Health Insurance Medicaid Payment Systems 
MedTrainer
JANUARY 12, 2024
The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation.
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). Most of the Proposed Rule’s provisions will be effective on January 1, 2026. Our initial takeaways are summarized below.
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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%
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.
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.
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. healthcare system were exorbitant.
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.
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