CMS reimbursement Archives - MedCity News https://medcitynews.com/tag/cms-reimbursement/ Healthcare technology news, life science current events Mon, 25 Sep 2023 05:29:10 +0000 en-US hourly 1 https://wordpress.org/?v=6.3.1 https://medcitynews.com/uploads/2021/03/cropped-mblue-32x32.png CMS reimbursement Archives - MedCity News https://medcitynews.com/tag/cms-reimbursement/ 32 32 40682243 How MIPS Value Pathways will Prove the Value of Rehab Therapy https://medcitynews.com/2023/09/how-mips-value-pathways-will-prove-the-value-of-rehab-therapy/ https://medcitynews.com/2023/09/how-mips-value-pathways-will-prove-the-value-of-rehab-therapy/#respond Mon, 25 Sep 2023 05:29:10 +0000 https://medcitynews.com/?p=645648

As value-based care models take hold, the time is ripe for rehab therapists to position themselves as primary players in the movement toward delivering optimal quality and value in the broader healthcare ecosystem.

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How Rehab Therapists Can Use RTM to Optimize Patient Care https://medcitynews.com/2023/04/how-rehab-therapists-can-use-rtm-to-optimize-patient-care/ https://medcitynews.com/2023/04/how-rehab-therapists-can-use-rtm-to-optimize-patient-care/#respond Tue, 25 Apr 2023 22:37:30 +0000 https://medcitynews.com/?p=629484

CMS has shown that they understand the value and efficacy of remote care as a billable service for rehab therapists—let’s not miss this opportunity to take the best care of our patients while getting paid.

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AppliedVR Earns First Unique CMS Code Ever Granted to a Digital Therapeutic https://medcitynews.com/2023/03/appliedvr-earns-first-unique-cms-code-ever-granted-to-a-digital-therapeutic/ https://medcitynews.com/2023/03/appliedvr-earns-first-unique-cms-code-ever-granted-to-a-digital-therapeutic/#respond Wed, 22 Mar 2023 20:31:18 +0000 https://medcitynews.com/?p=628638

CMS recently established a unique code for AppliedVR’s flagship product, marking the first time a digital therapeutic or immersive therapeutic has ever been placed in an existing benefit category. The eight-week program is a physician-prescribed solution that allows patients to manage their chronic lower back pain without opioids from the comfort of their own home.

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5 Factors Holding Back Healthcare Practices From Adopting RPM https://medcitynews.com/2023/03/5-factors-holding-back-healthcare-practices-from-adopting-rpm/ https://medcitynews.com/2023/03/5-factors-holding-back-healthcare-practices-from-adopting-rpm/#respond Thu, 02 Mar 2023 18:25:06 +0000 https://medcitynews.com/?p=625969

Just a quarter of healthcare practices offer remote patient monitoring, and the majority of them aren’t too eager to adopt the technology any time soon, according to a new report. A few factors are influencing this reluctance, including data security concerns, unclear reimbursement policies and training requirements.

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RTM Reimbursement Represents a New Age for Digital Therapeutics https://medcitynews.com/2022/12/rtm-reimbursement-represents-a-new-age-for-digital-therapeutics/ https://medcitynews.com/2022/12/rtm-reimbursement-represents-a-new-age-for-digital-therapeutics/#respond Wed, 21 Dec 2022 18:40:54 +0000 https://medcitynews.com/?p=615343

Ultimately, it is anticipated that CMS will further expand the use of reimbursable RTM beyond respiratory and MSK care and incorporate patient-reported information as a requirement for reimbursement of certain remote services.

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Coverage delays exacerbate inequity for Medicare beneficiaries https://medcitynews.com/2022/08/coverage-delays-exacerbate-inequity-for-medicare-beneficiaries/ https://medcitynews.com/2022/08/coverage-delays-exacerbate-inequity-for-medicare-beneficiaries/#respond Mon, 01 Aug 2022 18:00:30 +0000 https://medcitynews.com/?p=593867

Without reimbursement policies that can meet the opportunity of this new innovative era, patients and their providers will be denied access to the most cutting-edge, care. 

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How digital health is challenging traditional reimbursement models https://medcitynews.com/2022/04/how-digital-health-is-challenging-traditional-reimbursement-models/ https://medcitynews.com/2022/04/how-digital-health-is-challenging-traditional-reimbursement-models/#respond Tue, 19 Apr 2022 20:59:45 +0000 https://medcitynews.com/?p=583221

The traditional fee-for-service arrangements have caused misaligned incentives across the board for patients, physicians, and payers – and proved a huge obstacle to improving care. Recognizing this gap, CMS began to facilitate a shift towards outcome-based care by focusing on outpatient monitoring and disease management. This has led to progress in adopting new reimbursement models.

