December 4, 2024
Medicare Insider

This week’s Medicare updates include a final rule on the Increasing Organ Transplant Access model, the 2026 Medicare Advantage and Part D proposed rule, and more!

November 27, 2024
Medicare Insider

This week’s Medicare updates include OIG compliance program guidance for nursing facilities, a new local coverage determination, and more!

November 20, 2024
Medicare Insider

This week’s Medicare updates include a fact sheet on improper payment data for FY 2024, a report on rural-urban health disparities, and more!

November 13, 2024
Medicare Insider

This week’s Medicare updates include a fact sheet on 2025 premiums and deductibles, an OIG report on compliance with the hospital price transparency rule, and more!

November 6, 2024
Medicare Insider

This week’s Medicare updates include the 2025 MPFS and OPPS final rules, an MLN Fact Sheet on prohibited billing of Qualified Medicare Beneficiaries, and more!

October 30, 2024
Medicare Insider

This week’s Medicare updates include a memorandum on revised Conditions of Participation for reporting acute respiratory illnesses, an OIG report on improper Medicare Part D payments, and more!

October 23, 2024
Medicare Insider

This week’s Medicare updates include open enrollment tools and resources, additions to the OIG’s Work Plan, and more!

October 16, 2024
Medicare Insider

This week’s Medicare updates include a fact sheet on coverage of the JYNNEOS vaccine series, a request for information on the Medicare $2 Drug List Model, and more!

October 9, 2024
Medicare Insider

This week’s Medicare updates include accelerated and advance payments for providers and suppliers impacted by Hurricane Helene, a new national coverage determination final decision memo, and more!

October 2, 2024
Medicare Insider

This week’s Medicare updates include additional resources and flexibilities following Hurricane Helene, a revised MLN booklet on evaluation and management services, and more!

September 25, 2024
Medicare Insider

This week’s Medicare updates include the COVID-19 vaccine prices for the 2024-2025 season, an updated MLN fact sheet on disproportionate share hospitals, and more!

September 11, 2024
Medicare Insider

This week’s Medicare updates include a revised memorandum on rural emergency hospitals, suspended prior authorization requirements for certain osteogenesis stimulator HCPCS codes, and more!

September 4, 2024
Medicare Insider

This week’s Medicare updates include a new ABN form for skilled nursing facilities, a revised MLN Booklet on mental health services, and more!

August 28, 2024
Medicare Insider

This week’s Medicare updates include a favorable OIG Advisory Opinion, revised coding guidance for NCD 110.23, and more!

August 21, 2024
Medicare Insider

This week’s Medicare updates include an OIG report on improper payments for mechanical ventilation claims, new influenza vaccine payment allowances, and more!

August 14, 2024
Medicare Insider

This week’s Medicare updates include several new guidance documents on the Medicare Coverage Database, resources and flexibilities available in response to Hurricane Debby, and more!

August 7, 2024
Medicare Insider

This week’s Medicare updates include the 2025 IPPS final rule, the 2025 SNF PPS final rule, and more!

July 31, 2024
Medicare Insider

This week’s Medicare updates include two new OIG Advisory Opinions, a CMS fact sheet on recent improvements to oral healthcare policies across programs, and more!

July 24, 2024
Medicare Insider

This week’s Medicare updates include the 2025 ICD-10-CM files, new additions to the OIG Work Plan, and more!

July 17, 2024
Medicare Insider

This week’s Medicare updates include the 2024 OPPS and MPFS proposed rules, resources and flexibilities available to those impacted by Hurricane Beryl, and more!

July 10, 2024
Medicare Insider

This week’s Medicare updates include a final rule on disincentives for information blocking, a proposed rule on significant, anomalous, and highly suspect billing within accountable care organizations, and more!

July 3, 2024
Medicare Insider

This week’s Medicare updates include the 2025 Home Health Prospective Payment System proposed rule, a list of Part B drugs with a lower coinsurance for next quarter, and more!

