Humana Health Plan Overcharged Medicare by Nearly $200 Million Humana Health Plan Overcharged Medicare by Nearly $200 Million
The Medicare Advantage company may face a record penalty over alleged billing errors.Kaiser Health News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - April 20, 2021 Category: Consumer Health News Tags: Internal Medicine News Source Type: news

Introduction of Sepsis Performance Measure Had Little Impact
TUESDAY, April 20, 2021 -- Implementation of a Medicare requirement that hospitals report on their adherence to the Severe Sepsis and Sepsis Shock Early Management Bundle (SEP-1) had a variable impact on changes in process measures, with no... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - April 20, 2021 Category: Pharmaceuticals Source Type: news

Patients of Female Doctors More Likely to Receive Flu Vaccine
MONDAY, April 19, 2021 -- Medicare patients of female physicians are more likely than patients of male physicians in the same practice to receive the influenza vaccine, according to a research letter published online April 12 in JAMA Internal... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - April 19, 2021 Category: Pharmaceuticals Source Type: news

Adherence to CMS SEP-1 measures found to have variable effects on patient outcomes
(American College of Physicians) A longitudinal study found that adherence to the Medicare Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) had variable effects on sepsis treatment and patient outcomes in its current iteration, which requires that a patient receive all measure components for their treatment to be considered compliant. The findings are published in Annals of Internal Medicine. (Source: EurekAlert! - Infectious and Emerging Diseases)
Source: EurekAlert! - Infectious and Emerging Diseases - April 19, 2021 Category: Infectious Diseases Source Type: news

‘Like hunting for unicorns’: Australians on the search for adequate, affordable mental healthcare
Countless inquiries have found the same problems afflicting the mental health system, but cost and access barriers still leave those seeking and providing care in despairMany Australians experience the country ’s mental health system as inadequate, dangerous and financially punishing, saying they often feel unsafe in hospitals, are dismissed by health professionals and are hit with prohibitive costs that government subsidies do not come close to covering.And practitioners in turn have spoken of burnout and their frustration with misplaced funding, inadequate quick fixes, overmedication of patients and inconsistencies...
Source: Guardian Unlimited Science - April 18, 2021 Category: Science Authors: Melissa Davey Tags: Health Mental health Australia news Psychiatry Psychology Medicare Australia Post-traumatic stress disorder Australian politics Victoria Source Type: news

Arizona health care equipment company owner faces prison over fraud scheme
The woman had previously pleaded guilty to fraudulently billing Medicare for medical equipment that was never provided to patients, court documents show. (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - April 17, 2021 Category: American Health Authors: Phoenix Business Journal staff Source Type: news

Arizona health care equipment company owner faces prison over fraud scheme
The woman had previously pleaded guilty to fraudulently billing Medicare for medical equipment that was never provided to patients, court documents show. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - April 17, 2021 Category: Biotechnology Authors: Phoenix Business Journal staff Source Type: news

AI predicts heart disease mortality from CT lung screening exams
A deep-learning algorithm used to analyze CT lung cancer screening exams wa...Read more on AuntMinnie.comRelated Reading: Shared decision-making: Is it harmful for lung cancer screening? ACR urges Aetna to update lung cancer screening policy How can access to CT lung cancer screening be improved? Medicare urged to update lung cancer screening coverage ACR praises USPSTF's lung cancer screening changes (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - April 15, 2021 Category: Radiology Source Type: news

UnitedHealth Group Profits Jump As Insurer Adds 1 Million New Members
UnitedHealth Group ’s membership grew by more than 1 million in its health plans buoyed by a large increase in seniors signing up for privatized Medicare Advantage. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - April 15, 2021 Category: Pharmaceuticals Authors: Bruce Japsen, Senior Contributor Tags: Healthcare /healthcare Innovation /innovation Business /business pharma Source Type: news

CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2022
Notice of a proposed rule from the Centers for Medicare and Medicaid Services seeking comments on updates to the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year 2022. Among other things, this rule includes proposals to rebase and revise the SNF market basket, suppress the use of the SNF readmission measure for scoring and payment adjustment purposes in the FY 2022 SNF Value-Based Purchasing (VBP) program due to the COVID-19 public health emergency, and update to the diagnosis code mappings used under the Patient-Driven Payment Model (PDPM). Includes rural considerations throughout. Co...
Source: Federal Register updates via the Rural Assistance Center - April 15, 2021 Category: Rural Health Source Type: news

U.S. House passes legislation to delay Medicare payment cuts
The U.S. House of Representatives on April 13 passed a bill that would dela...Read more on AuntMinnie.comRelated Reading: ACR urges Congress to stop Medicare cuts Groups urge action on Medicare cuts CMS finalizes major cut in radiology reimbursement ACR lauds Congress for COVID-19 protection bill Imaging societies seek RVU budget neutrality waiver (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - April 14, 2021 Category: Radiology Source Type: news

Reps. ask CMS to change policy on radiopharmaceuticals
Two members of the U.S. House of Representatives have asked the U.S. Center...Read more on AuntMinnie.comRelated Reading: Federal programs to assist radiology practices during the pandemic Update on Medicare's Quality Payment Program E/M coding and billing for interventional radiology MedPAC: Imaging use, charges continue to stay steady Probe finds fault with patient notification at Washington, DC, VA (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - April 14, 2021 Category: Radiology Source Type: news

Reimbursement for AI in radiology is more than just billable codes
The radiology community is abuzz with talk of artificial intelligence (AI) system...Read more on AuntMinnie.comRelated Reading: Federal programs to assist radiology practices during the pandemic Update on Medicare's Quality Payment Program E/M coding and billing for interventional radiology What the new federal law on surprise billing means for radiology Small practices have opportunity for additional provider relief (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - April 14, 2021 Category: Radiology Source Type: news

Shared decision-making: Is it harmful for lung cancer screening?
Why is CT lung cancer screening the only screening exam to require a sessio...Read more on AuntMinnie.comRelated Reading: Medicare urged to update lung cancer screening coverage USPSTF's new lung cancer screening guidance lowers starting age How useful is shared decision-making for lung cancer screening? How high are complication rates from CT lung screening? Video beats brochure to prep smokers for CT screening (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - April 14, 2021 Category: Radiology Source Type: news

Patients of women doctors more likely to be vaccinated against the flu
New UCLA research suggests that elderly patients of female physicians are more likely than those of male physicians in the same outpatient practice to be vaccinated against the flu.This trend holds for all racial and ethnic groups studied and could provide insight into improving vaccination rates for influenza, COVID-19 and other illnesses,according to the research letter, which is published in the peer-reviewed JAMA Internal Medicine.Prior studies have shown that female physicianstend tospend more time with their patients, said study author Dr. Dan Ly, anassistant professor in the division of general internal medicine and...
Source: UCLA Newsroom: Health Sciences - April 14, 2021 Category: Universities & Medical Training Source Type: news

CMS: Medicare Program; FY 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements
Notice of a proposed rule from the Centers for Medicare and Medicaid Services updating the hospice wage index, payment rates, and cap amount for fiscal year 2022. Includes changes to the labor shares of hospice payment rates, updates to the Hospice Quality Reporting Program, and proposes clarifying changes to the election statement addendum that was implemented on October 1, 2020. Among other things, this rule also proposes making permanent selected regulatory blanket waivers issued to Medicare-participating hospice agencies during the COVID-19 public health emergency public and proposes changes to public reporting for the...
Source: Federal Register updates via the Rural Assistance Center - April 14, 2021 Category: Rural Health Source Type: news

Medicare Payment Patterns Examined for Hip Fracture Surgery
TUESDAY, April 13, 2021 -- Reimbursement for hospital charges is increasing faster than payments for surgeons performing hip fracture surgeries on Medicare beneficiaries, according to a study published online March 9 in the Journal of Orthopaedic... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - April 13, 2021 Category: Pharmaceuticals Source Type: news