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What CMS’ virtual care moves mean for healthcare at large https://medcitynews.com/2018/11/cms-virtual-care-healthcare/ https://medcitynews.com/2018/11/cms-virtual-care-healthcare/#respond Fri, 02 Nov 2018 17:09:00 +0000 https://medcitynews.com/?p=447245

In a phone interview, Matt Fisher, a partner with Mirick O’Connell, said CMS’ latest actions regarding virtual care are beneficial but noted doctors shouldn’t forget about the privacy and security side of the coin.

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OIG report: CMS improperly reimbursed doctors $3.7M in telehealth payments https://medcitynews.com/2018/04/oig-report-cms-telehealth/ https://medcitynews.com/2018/04/oig-report-cms-telehealth/#respond Mon, 16 Apr 2018 22:06:57 +0000 https://medcitynews.com/?p=440959 telehealth, telemedicine, physician, tablet, medicine

In a sample of 100 claims from 2014 and 2015, 69 met telehealth service requirements and the other 31 did not, resulting in an estimated $3.7 million in extra costs.

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2017: The year telehealth and digital health hit their stride https://medcitynews.com/2017/12/2017-telehealth-digital-health/ https://medcitynews.com/2017/12/2017-telehealth-digital-health/#respond Wed, 20 Dec 2017 15:15:47 +0000 https://medcitynews.com/?p=437388

This year, CMS promised reimbursement changes for telemedicine and remote patient monitoring in 2018. Meanwhile, the FDA unveiled its pre-certification pilot program for digital health. Despite being significant, these noteworthy events leave room for improvement in 2018.

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Small practices worried about new Medicare payment rules https://medcitynews.com/2016/08/small-practices-medicare-payment/ https://medcitynews.com/2016/08/small-practices-medicare-payment/#respond Thu, 25 Aug 2016 16:45:32 +0000 https://medcitynews.com/?p=383105 “The ways it’s structured now, the large practices will do well and the small practices will do badly,” said Paul Ginsburg, director of the Center for Health Policy at the Brookings Institution.

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Morning Read: Medicare shifting $900M to value-based care in 2017, FDA halts Juno trial after deaths https://medcitynews.com/2016/07/medicare-value-based-care-2017/ https://medcitynews.com/2016/07/medicare-value-based-care-2017/#respond Fri, 08 Jul 2016 11:55:46 +0000 https://medcitynews.com/?p=379282

Plus, KaloBios makes plans to buy out Shkreli’s shares, medical device M&A value soars as even volume dips in H1, while the Brexit fallout continues in the pharma industry.

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Does Medicare unfairly punish teaching hospitals? https://medcitynews.com/2016/04/medicare-teaching-hospitals/ https://medcitynews.com/2016/04/medicare-teaching-hospitals/#respond Wed, 20 Apr 2016 17:51:12 +0000 https://medcitynews.com/?p=372837 The penalties, created by the federal Affordable Care Act, have incited a vehement debate about quality at many academic medical centers often revered for cutting-edge treatments and top specialists. Are these vaunted hospitals really more dangerous than local, unsung hospitals?

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New model, rules proposed for Shared Savings ACOs https://medcitynews.com/2014/12/new-model-rules-proposed-shared-savings-acos/ https://medcitynews.com/2014/12/new-model-rules-proposed-shared-savings-acos/#comments Mon, 01 Dec 2014 23:05:29 +0000 https://medcitynews.com/?p=320924 Health systems that have adopted the Shared Savings model ACOs could have an additional three […]

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Heart doctor: Six initial reactions to the Medicare payment data dump https://medcitynews.com/2014/04/heart-doctor-six-initial-reactions-medicare-payment-data-dump/ https://medcitynews.com/2014/04/heart-doctor-six-initial-reactions-medicare-payment-data-dump/#respond Wed, 09 Apr 2014 22:50:26 +0000 http://www.drjohnm.org/?p=2544 What a day it was for medical news. After much legal wrangling, specifically by the […]

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Outside The Four Walls – It’s Where Medicine Is Going https://medcitynews.com/2013/12/outside-four-walls-medicine-going/ https://medcitynews.com/2013/12/outside-four-walls-medicine-going/#respond Tue, 03 Dec 2013 17:52:31 +0000 https://medcitynews.com/?p=263662 In 2-3 years, 50% of the reimbursement a hospital receives for most Medicare patient stays […]

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Medicare pushes start date of bonus/penalty plan to 2016 for mid-size doctor groups https://medcitynews.com/2013/07/medicare-pushes-start-date-of-bonuspenalty-plan-to-2016-for-mid-size-doctor-groups/ https://medcitynews.com/2013/07/medicare-pushes-start-date-of-bonuspenalty-plan-to-2016-for-mid-size-doctor-groups/#comments Mon, 22 Jul 2013 09:51:00 +0000 https://medcitynews.com/?guid=4b84ab52f5f495097bcd3a9bad508a49 Medicare is accelerating plans to peg a portion of doctors’ pay to the quality of their care.
The changes would affect nearly 500,000 physicians working in groups. The federal health law requires large physician groups to start getting bonuses or…