June 26, 2024
Medicare Insider

This week’s Medicare updates include a final rule on Part D health information technology standards, an FAQ on hospital price transparency requirements commencing July 1, and more!

June 12, 2024
Medicare Insider

This week’s Medicare updates include the OIG’s latest semiannual report to Congress, the third quarter NCCI edit files, and more!

June 5, 2024
Medicare Insider

This week’s Medicare updates include an OIG report on Medicare vulnerabilities related to off-the-shelf orthotic braces, a revised MLN Fact Sheet on swing bed services, and more!

May 29, 2024
Medicare Insider

This week’s Medicare updates include a new method for launching EMTALA complaints, the July 2024 quarterly update to the HCPCS file, and more!

May 22, 2024
Medicare Insider

This week’s Medicare updates include additions to the OIG Work Plan, clarification on several provider enrollment topics, and more!

May 15, 2024
Medicare Insider

This week’s Medicare updates include a proposed rule on the Increasing Organ Transplant Access payment model, a resource on Part B drug payment limits, and more!

May 8, 2024
Medicare Insider

This week’s Medicare updates include draft guidance on the Medicare Drug Price Negotiation Program, enhancements to home health consolidated billing edits, and more!

May 1, 2024
Medicare Insider

This week’s Medicare updates include a final rule on long-term care facility staffing standards, an implementation date extension for the hospice certifying requirement, and more!

April 24, 2024
Medicare Insider

This week’s Medicare updates include a new CMS initiative aimed at addressing climate change in the healthcare industry, a fact sheet on potential coverage changes for HIV PrEP drugs, and more!

April 17, 2024
Medicare Insider

This week’s Medicare updates include the FY 2025 IPPS proposed rule, new COVID-19 monoclonal antibody codes, and more!

April 10, 2024
Medicare Insider

This week’s Medicare updates include the CY 2025 Medicare Advantage and Part D final rule, two OIG reports on nursing home facility-initiated discharges, and more!

April 3, 2024
Medicare Insider

This week’s Medicare updates include the FY 2025 Inpatient Rehabilitation Facility PPS proposed rule, the FY 2025 Skilled Nursing Facility PPS proposed rule, and more!

March 27, 2024
Medicare Insider

This week’s Medicare updates include a new payment model for Accountable Care Organizations, the April 2024 OPPS update, and more!

March 20, 2024
Medicare Insider

This week’s Medicare updates include an FAQ on accelerated and advance payments related to the Change Healthcare cyberattack, additions to the OIG Work Plan, and more!

March 13, 2024
Medicare Insider

This week’s Medicare updates include an evaluation report on the Primary Care First model, a final decision memo on NCD 110.23, and more!

March 6, 2024
Medicare Insider

This week’s Medicare updates include guidance on the new Medicare Prescription Payment Plan, an OIG report on nursing home care during the COVID-19 pandemic, and more!

February 28, 2024
Medicare Insider

This week’s Medicare updates include a new OIG webpage on Single Audits, additions to several MLN booklets and fact sheets, and more!

February 21, 2024
Medicare Insider

This week’s Medicare updates include additions to the OIG Work Plan, draft guidance on the new Medicare Prescription Payment Plan, and more!

February 14, 2024
Medicare Insider

This week’s Medicare updates include a proposed rule on Accrediting Organizations, a memorandum on texting patient information and patient orders, and more!

February 7, 2024
Medicare Insider

This week’s Medicare updates include the 2025 Medicare Advantage and Part D advance notice, new CPT codes for RSV vaccine administration, and more!

January 31, 2024
Medicare Insider

This week’s Medicare updates include billing instructions for opioid use disorder treatment services, a reopened comment period on the federal independent dispute resolution process, and more!

January 24, 2024
Medicare Insider

This week’s Medicare updates include a new behavioral health model, data on the Acute Hospital Care at Home initiative, a final rule on interoperability and prior authorization, and more!

