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This week’s Medicare updates include additions to the OIG Work Plan, draft guidance on the new Medicare Prescription Payment Plan, and more!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

November 9, 2022
Medicare Insider

This week’s Medicare updates include the CY 2023 Medicare Physician Fee Schedule final rule, the CY 2023 Outpatient Prospective Payment System final rule, the corrections for the FY 2023 Inpatient Prospective Payment System final rule, and more!

November 2, 2022
Medicare Insider

This week’s Medicare updates include the implementation of enrollment and eligibility changes for Medicare as required by the Consolidated Appropriations Act of 2021, revised guidance on staff vaccination requirements, a change to the October 2022 update of the Ambulatory Surgical Center Payment System, and more! 

October 26, 2022
Medicare Insider

This week’s Medicare updates include new items added to the OIG Work Plan, an extension for certain payment rate adjustments for low volume and Medicare dependent hospitals, and more!

October 19, 2022
Medicare Insider

This week’s Medicare updates include a notice about how CMS is planning to handle payments for 340B drugs for the rest of the year, an update to the ambulance inflation factor for 2023, the notice of the new interest rate for Medicare overpayments and underpayments, and more!

October 12, 2022
Medicare Insider

This week’s Medicare updates include a fact sheet on changes to Medicare policies due to the Inflation Reduction Act, an updated list of lab tests subject to exception from the lab date of service policy, a request for information, and more! 

October 5, 2022
Medicare Insider

This week’s Medicare updates include the October 2022 update to the Outpatient Prospective Payment System, updates to the OIG Work Plan, an analysis of telehealth service compliance risks, and more!

September 28, 2022
Medicare Insider

This week’s Medicare updates include a revised MLN booklet on chronic care management services, the October 2022 update of the Ambulatory Surgical Center Prospective Payment System, an OIG review of Part B overpayments, and more!

September 20, 2022
Medicare Insider

This week’s Medicare updates include two updates to the OIG work plan, an updated emergency use authorization for the Pfizer and Moderna vaccines, details about a MEDCAC meeting to examine the requirements for clinical studies submitted for CMS coverage under Coverage with Evidence Development, and more! 

September 14, 2022
Medicare Insider

This week’s Medicare updates include the October update of the OPPS, the October I/OCE update, a revision to the manual regarding inpatient Part B services, and more!

September 7, 2022
Medicare Insider

This week’s Medicare updates include new information on billing for the Novavax vaccine, updates to COVID-19 emergency declaration blanket waiver details, an analysis of telehealth use for opioid use disorder during the pandemic, and more!

August 31, 2022
Medicare Insider

This week’s Medicare updates include updates to the manual regarding new payer only codes, information on a preliminary injunction against EMTALA guidance issued in July, the materials and recording from the August 2022 HOP Panel Meeting, and more!

August 24, 2022
Medicare Insider

This week’s Medicare updates include a blog post on CMS plans to wind down COVID-19 PHE waivers, a press release about the discontinuation of certain forms, the annual update to the clotting factor furnishing fee, and more!

August 17, 2022
Medicare Insider

This week’s Medicare updates include a notice about the suspension of prior authorization for certain DMEPOS items, an update on billing for one of the COVID-19 monoclonal antibody treatments, the quarterly update to the clinical laboratory fee schedule, and more!

August 10, 2022
Medicare Insider

This week’s Medicare updates include the FY 2023 IPPS Final Rule, a request for information on improving Medicare Advantage, an implementation transmittal for the updates to the Inpatient Psychiatric Facility Prospective Payment System, and more!

August 3, 2022
Medicare Insider

This week's Medicare updates include the FY 2023 Skilled Nursing Facility Prospective Payment System final rule, the FY 2023 Inpatient Psychiatric Hospital Prospective Payment System final rule, the FY 2023 Hospice Payment Rate Update final rule, and more!

July 27, 2022
Medicare Insider

This week’s Medicare updates include the renewal of the COVID-19 PHE for another 90 days, three new items added to the OIG Work Plan, billing information for the COVID-19 Novavax vaccine, and more!

July 20, 2022
Medicare Insider

This week’s Medicare updates include the 2023 OPPS Proposed Rule, a report to Congress on a potential unified payment system for post-acute care, a reminder about required services under EMTALA, and more!

July 13, 2022
Medicare Insider

This week’s Medicare updates include the CY 2023 Physician Fee Schedule Proposed Rule, a proposed decision memo for changes to cochlear implant coverage, updates to interpretive guidelines for infection prevention and antibiotic stewardship programs, and more!

July 13, 2022
Medicare Insider

This week’s Medicare updates include the CY 2023 Physician Fee Schedule Proposed Rule, a proposed decision memo for changes to cochlear implant coverage, updates to interpretive guidelines for infection prevention and antibiotic stewardship programs, and more!

