Starting this week and through the end of the COVID-19 public health emergency (PHE), Medicare covers and pays for over-the-counter (OTC) COVID-19 tests at no cost to people with Medicare Part B, including those with Medicare Advantage (MA) plans. In addition to helping prevent the spread of COVID-19, the goal is to find out if Medicare payment for OTC COVID-19 tests will … [Read more...] about Medicare covering OTC COVID-19 tests
Billing & collections
AMA asks Congress to fix Medicare physician payment system
The American Medical Association (AMA) has warned congressional leaders that the Medicare Payment Advisory Commission (MedPAC) report sent to Congress in mid-March contains flawed analyses that would imperil patient access to high-quality care. The MedPAC report recommended a continuation of the freeze in Medicare physician fee payments but ignores a host of trailing … [Read more...] about AMA asks Congress to fix Medicare physician payment system
Learn about changes and updates to telehealth
There's a lot you need to know about telehealth. That's why Medical Office Manager is offering a webinar, Telehealth—What Managers Need to Know, on April 6. It's free to Medical Office Manager members. Presenter Jen Bell of Karen Zupko and Associates will give you the tools and knowledge you need to comply with new telehealth regulations. Meanwhile here is Jen's update on … [Read more...] about Learn about changes and updates to telehealth
What managers need to know as telehealth flexibilities carry on
Telehealth rules that were loosened during the pandemic are likely to stay that way for awhile. President Biden signed the Consolidated Appropriations Act of 2022 into law last week. Included in the law is an extension to some telehealth flexibilities for an additional five months (151 days) after the end of the current public health emergency (PHE). Flexibilities that will be … [Read more...] about What managers need to know as telehealth flexibilities carry on
Newly proposed Medicare Part B Physician Fee Schedule contemplates Making COVID-19 telehealth changes permanent
On July 13, 2021, CMS published its proposed physician fee schedule rule for FY 2022. One of the key items is the proposal to make the temporary change allowing Medicare providers to deliver healthcare services via telehealth a permanent part of Medicare Part B. The Proposed Medicare Changes During the public health emergency (PHE), Congress added the home of the beneficiary … [Read more...] about Newly proposed Medicare Part B Physician Fee Schedule contemplates Making COVID-19 telehealth changes permanent
New federal rule to protect consumers from surprise medical bills
The Biden-Harris Administration has announced a rule to protect consumers from surprise medical bills. The U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management, issued “Requirements Related to Surprise Billing; Part I,” an interim final rule that will restrict excessive out of pocket costs to consumers from surprise … [Read more...] about New federal rule to protect consumers from surprise medical bills
Denial management: the missing ingredient in revenue cycle management
By John McDaniel The blueprint for effective Revenue Cycle Management (RCM) is complex in today’s healthcare environment. When we map out the RCM process, it includes the following steps: Patient scheduling and registration Insurance eligibility and benefit verification Collection of copayments and deductibles at time of service Claims submission Remittance processing … [Read more...] about Denial management: the missing ingredient in revenue cycle management
Provider pays $214K for violating federal COVID-19 workplace protocols
In one of the first of what will likely be a flood of enforcement actions, the Texas parent of an Iowa nursing home has agreed to repay $214,200 in federal monies for not following coronavirus safety protocols during an outbreak at the facility from April through July 2020. Among other things, the nursing home didn’t properly screen employees or require them to wear personal … [Read more...] about Provider pays $214K for violating federal COVID-19 workplace protocols
Getting Medicare reimbursement for telehealth services: The new CONNECT for Health Act
Like most cliches, the one about the COVID-19 pandemic’s transformation of medicine forever is laden with truth. Telemedicine is Exhibit A. Of course, telemedicine goes back decades. But the pandemic accelerated the breakdown of resistance on the parts of providers, regulators and above all, patients. It was supposed to be just temporary. But to use still one more cliché, now … [Read more...] about Getting Medicare reimbursement for telehealth services: The new CONNECT for Health Act
CMS reweighting 2020 MIPS cost performance category
The Centers for Medicare & Medicaid Services (CMS) recognizes the impact of the COVID-19 pandemic public health emergency (PHE) on clinicians across the country and continues to offer flexibilities to provide relief where possible. Under § 414.1350(d)(3), the Merit-based Incentive Payment System (MIPS) cost performance category weight is 15% of the final score for the 2020 … [Read more...] about CMS reweighting 2020 MIPS cost performance category