January 17, 2024
Medicare Insider

This week’s Medicare updates include a new physician specialty code for epileptologists, the final evaluation report for the Next Generation Accountable Care Organization Model, and more!

January 10, 2024
Medicare Insider

This week’s Medicare updates include a revalidation list data set, revisions to two vaccine webpages, several OIG Advisory Opinions, and more!

January 3, 2024
Medicare Insider

This week’s Medicare updates include instructions on new condition code 92, a proposed rule on new appeal processes for certain beneficiaries, and more!

December 20, 2023
Medicare Insider

This week’s Medicare updates include revised guidance for the Medicare Prescription Drug Inflation Rebate Program, information on global surgery package requirements, and more!

December 13, 2023
Medicare Insider

This week’s Medicare updates include a revised FAQ on the JW and JZ modifiers, the 2024 NCCI Policy Manual, new CPT codes for RSV vaccine administration, and more!

December 6, 2023
Medicare Insider

This week’s Medicare updates include implementation information for the Making Care Primary model, the latest edition of the OIG’s Semiannual Report to Congress, and more!

November 29, 2023
Medicare Insider

This week’s Medicare updates include a repository for hospital price transparency resources, clarification on the monthly facility amount and provider reporting period for rural emergency hospitals, and more!

November 15, 2023
Medicare Insider

This week’s Medicare updates include a proposed rule on Medicare Advantage, general compliance program guidance from the OIG, and more!

November 8, 2023
Medicare Insider

This week’s Medicare updates include the 2024 Medicare Physician Fee Schedule final rule, the 2024 Outpatient Prospective Payment System final rule, and more!

November 1, 2023
Medicare Insider

This week’s Medicare updates include new FAQs on JW and JZ modifiers, a draft copy of the 2024 End-Stage Renal Disease Prospective Payment System final rule, and more!

October 18, 2023
Medicare Insider

This week’s Medicare updates include website additions on preventive service codes and compliance tips, the 2024 premiums and deductibles for Medicare Parts A and B, and more!

October 11, 2023
Medicare Insider

This week’s Medicare updates include correction notices for several final rules, an action plan for sickle cell disease, coding instructions for the Novavax COVID-19 vaccine, and more!

October 4, 2023
Medicare Insider

This week’s Medicare updates include the 2024 premiums and deductibles for Medicare Advantage and Part D Prescription Drug plans, an OIG review of home health services furnished via telehealth, and more!

September 27, 2023
Medicare Insider

This week’s Medicare updates include a psychotherapy for crisis Web page, a memorandum on Nursing Home Care Compare staffing and quality measures, and more!

September 20, 2023
Medicare Insider

This week’s Medicare updates include CMS' list of Part B drugs with lower coinsurance, quarterly NCCI edits, updates to the OIG Work Plan, and more!

September 13, 2023
Medicare Insider

This week’s Medicare updates include an OIG report on nursing home emergency preparedness and safety standards, instructions for processing services during disenrollment from the Program of All-Inclusive Care for the Elderly, and more!

September 6, 2023
Medicare Insider

This week’s Medicare updates include an OIG featured topic page regarding managed care, the first 10 Part D drugs selected for price negotiation under the Inflation Reduction Act, and more!

August 30, 2023
Medicare Insider

This week’s Medicare updates include information on systematic validation edits for OPPS providers with multiple service locations, draft guidance on the new Medicare Prescription Payment Plan, and more!

August 23, 2023
Medicare Insider

This week’s Medicare updates include additions to the OIG's Work Plan, COVID-19 vaccine CPT code updates, influenza vaccine payment allowances, and more!

August 16, 2023
Medicare Insider

This week’s Medicare updates include information about a new place of service code, details about a claims processing error for outpatient rehab claims, an OIG review about organ procurement organizations’ overhead costs, and more! 