June 29, 2022
Medicare Insider

This week’s Medicare updates include the 2023 Home Health Prospective Payment System proposed rule, the 2023 End Stage Renal Disease Prospective Payment System proposed rule, updated EUAs for the Pfizer and Moderna COVID-19 vaccines, and more!

June 22, 2022
Medicare Insider

This week’s Medicare updates include the ICD-10-CM files for FY 2023, a new item for the OIG Work Plan, a revision to the July 2022 update to the OPPS, and more!

June 15, 2022
Medicare Insider

This week's Medicare updates include the Spring 2022 Semiannual Report to Congress, an update for Not Otherwise Classified codes for NCDs, the July 2022 update of the Ambulatory Surgical Center Payment System, and more!

June 8, 2022
Medicare Insider

This week’s Medicare updates include a revision to a transmittal on place of service codes for telehealth, an OIG review of outpatient outlier payments, updates to a handful of chapters in the Claims Processing Manual, and more!

June 1, 2022
Medicare Insider

This week’s Medicare updates include the July 2022 update to the Outpatient Prospective Payment System, the withdrawal of the SUNSET final rule, an updated memo on reporting COVID-19 data for hospitals and critical access hospitals, and more!

May 25, 2022
Medicare Insider

This week’s Medicare updates include new items added to the OIG Work Plan, an announcement about a redesign of the Medicare.gov website, a revised transmittal regarding changes to certain NCDs, and more!

May 18, 2022
Medicare Insider

This week’s Medicare updates include a proposed decision memo modifying an NCD on home use of oxygen, an OIG report on adverse events in hospitals, the quarterly update to the Medicare Physician Fee Schedule database, and more!

May 11, 2022
Medicare Insider

This week’s Medicare updates include the quarterly update to the clinical laboratory fee schedule, the quarterly update to the ESRD PPS, changes to the manual regarding pneumococcal vaccines, and more!

May 4, 2022
Medicare Insider

This week’s Medicare updates include a proposed rule implementing certain provisions of the Consolidated Appropriations Act of 2021, a final rule for the CY 2023 policy and technical changes to Medicare Advantage and Part D plans, three OIG advisory opinions, and more!

April 27, 2022
Medicare Insider

This week’s Medicare updates include the CY 2023 IPPS proposed rule, a data report on hospital and nursing home ownership, and more!

April 20, 2022
Medicare Insider

This week’s Medicare updates include the FY 2023 SNF PPS Proposed Rule, the renewal of the COVID-19 PHE, updated code descriptors for the Prior Authorization for Certain Hospital Outpatient Department Services program, and more!

April 13, 2022
Medicare Insider

This week’s Medicare updates include the quarterly Medicare Provider Compliance Newsletter, the rescinding of some of the COVID-19 PHE waivers, the 2023 Medicare Advantage and Part D Rate Announcement, and more!

April 6, 2022
Medicare Insider

This week’s Medicare updates include the 2023 Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) proposed rule, the 2023 Inpatient Rehabilitation Facility PPS proposed rule, the 2023 Hospice Payment Rate Update proposed rule, and more! 

March 30, 2022
Medicare Insider

This week’s Medicare updates include the April update for the OPPS, the April update for the Ambulatory Surgical Center Payment System, a revision to the Program Integrity Manual to clarify information regarding provider enrollment, and more!

March 23, 2022
Medicare Insider

This week’s Medicare updates include new additions to the OIG Work Plan, an advisory opinion on subsidizing items in a clinical trial, an OIG data brief on telehealth use, and more!

March 16, 2022
Medicare Insider

This week’s Medicare updates include the April 2022 update for the IPPS, a correction for claims processing when osteoporosis drugs are billed for other indications, the April 2022 update for the DMEPOS fee schedule, and more! 

March 9, 2022
Medicare Insider

This week’s Medicare updates include CLIA guidance for temporary testing sites, an NCA on cochlear implantation, an update to manual language regarding critical care E/M services, and more!

March 2, 2022
Medicare Insider

This week’s Medicare updates include an OIG review of bariatric surgery, an announcement on a redesigned ACO for 2023, the quarterly update to the ESRD prospective payment system, and more!

February 23, 2022
Medicare Insider

This week’s Medicare updates include new additions to the FAQ on Medicare fee-for-service billing during the COVID-19 PHE, updates to the OIG work plan, changes to NCDs, and more!

February 9, 2022
Medicare Insider

This week’s Medicare updates include an update to the ICD-10-CM Coding Guidelines, the 2023 Medicare Advantage and Part D Advance Notice, additional FAQs on nursing home visitation, and more!