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MedPAC: Medicare’s re-admission penalties too harsh for hospitals serving the poor https://medcitynews.com/2013/06/medpac-medicares-re-admission-penalties-too-harsh-for-hospitals-serving-the-poor/ https://medcitynews.com/2013/06/medpac-medicares-re-admission-penalties-too-harsh-for-hospitals-serving-the-poor/#respond Fri, 14 Jun 2013 17:21:00 +0000 https://medcitynews.com/?guid=a5cf8a725db0cabbbbbbf11865ddf30a The financial penalties that Medicare imposes on hospitals with high rates of patient readmissions are too harsh for hospitals serving the poor and should be changed, according to a congressional advisory agency.
Since last fall, Medicare has been red…

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Lawsuit aims to overturn Medicare rules for “observation” care https://medcitynews.com/2013/05/lawsuit-aims-to-overturn-medicare-rules-for-observation-care/ https://medcitynews.com/2013/05/lawsuit-aims-to-overturn-medicare-rules-for-observation-care/#comments Fri, 03 May 2013 09:52:00 +0000 https://medcitynews.com/?guid=e8e330ba60b90466d7cfa049eb8e4d63 Hospitals don’t have to tell patients they are under “observation” care and Medicare will not cover the costs of that care if the patient is not admitted. Patients who are not admitted for at least three consecutive days do not qualify Medicare’s nursing home coverage. Advocates have filed a lawsuit to change these rules.

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The “right” to healthcare does not require a doctor to work for free https://medcitynews.com/2012/11/one-persons-right-to-healthcare-does-not-require-a-doctor-to-work-for-free/ https://medcitynews.com/2012/11/one-persons-right-to-healthcare-does-not-require-a-doctor-to-work-for-free/#comments Fri, 23 Nov 2012 18:25:14 +0000 https://medcitynews.com/?p=171803 After the election, a lot of people are excited that they can now get healthcare. […]

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AHA sues Medicare over audit program aimed at trimming improper payments https://medcitynews.com/2012/11/aha-sues-medicare-over-audit-program-aimed-at-trimming-improper-payments/ https://medcitynews.com/2012/11/aha-sues-medicare-over-audit-program-aimed-at-trimming-improper-payments/#respond Sat, 03 Nov 2012 12:00:00 +0000 https://medcitynews.com/?guid=02222958dac64fd7e40cdfc798ccaf0d The American Hospital Association sued the agency that oversees Medicare, saying an audit program is depriving hospitals of reimbursements for care they provide.

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Analyst: Edwards Lifesciences’ missed TAVI sales akin to U.S Ryder Cup loss https://medcitynews.com/2012/10/analyst-compares-edwards-lifesciences-missed-tavi-sales-to-u-s-ryder-cup-loss/ https://medcitynews.com/2012/10/analyst-compares-edwards-lifesciences-missed-tavi-sales-to-u-s-ryder-cup-loss/#respond Tue, 09 Oct 2012 18:55:46 +0000 https://medcitynews.com/?p=157396 Losing the Ryder Cup this year to the Europeans was every bit unexpected. Almost as […]

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What’s the best way to avoid Medicare readmission penalties? Stop trying https://medcitynews.com/2012/09/whats-the-best-way-to-avoid-medicare-readmission-penalties-stop-trying/ https://medcitynews.com/2012/09/whats-the-best-way-to-avoid-medicare-readmission-penalties-stop-trying/#comments Mon, 17 Sep 2012 11:17:13 +0000 https://medcitynews.com/?p=151509 As a cardiac electrophysiologist, I’m pretty far removed from public policy.  But I have to […]

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Mayo, S.F. startup launch health IT tool to track data around cardiology patient readmits https://medcitynews.com/2012/09/mayo-sf-startup-launch-health-it-tool-aiming-to-revolutionize-healthcare-by-harnessing-big-data/ https://medcitynews.com/2012/09/mayo-sf-startup-launch-health-it-tool-aiming-to-revolutionize-healthcare-by-harnessing-big-data/#respond Mon, 10 Sep 2012 14:30:23 +0000 https://medcitynews.com/?p=150478 The Mayo Clinic announced Monday that it is partnering with a California startup that aims […]

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New Tool to Help Physicians Get Maximum Reimbursement https://medcitynews.com/2012/01/new-tool-to-help-physicians-get-maximum-reimbursement/ https://medcitynews.com/2012/01/new-tool-to-help-physicians-get-maximum-reimbursement/#comments Thu, 19 Jan 2012 19:46:19 +0000 http://www.medcitynews.com/?p=118367 The U.S. health care industry has evolved and changed rapidly over the past several decades. This evolution took place in response to a number of environmental influences including, technological advances, demographic shifts, and economic and political changes.

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