August 9, 2023
Medicare Insider

This week’s Medicare updates include the 2024 IPPS final rule, the 2024 Skilled Nursing Facility PPS final rule, a new dementia care model, and more!

August 2, 2023
Medicare Insider

This week’s Medicare updates include the 2024 Inpatient Rehabilitation Facility Prospective Payment System final rule, the 2024 Hospice Payment Rate Update final rule, and more!

July 26, 2023
Medicare Insider

This week’s Medicare updates include additions to the OIG’s Work Plan, a request for information on an episode-based payment model, guidance on pre-entitlement billing, and more!

July 19, 2023
Medicare Insider

This week’s Medicare updates include the 2024 OPPS proposed rule, the 2024 MPFS proposed rule, a Medicare dental coverage webpage, and more!

July 12, 2023
Medicare Insider

This week’s Medicare updates include FY 2024 ICD-10-CM codes and coding guidelines, a proposed rule on the 340B drug pricing program, guidance on telehealth services, and more!

July 5, 2023
Medicare Insider

This week’s Medicare updates include the CY 2024 End-Stage Renal Disease Prospective Payment System proposed rule, a fact sheet on the Enhancing Oncology Model, and more!

June 28, 2023
Medicare Insider

This week’s Medicare updates include guidance on the Transitional Coverage for Emerging Technologies pathway, the July 2023 versions of the OPPS Addendum A and B files, and more!

June 21, 2023
Medicare Insider

This week’s Medicare updates include a report on national health expenditure projections, additions to the OIG’s Work Plan, tools for lowering prescription drug costs for low-income seniors and people with disabilities, and more!

June 14, 2023
Medicare Insider

This week’s Medicare updates include a revised fact sheet on Part D vaccines, billing guidelines for gender-specific services, a one-time change to the annual average 96-hour patient length of stay calculation for CAHs, and more!

June 7, 2023
Medicare Insider

This week’s Medicare updates include a final rule on COVID-19 vaccination requirements for healthcare staff, guidance on modifier -JZ, coverage guidelines for Alzheimer’s drugs, and more!

May 31, 2023
Medicare Insider

This week’s Medicare updates include changes to COVID-19 vaccine codes, the July 2023 update to the ASC Payment System, instructions for the MPFS look-up tool, and more!

May 24, 2023
Medicare Insider

This week’s Medicare updates include the July 2023 update to the Outpatient Prospective Payment System, educational materials on payment provisions for dental services, and more!

May 17, 2023
Medicare Insider

This week’s Medicare updates include post-public health emergency guidance, an index for previous COVID-19 waivers, and more!

May 10, 2023
Medicare Insider

This week’s Medicare updates include guidance on the COVID-19 public health emergency conclusion, the quarterly update to the Clinical Laboratory Fee Schedule, and more!

May 3, 2023
Medicare Insider

This week’s Medicare updates include an FAQ on the PHE conclusion, a fact sheet on hospital price transparency enforcement updates, HCPCS application summaries and coding recommendations, and more! 

April 26, 2023
Medicare Insider

This week’s Medicare updates include two additions to the OIG’s Work Plan, the publication of Medicare-certified hospice and home health agency ownership data, and more!

April 19, 2023
Medicare Insider

This week’s Medicare updates include the FY 2024 IPPS proposed rule, resources for the COVID-19 public health emergency conclusion, and more!

April 12, 2023
Medicare Insider

This week’s Medicare updates include the FY 2024 Inpatient Rehabilitation Facility Prospective Payment System proposed rule, the FY 2024 Hospice Payment Rate Update proposed rule, and more!

April 5, 2023
Medicare Insider

This week’s Medicare updates include an OIG featured topics page for hospice, revisions to the April 2023 OPPS update, clarification on how the national emergency differs from the PHE, and more!

March 29, 2023
Medicare Insider

This week’s Medicare updates include an OIG review of payments for spinal facet-joint interventions, revisions to the April 2023 update to the ASC Payment System, and more!

