WASHINGTON — Physician groups expressed concerns over what one group called a “substantial” decrease in Medicare fee-for-service physician payments under a final rule for 2023 issued Tuesday by the Centers for Medicare & Medicaid Services (CMS). The 2023 Medicare Physician Fee Schedule includes a 4.5% decrease in the conversion factor — the multiplier that Medicare applies to […]
Today, the U.S. Department of Health and Human Services (HHS), through its Centers for Medicare & Medicaid Services (CMS), is expanding access to behavioral health care, cancer screening coverage, and dental care. The Calendar Year 2023 Physician Fee Schedule (PFS) final rule announced today also promotes innovation and coordinated care in the Medicare program through […]
Healthcare providers, including doctors and therapists who treat nursing home patients, will see a key payment factor cut by 4.4% next year. The Centers for Medicare & Medicaid Services announced the change to the Medicare Physician Pay Schedule conversion factor in a broader physician payment rule published late Tuesday. The conversion factor is part of a […]
The Centers for Medicare & Medicaid Services (CMS) finalized new rules aimed at expanding access to behavioral health for Medicare beneficiaries. On Tuesday, CMS announced it finalized rules that allow for greater flexibility in billing and supervising certain types of providers as well as permanently covering some telehealth services provided in Medicare beneficiaries’ homes. They […]
As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access the healthcare services they need in as safe a manner as possible. In order to provide our clients with quick […]
COVID-19 has exacerbated the nation’s struggle with mental health and substance use disorders (collectively called “behavioral health conditions”), fueling a full-blown crisis. For some Americans during the pandemic, this has meant feeling depressed and hopeless, making it challenging for them to perform everyday tasks. For older Americans and people with disabilities who may have already […]
On November 01, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) final rule that includes changes to the Medicare Shared Savings Program (Shared Savings Program) to advance CMS’ overall value-based care strategy of growth, alignment, and equity. Through the changes we finalized, we seek […]
On November 01, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates and policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2023. The calendar year (CY) 2023 PFS final rule is one of several rules that reflect a broader […]
Today, the U.S. Department of Health and Human Services (HHS), through its Centers for Medicare & Medicaid Services (CMS), is expanding access to behavioral health care, cancer screening coverage, and dental care. The Calendar Year 2023 Physician Fee Schedule (PFS) final rule announced today also promotes innovation and coordinated care in the Medicare program through […]
The Centers for Medicare & Medicaid Services (CMS) has finalized changes in CMS’s annual Physician Fee Schedule (PFS) proposed rule to significantly expand access to behavioral health services and moves the health system closer to achieving equitable outcomes through high quality, affordable, person-centered care. These changes will ensure CMS continues to deliver on our goals […]
The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) found that despite the positive impact of telehealth flexibilities on home health agencies (HHAs), there is a need for further review of the services they provide and the patients it benefits most. As COVID-19 cases grew, so did restrictions on in-person healthcare. This […]
On September 26, the US Government Accountability Office (GAO) released a report titled “Medicare Telehealth: Actions Needed to Strengthen Oversight and Help Providers Educate Patients on Privacy and Security Risks.” The 75-page report describes the utilization of Medicare telehealth services under current pandemic-related waivers, the Centers for Medicare & Medicaid Services (CMS) efforts to identify and monitor risks posed […]
The Congressional Budget Office identified telehealth as one of the tools to help reduce prices paid by commercial health insurers in a recently released policy analysis. The paper noted both positive and potentially negative consequences, something that might not please proponents of the technological efficiency Policies that could decrease costs by regulating price growth, encouraging […]
The U.S. Centers for Medicare & Medicaid Services (CMS) should implement billing codes and quality assessments for telehealth services, according to new recommendations from the Government Accountability Office (GAO). The recommendations include calls for billing modifiers or clarified guidance on audio-only telehealth claims, a quality evaluation methodology for those services, and education programs designed to […]
Recently, the Office of Inspector General (“OIG”) for the Department of Health and Human Services published its Report on Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks (OEI-02-20-00720). OIG’s report describes providers’ billing for telehealth services and identifies ways to safeguard Medicare from fraud, waste and abuse related to telehealth. OIG […]
