposed Transforming Episode Accountability Model (“TEAM”).

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Hall Render

AUGUST 27, 2024

The Centers for Medicare & Medicaid Services (“CMS”) will publish the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) in the Federal Register on August 28 with an effective date of October 1, 2024. By FY 2027, these changes will increase IPPS spending by $459 million.

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Compliancy Group

NOVEMBER 16, 2022

healthcare system since 2010’s Affordable Care Act. Under MACRA, the Centers for Medicare and Medicaid Services created regulations for healthcare providers’ use of health information technology. One of these incentives is the Merit-Based Incentive Payment System, or MIPS.

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Hall Render

AUGUST 1, 2022

REHs may not operate swing beds but may maintain a distinct part skilled nursing facility, which will be paid under the skilled nursing facility prospective payment system. Proposed REH Payments. CMS ultimately proposed a monthly facility payment of $268,294 (just over $3.2 5 Percent OPPS Increase.

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Hall Render

AUGUST 11, 2023

On August 7, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule (“Final Rule”) that updated Medicare payment policies and rates for skilled nursing facilities (“SNFs”) under the Skilled Nursing Facility Prospective Payment System (“SNF PPS”) for fiscal year (“FY”) 2024.

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Hall Render

MAY 30, 2023

On April 4, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) that would update Medicare payment policies and rates for skilled nursing facilities (“SNFs”) under the Skilled Nursing Facility Prospective Payment System (“SNF PPS”) for fiscal year 2024.

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Hall Render

AUGUST 29, 2024

On August 28, 2024, the Centers for Medicare & Medicaid Services (“CMS”) published the Fiscal Year 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”), which can be found here. Applications for Round 23 can be submitted through the MEARIS portal.

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Hall Render

NOVEMBER 14, 2024

New Policy Requirements In the Final Rule, CMS finalized a new standard at 42 CFR § 484.105(i) that would require HHAs to develop, implement and maintain an acceptance-to-service policy that is applied consistently to each prospective patient referred for home health care.

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Hall Render

FEBRUARY 14, 2025

The Centers for Medicare & Medicaid Services (CMS) recently finalized a rule (Final Rule) that expands its ability to impose a Provisional Period of Enhanced Oversight (PPEO) on providers, including post-acute providers, reactivating their Medicare enrollment. CMS finalized new 42 CFR Sec. Specifically, new 42 CFR Sec.

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Hall Render

MAY 10, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) announced its plan to implement the Transforming Episode Accountability Model (“TEAM”), a new mandatory alternative payment model unveiled as part of the 2025 Hospital Inpatient Prospective Payment System proposed rule.

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Hall Render

MARCH 20, 2024

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

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Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

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C&M Health Law

AUGUST 10, 2022

On July 29, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for skilled nursing facilities (SNFs) and enacts changes to the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program beginning in FY 2023.

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Hall Render

NOVEMBER 25, 2024

On November 20, 2024, the Office of Inspector General (“OIG”) for the U.S. When a nursing facility submits a claim to Medicare or Medicaid for reimbursement, the claim submission form includes certifications that the claimed services were provided in compliance with all applicable statutes, regulations and rules.

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Physician Credentialing Company

OCTOBER 25, 2024

Medicare and Medicaid may have different payment systems from those of the private health insurance plans. The lack of documentation may result in an audit, leading to claim denial and fines for noncompliance with Medicare and Medicaid regulations. 2022: $112.29 2021: $103.28 2020: $94.55 between 2020 to 2021.

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Hall Render

MAY 2, 2023

The CMS Memo confirms that this requirement will remain in effect until May 21, 2024 unless additional regulatory action is taken. In the CY 2022 Rule, CMS set December 31, 2024, as a termination date for most COVID SNF notification requirements. The F-Tag associated with this regulation is F-887. COVID Staff Vaccine.

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