This week’s Medicare updates include draft guidance for the third cycle of the Medicare Drug Price Negotiation Program, the July 2025 HCPCS quarterly update file, and more!
Make sure staff who handle audit requests understand when a missing signature should — or should not — trigger an automatic denial of your claims or prior authorization requests. Recent guidance from CMS clarifies how auditors should proceed when a medical record lacks a signature.
A final rule issued by CMS in February includes several changes to Medicare Advantage (MA) regulations aimed at ensuring health equity, quality, and safety.
Audits are ramping up across the country, creating additional headaches for many healthcare organizations as they simultaneously struggle with the delta variant of COVID-19.
Facing the unprecedented COVID-19 public health emergency, CMS released the 2021 OPPS proposed rule later than ever before, with the agency generally reinforcing its recent focus on site-neutral payment policies, lowering reimbursement for drugs purchased under the 340B program, and adding more services to the list of prior authorization.
