When the controversial Medicare Part B Drug Payment Model final rule was not released by the Centers for Medicare & Medicaid Services (CMS) as expected before Nov. 21, it signaled an increasing likelihood of defeat for the proposed rule—a signal proved true on Dec. 15. A spokesperson for the CMS said, “After considering comments, CMS… [Read More]
The ACR and 315 other organizations have publicly said savings would not be achieved by the demonstration project and that it will reduce access to care for patients…... [Read More]
The ACR will seek Congressional action if the Medicare Part B demonstration project proposed by the Centers for Medicare & Medicaid Services (CMS) is not significantly altered by the agency. Today, Medicare Part B generally pays physicians and hospital outpatient departments the average sales price of a drug, plus a 6% add-on, minus reductions required… [Read More]
Based on a request by the ACR Insurance Subcommittee, off-label use of mycophenolate for scleroderma has been added to a Medicare-approved compendium. ... [Read More]
Physicians have three contractual options when it comes to the Medicare program: participating, non-participating and opting out. Providers should keep the old saying “look before you leap” at the forefront when considering opting in or out of the Medicare program. Since 2001, physician costs have been on the rise, with only minimal increases in reimbursements,… [Read More]
2014 marks final year to reap financial benefits for adopting, implementing electronic health record system in physician practice... [Read More]
Although HHS reports no significant changes in Medicare participation for office-based physicians, the numbers may be misleading. (posted Oct. 16, 2013)... [Read More]
The Medicare Payment Advisory Commission (MedPAC) reported to Congress in January that Medicare’s switch to a payment method known as ASP, or Average Sale Price, has reduced spending on drugs in the Medicare Part B program. This system reflects actual market spending, rather than wholesale prices.... [Read More]
According to the 2003 U.S. Census, 29 million people in the United States make less than 200% of the federal poverty level and have no health insurance. Many persons have difficulty affording prescribed medications. In addition to Medicare Part D, there are more than 350 public and private patient assistance programs, including programs by pharmaceutical companies, that help patients pay for prescriptions.... [Read More]
Rheumatology leaders are encouraged by continued implementation of E/M coding changes, telehealth flexibilities and rheumatology-specific MIPS Value Pathway, but have concerns regarding conversion factor reductions and the CMS EHR interoperability and digital quality measures proposal.... [Read More]