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CMS clarifies final overpayment rule: 5 things to know Print E-mail
Written by Laura Dyrda | Becker's ASC Review   
Tuesday, 16 February 2016 10:52
Preview of Medicare Advantage and Part D Advance Notice and Call Letter: CMS Likely to Address Risk Adjustment, Provider Network, and Other Issues Print E-mail
Written by   
Friday, 12 February 2016 19:01

The federal government will soon kick off the all-important annual sub-regulatory cycle for the Medicare Advantage (MA) and Part D programs, issuing proposed policy changes and payment rates for calendar year (CY) 2017. The proposed guidance-expected to be issued on February 19-is likely to include substantial proposed changes to the MA risk adjustment methodology and may address increased provider network oversight for MA Organizations (MAOs), among other topics.

Key topics that the Centers for Medicare & Medicaid Services (CMS) is expected to address in the document-known as CY 2017 Advance Notice and Draft Call Letter-include the following...

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Last Updated on Saturday, 05 March 2016 08:34
CMS Finalizes Prior Authorization Program for Certain DMEPOS Items Print E-mail
Written by FHI's Week in Review   
Tuesday, 12 January 2016 18:15

In a January 7, 2016 post by, the authors report:

On December 30, 2015, the Centers for Medicare & Medicaid Services (CMS) published its final rule establishing a prior authorization program for certain durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) items frequently subject to unnecessary utilization (the Final Rule). As noted in our commentary on the proposed rule the Final Rule creates a "Master List" of items that could require prior authorization as a condition of Medicare payment as well as a subset list of items for which prior authorization is required. The provisions of the Final Rule are effective on February 29, 2016.

Read more in the current issue of Week in Review>>
CMS finalizes hip, knee bundled payment program: 10 things to know Print E-mail
Written by Ayla Ellison | Becker's Hospital Review   
Tuesday, 17 November 2015 00:00

CMS has finalized a new payment model that holds acute care hospitals accountable for the quality of care they deliver to Medicare beneficiaries for hip and knee replacement from surgery through recovery.

Here are 10 things to know about the new Comprehensive Care for Joint Replacement Model.

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Medicare Approves Payment for End-of-Life Counseling Print E-mail
Written by Robert Lowes | Medscape Medical News   
Friday, 30 October 2015 00:00

A proposal too hot to handle in the nascent days of the Affordable Care Act (ACA) became a reality today <October 30, 2015> when the Centers for Medicare and Medicaid Services (CMS) approved payment for voluntary end-of-life counseling as part of its 2016 Medicare physician fee schedule.

The new policy will help seniors "make important decisions that give them control over the type of care they receive and when they receive it," CMS said in a news release.

Last Updated on Friday, 06 November 2015 17:31
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