MedPAC Holds March 2024 Meeting
On March 7 and 8, 2024, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting, which included the following sessions: Assessing data sources for measuring health…
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Competitive Bidding: A Primer
For suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS, herein referred to as DME, except when referenced by a federal authority) included in Medicare’s competitive bidding…
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CMS Finalizes Disproportionate Share Hospital Third-Party Payer Rule
On February 20, 2024, the Centers for Medicare & Medicaid Services (CMS) released the final “Medicaid Program: Disproportionate Share Hospital Third-Party Payer Rule” to address legislative provisions in…
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CMS Releases Proposed Rule Increasing Oversight of Accrediting Organizations
On February 8, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule, Strengthening Oversight of Accrediting Organizations and Preventing Accrediting Organization Conflict of Interest,…
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Federal efforts to ensure cybersecurity in medical devices
Advances in technology continue to expand the promise and capabilities of medical devices. Previously limited to such basic items as bedpans, bandages, crutches, and wheelchairs, the category now…
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MACPAC holds January 2024 meeting
On January 25 and 26, 2024, the Medicaid and CHIP Payment and Access Commission (MACPAC) held a virtual public meeting, which included the following sessions: Denials and Appeals…
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For 2025, CMS Proposes Changes Resulting in a 3.7% Increase in Plan Payments and Implements Inflation Reduction Act Provisions on Part D Benefit Redesign
The Centers for Medicare & Medicaid Services (CMS) has released its Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and…
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FDA & CMS Indicate Alignment on Regulatory Approach to LDTs
On January 18, 2024, the Food and Drug Administration (FDA) and the Centers for Medicare & Medicaid Services (CMS) communicated an aligned stance on the regulation of laboratory-developed…
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CMS Finalizes Changes to Prior Authorization, Expanding Access to Health Information
On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care…
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MedPAC holds January 2024 meeting
On January 11 and 12, 2024, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting, which included the following sessions: Assessing payment adequacy and updating payments:…
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Making sense of HCPCS
The Healthcare Common Procedure Coding System (HCPCS, pronounced “hix-pix”) maintained by the Centers for Medicare & Medicaid Services (CMS) comprises two medical code sets, HCPCS Level I and…
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Ransomware in Healthcare
On Thanksgiving Day, 2023, Ardent Health Services, which owns and operates 30 hospitals and over 200 sites of care in six states, recognized that it was the victim…
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