Last week, the Trump administration announced the first mandatory CMS pay model to reign in the cost of prescription drugs. This proposal from the Department of Health & Human Services is a two-step process. One would be to decrease drug rates paid by Medicare Part B by indexing them to be in line with the […]
Controlling Prescription Drug Costs Read More »
The Patient-Centered Evaluation and Management Services Coalition submitted an open letter to Congress in September sharing their concerns over the new proposed 2019 rule. For more on the details of this rule, check out Part 1 and Part 2. Their concerns are not only over the new payment structure but the documentation guidelines as well:
Open Letter to CMS on Proposed E/M Rule Read More »
Trust is something very different for each person. What constitutes trust for you, may not be the same for the other person. Trust has two legs upon which it stands: Leg One: Capabilities Results Track Record Leg Two: Integrity Motives Intent Trust is a cornerstone for relating and communicating more effectively with others. Without it,
We have talked about managing denials in the past, but have rarely gotten payor specific. In this recent article from Healthcaredive.com, they targeted in on Medicare Advantage plans. This stems from an investigation by the HHS Office of Inspector General. They have discovered a high number of overturned denials for Medicare Advantage organizations. Three-fourths between
Medicare Advantage Denials Read More »
Last week saw a push from hospitals to lobby lawmakers about CMS’s proposal for site neutral payments. The site neutral payment proposal would be to pay the same rate for services delivered at off-campus hospital outpatient departments and independent doctor’s offices. According to CMS, they could save $610 million and patients could save $150 million
Pros and Cons of Site Neutral Payments Read More »
