CMS announced revised pricing for covered drugs and biologicals in the July 2018 update to the OPPS. Hospitals should thoroughly review all of the updates to ensure any required changes are in place by the stated effective dates.
Healthcare providers are often confused about what a commercial or managed care payer would want in order to approve the claim. Much of this confusion comes from the timing of requirements to ensure reimbursement.
Predicting CMS policies can be a foolhardy exercise, especially with a relatively new administration and frequent turnover at the highest levels of HHS over the last year. But it’s safe to say drug payment policy has been and will continue to be a focus of the current regime.
This week’s Medicare updates include corrections to the 2018 Quality Payment Program final rule, two OIG reviews on issues related to Round 2 of the Competitive Bidding Program, the quarterly update to Part B drug pricing files, and more!
