This week’s updates include removal of multiple NCDs and the quarterly update to the CCI edits. Click the link above to read more about this week’s updates.
This week’s note is about MLN Matters’ recent “Preventative Services” Educational Tool. Click the link above for more information and an in-depth analysis.
Hackers gained unauthorized access to the information technology system of Anthem, Inc., and exposed the PHI of more than 80 million people who are currently or were previously covered by the insurance provider. The attack also exposed the PHI of Anthem's employees, including President and Chief Executive Officer Joseph R. Swedish.
Historically, the healthcare revenue cycle has been dominated by fee-for-service (FFS) payment arrangements that reimburse providers for the volume of care they provide. These reimbursement models have always been tempered by medical necessity determinations to ensure that the care delivered to patients is in fact medically necessary. Over the past several decades, healthcare costs have been rising precipitously. In response, new payment models have been developed to curb that trend and to deliver more cost-effective care with higher quality and better outcomes.