CMS: Medicare Program; FY 2022 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2021 (FY 2022)
Notice of proposed rule from the Centers for Medicare and Medicaid Services updating the FY 2022 prospective payment rates, outlier threshold, and wage index for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPF), including psychiatric hospitals and excluded psychiatric units of an acute care hospital or Critical Access Hospital. The proposed rule also updates and clarifies the IPF teaching policy with respect to IPF hospital closures and displaced residents, proposes a technical change to the 2016-based IPF market basket price proxies, and updates quality measures and reporting require...
Source: Federal Register updates via the Rural Assistance Center - April 13, 2021 Category: Rural Health Source Type: news

Sanders Proposal Brings Medicare Closer To The Brink Of Collapse
Lowering Medicare's eligibility age would put more financial stress on the entitlement, which is dangerously close to insolvency. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - April 12, 2021 Category: Pharmaceuticals Authors: Sally Pipes, Contributor Tags: Policy /policy Business /business Innovation /innovation Healthcare /healthcare sallypipesblog Source Type: news

CMS: Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2022 and Updates to the IRF Quality Reporting Program
Notice of a proposed rule from the Centers for Medicare and Medicaid Services (CMS) seeking comments on updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2022. Among other things, this proposed rule would update the cost-to-charge ratio (CCR) ceiling and urban/rural average CCRs for FY 2022 and make revisions and updates to quality measures and reporting requirements under the IRF quality reporting program. Comments are due by June 7, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 12, 2021 Category: Rural Health Source Type: news

ACR urges Aetna to update lung cancer screening policy
The American College of Radiology (ACR) is urging Aetna to update its lung cance...Read more on AuntMinnie.comRelated Reading: How can access to CT lung cancer screening be improved? Medicare urged to update lung cancer screening coverage ACR praises USPSTF's lung cancer screening changes USPSTF's new lung cancer screening guidance lowers starting age ACR Data Science Institute expands list of AI use cases (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - April 9, 2021 Category: Radiology Source Type: news

Public Inspection: CMS: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2022
Pre-publication notice of a proposed rule from the Centers for Medicare and Medicaid Services seeking comments on updates to the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year 2022. Among other things, this rule includes proposals to rebase and revise the SNF market basket, suppress the use of the SNF readmission measure for scoring and payment adjustment purposes in the FY 2022 SNF Value-Based Purchasing (VBP) program due to the COVID-19 public health emergency, and update to the diagnosis code mappings used under the Patient-Driven Payment Model (PDPM). Includes rural consideration...
Source: Federal Register updates via the Rural Assistance Center - April 9, 2021 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: FY 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements
Pre-publication notice of a proposed rule from the Centers for Medicare and Medicaid Services updating the hospice wage index, payment rates, and cap amount for fiscal year 2022. Includes changes to the labor shares of hospice payment rates, updates to the Hospice Quality Reporting Program, and proposes clarifying changes to the election statement addendum that was implemented on October 1, 2020. Among other things, this rule also proposes making permanent selected regulatory blanket waivers issued to Medicare-participating hospice agencies during the COVID-19 public health emergency public and proposes changes to public r...
Source: Federal Register updates via the Rural Assistance Center - April 9, 2021 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services (CMS) is seeking comments on the following information collections: 1) Medicare Advantage Chronic Care Improvement Program (CCIP) Attestations; 2) Medicare Beneficiary Experiences with Care Survey (MBECS) System; 3) Program Integrity II; 4) Medicare Registration Application; and 5) Organ Procurement Organization/Histocompatibility Laboratory Cost Report. Comments are due by June 8, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 9, 2021 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2022 and Updates to the IRF Quality Reporting Program
Pre-publication notice of a proposed rule from the Centers for Medicare and Medicaid Services seeking comments on updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2022. Among other things, this proposed rule would update the cost-to-charge ratio (CCR) ceiling and urban/rural average CCRs for FY 2022 and make revisions and updates to quality measures and reporting requirements under the IRF quality reporting program. Comments are due by June 7, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 8, 2021 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: FY 2022 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2021 (FY 2022)
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services updating the FY 2022 prospective payment rates, outlier threshold, and wage index for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPF), including psychiatric hospitals and excluded psychiatric units of an acute care hospital or Critical Access Hospital. The proposed rule also updates and clarifies the IPF teaching policy with respect to IPF hospital closures and displaced residents, proposes a technical change to the 2016-based IPF market basket price proxies, and updates quality measures and r...
Source: Federal Register updates via the Rural Assistance Center - April 8, 2021 Category: Rural Health Source Type: news

