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 …

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 …

Implementation Of The New Payment Models Delayed By CMS

The Centers for Medicare and Medicaid Services (CMS) has released an Interim Final Rule on March 21, 2017, which delays the effective date of many new Medicare payment models that were developed and introduced by the CMS Innovation Center, along with the introduction of updates to an existing model. To be specific, the Interim Final Rule delays the January 3, 2017 Original Final Rule with the implications that are listed below. Delay of effective dates of 3 episodic payment models until October 1, 2017. These models were designed to test the correctness of…Read more …

HHS And President Trump Work Out Plans To Reduce Pharmaceutical Drug Costs

Dr. Tom Price, the newly elected secretary of Health and Human Services Secretary, recently informed a House appropriations subcommittee that HHS is working on a new plan with President Donald Trump. The primary objective of the new plan is to considerably reduce the price of pharmaceutical drugs. Dr. Price stated that the significant increase in the drug prices is one of the major issues that all the members of the Congress will be targeting. He also added that the agency is planning to put forward a new “bidding” system, which will benefit all…Read more …

Stalled Healthcare Bill Puts Pressure On HHS Secretary

The stalling of the health care bill has put increasing pressure on President Donald Trump and the new Health and Human Services Secretary Tom Price. Together, both of them are presented with the intricate task of managing the law, which remains increasingly unfavorable among most members within the Republican Party itself. In addition, they will also need to pacify the strong Democrat opposition in regards to the stalling of the law.  To prevent a further losing of support, the House GOP leaders have called off a vote recently, which was part a three-pronged…Read more …

CMS Trying To Attract More Doctors And Patients To ACO

Recent reports suggest that the CMS is trying to improve provider and patient participation in Accountable Care Organizations (ACOs). They are planning to improve participation by automating the process to pair patients with the doctors who are participating in the ACO models. This means that in the coming weeks, Medicare beneficiaries will be able to go to a website that has their enrollment details and list their primary care doctor. “ACOs have told us they prefer to know with more certainty at the beginning of the performance year what beneficiaries the CMS will…Read more …

The Expansion Of Bundled Payment Programs Has Been Delayed By The CMS

In the latest move, the Centers for Medicare and Medicaid Services has delayed several bundled payment initiatives. This includes the implementation of cardiac bundled payment initiatives and the expansion of Comprehensive Care for Joint Replacement Model. In addition to that, this new policy from CMS will also extend Cardiac Rehabilitation Incentive Payment Model’s effective date from July 1 to October 1. Reports from several sources also claim that the interim rule from CMS has also delayed the effective date of a final rule for the second time. The effective date for the final…Read more …

Trump’s 2018 Budget Proposes Highest Priority For Medicaid And Medicare Programs

President Donald Trump’s upcoming fiscal budget for 2018 is expected to direct more funds to curtail many of Medicare and Medicaid frauds, wastages, and abuses. It indicates major changes to Medicare, Medicaid, and the Children’s Health Insurance Program. This new proposal in the upcoming budget is made with the intention of focusing the agency resources on the highest priority activities vital for the efficient running of the programs. The proposed fiscal 2018 budget covers the discretionary funding and has requested a sum of $69 for the HHS. This, however, is lower to about…Read more …

Doctors Remain Clueless About MACRA Compliance Requirements

It is reported that doctors are potentially facing loss of millions of dollars in Medicare reimbursement. This is due to the lack of MACRA-related guidance from the CMS, says a letter from the Medical Group Management Association (MGMA) to the CMS. In a final rule that was announced last year, CMS said that they would exempt those physician practices, which have less than thirty thousand dollars in Medicare charges or less than hundred unique Medicare patients every year, from complying with the MIPS plan that is outlined under the MACRA. CMS was supposed…Read more …