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Articles tagged with "Centers for Medicare & Medicaid Services (CMS)"

U.S. Government Website for Comparing Doctors Lacks Data

Lisa Rapaport  |  

(Reuters Health)—Physician Compare, a U.S. website created to help patients find high-quality doctors, is missing so much information on individual providers that it may not be helpful, a new study suggests. Quality reporting has been a work in progress for almost three decades since a landmark 1999 report from the Institute of Medicine, ‘To Err…

Med Student Documentation Guidelines Need Careful Implementation

Will Boggs, MD  |  

NEW YORK (Reuters Health)—New student-documentation guidelines from the Centers for Medicare and Medicaid Services (CMS) require careful implementation to avoid reductions in meaningful teaching physician involvement, according to a new report. The revised Medicare Claims Processing Manual allows the teaching physician to verify in the medical record any student documentation of services, rather than re-documenting…

Reminder: How to Handle Part D Prior Authorization Requests

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Note: Although originally posted in January 2018, the advice below remains valid. We see this issue recur each year. As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B,…

Year in Review: The Impact of Advocacy & RheumPAC in 2018

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In 2018, did you interact with the Medicare payment system, receive payment for a consultation code or worry about the Centers for Medicaid & Medicare Services (CMS) reducing reimbursement through its proposal to combine evaluation and management codes in the Physician Fee Schedule? If your answer to any of those questions is yes, then you…

2019 Changes to E/M Documentation

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As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…

CMS Proposes New Part B Drug Payment Model

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Late last month, the Centers for Medicare & Medicaid Services (CMS) released an advance notice of proposed rulemaking (ANPRM), seeking feedback on a potential drug pricing model called the International Pricing Index (IPI) model. This comment solicitation is in alignment with the administration’s blueprint to lower drug costs and reduce out-of-pocket costs, and is an…

U.S. to Boost Drug Price Negotiation in Medicare Advantage Health Plans

Reuters Staff  |  

(Reuters)—The Trump administration said on Tuesday it would give Medicare Advantage health plans for the elderly new tools to negotiate for lower prescription drug prices. The Centers for Medicare and Medicaid Services (CMS) said Medicare Advantage plans will be allowed to require that patients first try certain lower-cost drugs before moving to a more expensive…

ACR Leads Fight Against Proposed Reimbursement Cuts to E/M Services

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On July 12, the Centers for Medicare and Medicaid Services (CMS) issued its proposed plan for changes to the Medicare Physician Fee Schedule for 2019.1 Citing the need to reduce paperwork and improve patient care, the CMS detailed a number of changes to payments physicians receive from Medicare that could have a significant impact on…

ACR Seeks CMS Exemption to Perform Synovial Fluid Crystal Analysis

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Marcus Snow, MD, is a rheumatologist in a multispecialty clinic in Nebraska. During the average day, the nephrologist in his clinic can assess urinary sediment. The urologist can examine semen specimens for viability. However, despite clinical training and competency, Dr. Snow and his rheumatology colleagues cannot perform synovial fluid crystal analysis for their patients. The…