Why Do New Cancer Diagnoses Rise at Age 65?
A sudden jump in cancer cases among Americans at age 65 may be due to the fact that many older adults delay care until they have Medicare coverage. (Source: WebMD Health)
Source: WebMD Health - April 7, 2021 Category: Consumer Health News Source Type: news

More Medicare patients to be covered for Heartflow Analysis
Patients with coronary artery disease in 38 states will soon have Medicare coverag...Read more on AuntMinnie.comRelated Reading: NHS England requires use of HeartFlow's FFR-CT software HeartFlow touts PROMISE study findings Will Medicare reimbursement propel radiology AI market? FDA clears HeartFlow's virtual modeling software HeartFlow hires new president and CEO (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - April 7, 2021 Category: Radiology Source Type: news

Cancer Diagnoses Jump at 65 Years When Medicare Kicks In Cancer Diagnoses Jump at 65 Years When Medicare Kicks In
An abrupt jump in cancer diagnoses at the age of 65 in the US suggests that people are not seeking medical care until they are eligible for Medicare health insurance.Medscape Medical News (Source: Medscape Hematology-Oncology Headlines)
Source: Medscape Hematology-Oncology Headlines - April 7, 2021 Category: Cancer & Oncology Tags: Hematology-Oncology News Source Type: news

India's Shilpa Medicare can make 100-200 million doses of COVID-19 shot, says executive
The company's shares jumped as much as 9.2% on India's National Stock Exchange following the news. (Source: The Economic Times Healthcare and Biotech News)
Source: The Economic Times Healthcare and Biotech News - April 7, 2021 Category: Pharmaceuticals Source Type: news

Branded Rx Requests Up Medicare Costs by $1.6 Billion
TUESDAY, April 6, 2021 -- Prescribers and patients motivated 30.4 percent of all branded dispensing of multisource drugs in the Medicare Part D program in 2017, according to a study published online March 2 in JAMA Network Open. Mariana P. Socal,... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - April 6, 2021 Category: Pharmaceuticals Source Type: news

Medicare Spending on Physician Services Down $9.4B During First Half of 2020
Declines seen regardless of service type, setting, or specialty, and state or region (Source: The Doctors Lounge - Psychiatry)
Source: The Doctors Lounge - Psychiatry - April 5, 2021 Category: Psychiatry Tags: Cardiology, Dermatology, Endocrinology, Family Medicine, Geriatrics, Gastroenterology, Gynecology, Infections, AIDS, Internal Medicine, Allergy, Emergency Medicine, Nephrology, Neurology, Nursing, Oncology, Ophthalmology, Orthopedics, ENT, Psychiatry, Pul Source Type: news

Medicare Spending on Physician Services Down $9.4B During First Half of 2020
MONDAY, April 5, 2021 -- Medicare spending on physician services declined an estimated $9.4 billion between January and June 2020, according to a report from the American Medical Association (AMA). Kurt Gillis, Ph.D., on behalf of the AMA, used... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - April 5, 2021 Category: Pharmaceuticals Source Type: news

Las Vegas Hospital Told to Pay $23M in Medicare Overpayments Las Vegas Hospital Told to Pay $23M in Medicare Overpayments
The Office of the Inspector General for the US Department of Health and Human Services conducted a routine audit of Sunrise Hospital and Medical Center of Las Vegas.Associated Press (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - April 5, 2021 Category: Consumer Health News Tags: Hospital Medicine News Source Type: news

