Despite industry concerns, the Centers for Medicare & Medicaid Services (CMS) has finalized the Patient-Driven Groupings Model (PDGM) planned to start in 2020. The agency has also finalized several other changes to how home health providers are reimbursed for their services starting in 2019, tweaking remote patient monitoring rules and refining the Value-Based Purchasing Model […]
By Maria Castellucci | October 31, 2018 The CMS issued a final rule Wednesday that allows home health agencies to bill Medicare for remote patient monitoring. Home health is expected to boom in the coming years as the baby boomers continue to retire. Remote patient monitoring allows providers to collect health information about patients digitally and […]
Beginning Jan. 1, 2020, home health providers will be allowed to build the costs of remote monitoring technology into Medicare reimbursement, according to a new rule finalized by the Centers for Medicare & Medicaid Services on Wednesday. The rule (PDF), which includes a $420 million pay increase for home health agencies next year, would not allow home […]
As previously noted in our Digital Health Mid-Year Review, 2018 has seen greater acceptance of telemedicine within the Medicare program. Both regulatory and statutory changes have expanded reimbursement opportunities and, consequentially, opportunities for the deployment of telemedicine technologies. As we noted then, however, improvement in the Medicare reimbursement environment for telemedicine services has been tied to a […]
CMS is proposing to loosen reimbursement and access restrictions on the use of telehealth and telemedicine in Medicare Advantage plans, giving providers more opportunities to use connected care technology. By Eric Wicklund October 29, 2018 – The Centers for Medicare & Medicaid Services is looking to expand telehealth access for members enrolled in Medicare Advantage plans. […]
Recently, the Centers for Medicare & Medicaid Services (CMS) released their Contract Year (CY) 2020 Medicare Advantage and Part D proposed rule, a wide-ranging proposal that expands access to telehealth in Medicare Advantage, updates the methodology for calculating Medicare Advantage Star Ratings, and makes policy updates to address program integrity. In the proposed rule, CMS […]
Contract Year (CY) 2020 Medicare Advantage and Part D Flexibility Proposed Rule (CMS-4185-P) On October 26, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that updates Medicare Advantage (MA or Part C) and the Medicare prescription drug benefit program (Part D) by promoting flexibility and innovation so that MA and […]
CMS Proposes to Modernize Medicare Advantage, Expand Telehealth Access for Patients Proposed rule would strengthen the popular system for private health insurance plans to provide Medicare coverage, increase plan flexibility to offer telehealth benefits, and improve coordination for dual-eligible beneficiaries In a proposed rule issued today, the Centers for Medicare & Medicaid Services (CMS) took […]
In Depth The Centers for Medicare & Medicaid Services (CMS) released a Notice of Proposed Rulemaking on Friday, October 26, 2018 (the Proposed Rule) addressing expanded telehealth coverage in Medicare Advantage (MA), extrapolation of Risk Adjustment Data Validation (RADV) audit results, and updates to the MA and Part D Quality Star Ratings program, among othertopics. […]
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CMS finalizes calendar year 2019 and 2020 payment and policy changes for Home Health Agencies and Home Infusion Therapy Suppliers On October 26, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule [CMS-1689-F] setting out finalized Calendar Year (CY) 2019 Medicare payment updates, finalized quality reporting changes for home health agencies (HHAs), […]
The Centers for Medicare & Medicaid Services on Friday unveiled a proposal that the agency says will expand telehealth coverage to enrollees in Medicare Advantage plans. Under the proposed rule, which would take effect in calendar year 2020, Medicare Advantage plans could cover telehealth services for both rural and urban enrollees, as well as in-home […]
Please see below for CMS Final Rule Update* CMS has proposed three new codes for RPM services, retitled “Chronic Care Remote Physiologic Monitoring,” which do a far better job reflecting how providers can more effectively and efficiently use RPM technology to monitor and manage patient care needs, including chronic care management. If finalized, these three […]
Oct 17, 2018 Tanya Albert Henry Contributing Writer Reflecting the reality that physicians and their staff spend an increasing amount of time engaging with technology to enhance and improve patient care, the 2019 Current Procedural Terminology (CPT®) code set that takes effect Jan. 1 provides health professionals the codes they need to get paid for […]
The AMA’s new CPT codes streamline virtual care visits, simplifying and incentivizing telehealth services for mainstream clinical practices. Recently, the American Medical Association revealed the 2019 Current Procedural Terminology (CPT) code set. These codes make it possible for physicians and other healthcare providers to bill insurers for services provided to patients. With this year’s changes […]