March 22, 2023
Medicare Insider

This week’s Medicare updates include a correction to the Physician Fee Schedule regarding time thresholds for reporting code G0316, a fact sheet regarding billing procedures for Medicare beneficiaries with open Medicare Secondary Payer records, the quarterly update to the ambulatory surgical center payment system, and more! 

March 15, 2023
Medicare Insider

This week’s Medicare updates include the April 2023 update to the OPPS, the April 2023 update to the I/OCE, OIG information on the end of certain COVID-19 PHE flexibilities, and more!

March 8, 2023
Medicare Insider

This week’s Medicare updates include a fact sheet on the end of the COVID-19 PHE, a fact sheet on changes to advance care planning, an OIG review of payments for definitive drug testing services, and more! 

March 1, 2023
Medicare Insider

This week’s Medicare updates include the extension of a publication date for a final rule on potential civil monetary penalties for failure to meet Medicare secondary payer reporting obligations, additional information on the end of the COVID-19 PHE, an implementation transmittal for additional sections of the Consolidated Appropriations Act and Further Continuing Appropriations and Extensions Act, and more! 

February 22, 2023
Medicare Insider

This week’s Medicare updates include details on billing for insulin ahead of the new coinsurance cap, updates to the OIG work plan, information on new drug pricing models, and more!

February 15, 2023
Medicare Insider

This week's Medicare updates include changes to the manual to add in clarification about payment for vaccines at critical access hospitals, updates to the manual pertaining to billing changes from CY 2020 and CY 2021 final rules, and more!

February 8, 2023
Medicare Insider

This week’s Medicare updates include the 2024 Medicare Advantage Advance Notice, resources on waivers that will end with the PHE in May, a correction to instructions on split-shared billing, and more!

February 1, 2023
Medicare Insider

This week’s Medicare updates include new versions of the MOON and IMM/DND forms, the 2023 update to the therapy code list, guidance for facilities transitioning to rural emergency hospitals, and more!

January 25, 2023
Medicare Insider

This week's Medicare updates include an FAQ on the JW/JZ modifiers, a revised version of the January 2023 OPPS update transmittal, new items on the OIG Work Plan, and more!

January 11, 2023
Medicare Insider

This week’s Medicare updates include the April quarterly update to the ICD-10-CM codes and guidelines, a correction notice for the 2023 OPPS final rule, an updated list of lab tests subject to exceptions from the lab date of service policy, and more!

January 4, 2023
Medicare Insider

This week’s Medicare updates include guidance on using the 340B modifier in relation to the Part B inflation rebate, the January 2023 update to the ASC payment system, provider education on prior authorization for facet joint interventions, and more!

December 23, 2022
Medicare Insider

This week’s Medicare updates include additional corrections to the FY 2023 IPPS final rule, new items for the OIG Work Plan, a proposed rule on Medicare Advantage changes, and more!

December 14, 2022
Medicare Insider

This week’s Medicare updates include the January 2023 OPPS update transmittal, a proposed rule on interoperability and improving prior authorization processes, billing instructions for home or residence services, and more! 

December 7, 2022
Medicare Insider

This week’s Medicare updates include instructions on billing CAR T-Cell therapy in a physician office, revisions to an MLN booklet on Medicare coverage for power mobility devices, an implementation transmittal for the FY 2023 IPPS, and more! 

November 30, 2022
Medicare Insider

This week’s Medicare updates include an OIG review on compliance with Medicare regulations for billing advance care planning services, an update to the cost report for independent renal dialysis facilities, and more! 

November 16, 2022
Medicare Insider

This week’s Medicare updates include the 2023 update to the KX modifier threshold amounts, revisions to language in the Medicare Claims Processing Manual regarding instructions for billing hospital Part B inpatient services, enrollment application information for rural emergency hospitals, and more!