OIG Report Indicates Fraudulent Upcoding at Hospitals is More Prevalent than Expected, Recommends More CMS Oversight and Auditing of Medicare Spending
Oddly, as upcoding severity levels have risen, reported higher-severity inpatient hospital stays have dropped, OIG reported Medicare upcoding fraud is a growing problem for the federal Centers for Medicare and Medicaid Services (CMS). Now, a report from the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) suggests that the practice […] The post OIG Report Indicates Fraudulent Upcoding at Hospitals is More Prevalent than Expected, Recommends More CMS Oversight and Auditing of Medicare Spending appeared first on Dark Daily. (Source: Dark Daily)
Source: Dark Daily - April 5, 2021 Category: Laboratory Medicine Authors: Jude Tags: Coding, Billing, and Collections Compliance, Legal, and Malpractice Laboratory Management and Operations Laboratory News Laboratory Operations Laboratory Pathology Laboratory Testing Management & Operations AI AI in pathology laboratory Source Type: news

Federal programs to assist radiology practices during the pandemic
At around this time last year, we were beginning to learn about the variou...Read more on AuntMinnie.comRelated Reading: Update on Medicare's Quality Payment Program E/M coding and billing for interventional radiology What the new federal law on surprise billing means for radiology Small practices have opportunity for additional provider relief New diagnosis codes related to COVID-19 take effect in 2021 (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - April 5, 2021 Category: Radiology Source Type: news

Research letter: characterization of older adults hospitalized with traumatic brain injury admitted to long-term acute care hospitals - Kumar RG, Zhang W, Evans E, Dams-O'connor K, Thomas KS.
OBJECTIVE: To describe patient, hospital, and geographic characteristics of older adult Medicare beneficiaries hospitalized with traumatic brain injury (TBI) and admitted to long-term acute care hospitals (LTACHs). SETTING: Acute hospital and LTACH facilit... (Source: SafetyLit)
Source: SafetyLit - April 4, 2021 Category: International Medicine & Public Health Tags: Age: Elder Adults Source Type: news

Viewpoint: Here ’s how to get more disabled Texans working
It ’s been more than 30 years since the Americans with Disabilities Act became law, but even with equal protections legally guaranteed, progress for disabled Texans has been mixed. On the one hand, employment for disabled adults in the U.S. fell over the past three decades, leaving many at heightened risk of poverty. On the other, a program new in 1997, now known as Medicare Advantage, has helped expand their health care access. The public generally associates Medicare with senior citizens, but… (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - April 1, 2021 Category: Biotechnology Authors: Dennis Borel Source Type: news

STATdx adds MIPS measures
Radiology decision-support software STATdx is adding measures for Medicare'...Read more on AuntMinnie.comRelated Reading: Infinitt inks deal with Elsevier Elsevier debuts Amirsys upgrades at RSNA 2014 Elsevier acquires education firm Amirsys ASOR members offered discount on STATdx (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - March 31, 2021 Category: Radiology Source Type: news

How can access to CT lung cancer screening be improved?
Researchers are sounding the alarm yet again that access and adherence to C...Read more on AuntMinnie.comRelated Reading: Medicare urged to update lung cancer screening coverage ACR praises USPSTF's lung cancer screening changes USPSTF's new lung cancer screening guidance lowers starting age How useful is shared decision-making for lung cancer screening? IASLC: Screen nonsmokers for lung cancer, too (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - March 31, 2021 Category: Radiology Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services (CMS) is seeking comments on the following information collections: 1) National Implementation of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and 2) Hospice Facility Cost Report Form. Comments are due by June 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - March 31, 2021 Category: Rural Health Source Type: news

SNMMI issues new guidelines on V/Q scans
It may be feasible to resume ventilation/perfusion (V/Q) scans in the U.S. a...Read more on AuntMinnie.comRelated Reading: CMS ends noncoverage of PET infection and inflammation SNMMI confirms Medicare reimbursement error for Cerianna SNMMI, Zionexa call out CMS for reimbursement error SNMMI urges fast-track review of Technegas for V/Q scans SNMMI: Imagers should get COVID-19 shots early (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - March 30, 2021 Category: Radiology Source Type: news

CMS: Medicare, Medicaid, and CLIA Programs; Clinical Laboratory Improvement Amendments of 1988 Exemption of Permit-Holding Laboratories in the State of New York
Notice from the Centers for Medicare and Medicaid Services (CMS) announcing that laboratories located in and licensed by the State of New York that possess a valid permit under the New York State Public Health Law are exempt from the requirements of the Clinical Laboratory Improvement Amendments of 1988 (CLIA) for a period of 6 years. This exemption is effective March 26, 2021, to March 26, 2027. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - March 30, 2021 Category: Rural Health Source Type: news

