Senate Finance Committee Reestablishes Bipartisan Bill Intended For Chronic Care

The Senate Finance Committee has come up with a reintroduction of the bipartisan bill intended to develop care for the chronically ill Medicare population. First introduced in 2015, the bill was not approved and was eventually expired after the adjournment of the 114th Congress. The bill also failed to secure any vote in the Senate during that time. The primary focus of the bill is in the Medicare Advantage (MA) program. It facilitates MA plans in providing with an assortment of supplemental benefits for the chronically ill enrollees starting in 2020. For covering…Read more …

CMS Adds Administrative Simplification Fact Sheet And Infographic On Its Website

The Centers for Medicare and Medicaid Services (CMS) has been actively trying to strengthen their online presence on the topic of HIPAA Administrative Simplification over the last few months. A few months earlier, CMS successfully launched a new website, which was entirely dedicated for Administrative Simplification. The website launched by CMS contains information on covered entities, a FAQ page, and several educational materials on electronic business transaction standards. CMS recently made a few more additions to the website with the sole purpose of improving the understanding of the least-known provision of HIPAA, which…Read more …

Anthem-Cigna Merger Face More Hurdles

Insurance behemoth, Anthem lost their appeal of the February decision of a Federal Judge to block their 54 billion-dollar merger with Cigna. A three-judge panel rejected the appeal by Anthem, and the Department of Justice blocked their merger in the U.S. District Court noting the projected effect of the merger on competition in the market. Anthem claimed that their merger with Cigna would result in administrative efficiencies that can lead to decreased insurance premium for the users. However, neither the U.S. Court of Appeals nor the U.S. District Court agreed with the claims…Read more …

CMS Opens New Mailbox For Beneficiary Notices Initiative

The Medicare program allows the beneficiaries to receive formal notifications concerning the different benefits, denials and coverage status from the providers. The Advance Beneficiary Notices of Non-Coverage and Skilled Nursing Facility are also included along with these notifications. Previously the Congress has issued a law in 2015 called the Notice Act, which has made it compulsory for hospitals for issuing both written and oral notification for informing the patients. This would allow the patients to become well informed whether they are put under observation status, which is different from that being admitted as…Read more …

Federal Hiring Freeze Lifted By Trump But With Orders To Reorganize Agencies

After taking the President’s Office, Donald Trump issued an order, which places a hiring freeze for all the federal agencies. However, in the month of April, the freeze was lifted by President Trump and he proposed a 2% increase in pay for the federal employees in the coming year. He also ordered for a reorganization of all the federal agencies. Yet again, it is not yet clear how this reorganization will look like or affect medical billing and coding companies. President Trump ordered the Office of Management and Budget (OMB) to come up…Read more …

President Trump Appoints New Personnel For Key HHS Positions

Under the tenure of President Donald Trump, some of the key HHS positions are remaining vacant mostly at the subcabinet level. In the Department of Health and Human Services (HHS), hundreds of sub-cabinet level positions remain unfilled even today. A noteworthy position that is yet to be filled is the Director for the Medicare program. However, efforts are being made to fill these positions soon. President Trump recently nominated Brett Giroir for the position of the HHS Assistant Secretary for Health. Currently serving as the President and CEO of the biopharmaceutical company ViraCyte,…Read more …

CMS Sends MIPS Participation Letters To Eligible Clinicians

The Centers for Medicare and Medicaid Services (CMS) had recently announced that the participation letters for the Quality Payment Program (QPP) would be sent to all the Eligible Clinicians starting late April through May. The Medicare Administrative Contractor (MAC), which processes the Medicare Part B claims of clinicians, will send these participation letters. Clinicians were very much upset and confused about the Merit-based Incentive Payment System (MIPS) participation and criteria and these letters will let them know if they have to take part or if they are exempted from MIPS. These participation letters…Read more …

HBMA Testifies On Health Plan IDs

A non-profit, educational resource and advocacy group, the Healthcare Billing & Management Association (HBMA) recently participated in a hearing, which was conducted by the National Committee on Vital and Health Statistics (NCVHS). HBMA actually represents third-party billing professionals and medical billers. The Government Relations Committee Member of HBMA, Dave Nicholson also went on to submit a testimony to the NCVHS Subcommittee regarding standards on the issue of restarting or resuming Health Plan ID implementation during the hearing. The Centers for Medicare and Medicaid Services (CMS) had earlier delayed the implementation of regulations that…Read more …

Congress Announces Bipartisan Agreement On $1.1 Trillion Spending Bill

The Congress has declared a new bipartisan agreement on a compilation of appropriations Bill used to support the government for the rest of the fiscal year. Since the previous year, the Congress has been actively involved in passing short-term Continuing Resolutions (CR) for funding the government. A recently passed CR has expired and the Congress has made a provision by passing a one-week CR for completing the Bill. With this new $1.1 trillion Bill, the overall defense spending, which is one of the main priorities of the Trump Administration, is expected to increase…Read more …

CMS Publishes Final Rule For Stabilizing ACA Exchange Marketplaces

It seemed that Tom Price was eager to oversee the transition of the government away from the Affordable Care Act (ACA) when he was elected as the new Secretary of the Department of Health and Human Services (HHS). Additionally, reports also indicated that he also wanted to implement a new act to replace the ACA. However, Tom Price has actually been trying to stabilize the Healthcare Exchange market of ACA for next year in the first months of his tenure. The Centers for Medicare and Medicaid Services (CMS) recently published a final rule…Read more …