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

CMS Announces 90% Cut to Obamacare’s Advertising Budget

Reuters Staff  |  

WASHINGTON (Reuters)—The U.S. Centers for Medicare and Medicaid Services (CMS) said on Thursday it plans to spend $10 million on advertising for the upcoming Obamacare open enrollment period that starts in November, a sharp cut from the $100 million spent last year. The agency also said it will cut funding for so-called navigators, who help…

The Important Role of the AMA RVS Update Committee in Medicare Payments

Timothy J. Laing, MD  |  

Believe it or not, change begins with one person willing to lead by example—and you can be that person. All too often, we get caught up with the changes we want. However, instead of talking about what we would like, it’s time to lead. The best way to do this is to show others you’re…

How to Document a Patient’s Medical History

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The levels of service within an evaluation and management (E/M) visit are based on the documentation of key components, which include history, physical examination and medical decision making. The history component is comparable to telling a story and should include a beginning and some form of development to adequately describe the patient’s presenting problem. To…

CMS Notifying Clinicians of Their MIPS Status

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According to the Centers for Medicare & Medicaid Services (CMS), the Medicare Administrative Contractors (MACs) that process Medicare Part B claims have begun informing providers of their participation status in the Merit-Based Incentive Payment System (MIPS). This information is coming in the form of hard-copy letters that started mailing in late April and will continue…

Trump Administration Proposes Stricter Obamacare Rules

Caroline Humer  |  

NEW YORK—The Trump administration on Wednesday proposed changes to the Obamacare individual insurance market that insurers welcomed as a good start but that others pointed out could raise out-of-pocket cost for consumers. President Donald Trump and congressional Republicans have promised to scrap the 2010 healthcare law that is a key legacy of Democrat Barack Obama’s…

OIG Releases 2017 Work Plan: A Summary

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Each fall, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) puts out its Work Plan for the upcoming fiscal year to summarize its initiatives and priorities for new and ongoing work of HSS programs. Below is a summary of the key areas the OIG will focus on in 2017: Drug…

Pfizer Announces Medicare Reimbursement for Inflectra (infliximab-dyyb), the First Biosimilar Monoclonal Antibody Available in the United States

Pfizer  |  

On Jan. 6, Pfizer Inc. announced that the Centers for Medicare and Medicaid Services (CMS) has included payment information for INFLECTRA (infliximab-dyyb), a biosimilar to REMICADE (infliximab), in its January Average Selling Price (ASP) pricing file. This pricing took effect as of January 1, 2017. Additional claims processing information is listed in the MLN Matters…

New Physician Payment Reforms Highlight Need for Quality Coding, Accurate Documentation

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To be an effective practice owner, it is necessary to understand the financial circumstances and environment of the practice’s operation. Well-managed practices prevent the loss of time and money. Therefore, to improve productivity and operating efficiencies, you need to have a basic understanding of billing and payment initiatives that will impact the practice’s bottom line….