Update on Medicare's Quality Payment Program
Medicare's Quality Payment Program continues to be modified due to the COVID-1...Read more on AuntMinnie.comRelated Reading: E/M coding and billing for interventional radiology What the new federal law on surprise billing means for radiology Small practices have opportunity for additional provider relief New diagnosis codes related to COVID-19 take effect in 2021 How will MPFS changes affect your radiology practice? (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - March 29, 2021 Category: Radiology Source Type: news

Public Inspection: CMS: Medicare, Medicaid, and Clinical Laboratory Improvement Amendments Programs: Exemption of Permit-Holding Laboratories in New York
Pre-publication notice from the Centers for Medicare and Medicaid Services (CMS) announcing that laboratories located in and licensed by the State of New York that possess a valid permit under the New York State Public Health Law are exempt from the requirements of the Clinical Laboratory Improvement Amendments of 1988 (CLIA) for a period of 6 years. This exemption is effective March 26, 2021, to March 26, 2027. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - March 29, 2021 Category: Rural Health Source Type: news

CMS: CLIA Program; Announcement of the Re-Approval of the College of American Pathologists (CAP) as an Accreditation Organization Under the Clinical Laboratory Improvement Amendments of 1988
Notice from the Centers for Medicare and Medicaid Services (CMS) approving the College of American Pathologists (CAP) as an accreditation organization for clinical laboratories under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) program. The approval is effective March 27, 2021, until March 26, 2027. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - March 29, 2021 Category: Rural Health Source Type: news

CMS: Medicare and Medicaid Programs; Application From the Joint Commission for Continued Approval of Its Hospice Accreditation Program
Notice from the Centers for Medicare and Medicaid Services (CMS) approving the Joint Commission for continued recognition as a national accrediting organization for hospices that wish to participate in the Medicare or Medicaid programs. The approval is effective June 18, 2021, through June 18, 2025. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - March 29, 2021 Category: Rural Health Source Type: news

Spotlight on Policy: Amid COVID-19 CMS Holds Physicians Harmless From Up to 9% of MIPs Penalties
Earlier this year, the Centers for Medicare& Medicaid Services announced it will hold physicians harmless from up to 9% Merit-Based Incentive Payment System (MIPS) penalties due to the significant disruptions of the COVID-19 public health emergency on physician practices ’ performance in 2020. Your MIPS eligibility status is specific to each practice you’re associated with. AMDA – The Society for Post-Acute and Long-Term Care Medicine advocated for this automatic relief from MIPS penalties and applauds CMS for ensuring PALTC clinicians will not be unduly penal ized during the pandemic. (Source: Caring for the Ages)
Source: Caring for the Ages - March 27, 2021 Category: Health Management Source Type: news

You Can ’t Always Get What You Want: Appealing CMS Enforcement Actions
Many of the country ’s 15,400 skilled nursing facilities live in almost mortal fear of a survey that results in enforcement actions by the Centers for Medicare& Medicaid Services. When surveyors determine that noncompliance exists, CMS has a veritable quiver of arrows at its disposal to target the allegedly offending SNF. CMS is authorized by the statute (the Social Security Act) and its implementing regulations at 42 CFR Part 498 to impose one or more “sanctions” (euphemistically referred to as “remedies” but more accurately described as “enforcement actions”) when a SNF is no...
Source: Caring for the Ages - March 27, 2021 Category: Health Management Authors: Alan C. Horowitz Source Type: news

AMDA Establishes Behavioral Health Council
When the Centers for Medicare& Medicaid Services describes the mission of nursing homes, it notes that “each resident must receive and the facility must provide the necessary behavioral health care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being” (42 CFR § 483.40). The majority of residents living in post-acute and long-term care communiti es have one or more psychiatric diagnoses, and all are by definition contending with a major life transition. (Source: Caring for the Ages)
Source: Caring for the Ages - March 27, 2021 Category: Health Management Authors: Richard Juman, Lea Watson Source Type: news