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The Trump Administration Releases Two New Rules on Price Transparency

Today the Trump Administration released a proposed rule and a final rule designed to increase price transparency through hospitals by giving patients tools to access pricing information through their health plans. The Administration has finalized requirements for hospitals to disclose

Avoid Audits! Stay on Top of the SNF Three Day Billing Rule

14NovemberSkilled Nursing

In a recent report, the Office of Inspector General (OIG) determined that Medicare improperly paid for Skilled Nursing Facility (SNF) services when the Medicare 3-Day inpatient hospital stay requirement was not met. CMS developed the Skilled Nursing Facility 3-Day Rule Billing Fact Sheet to

Proposed Medicaid Fiscal Accountability Rule Could Dramatically Lower Reimbursement for Providers

12NovemberMedical Billing & Collections, Skilled Nursing

Today, CMS released their proposed Medicaid Fiscal Accountability Rule (MFAR), which works to ensure transparency in Medicaid payments and clamp down on impermissible financing arrangements. From CMS’ Press Release: “States often make additional payments to providers above the normal reimbursement

Medicare Part A and Part B Premiums Increase for 2020

11NovemberUncategorized

Each year the Medicare premiums, deductibles, and copayment rates are adjusted according to the Social Security Act. For 2020, the Medicare Part B monthly premiums and the annual deductible are higher than the 2019 amounts. The standard monthly premium for

Enrollment Fact Sheet for the New Medicare Part B Opioid Use Disorder Benefit

8NovemberBehavioral Health Today

CMS is implementing policies to expand access to opioid use disorder (OUD) treatment services furnished by opioid treatment programs (OTPs). These new policies will be covered under the Medicare Part B benefit and have been finalized under the 2020 Physician

Some SNF Claims Being Placed on Hold

7NovemberSkilled Nursing

CMS is holding a number of claims from SNFs as they continue to refine their payment systems for PDPM. See the following from CMS’ Medicare Learning Network (MLN): “CMS is holding claims with: Dates of service October 1, 2019 or

CMS Approves Major Medicaid Behavioral Health Demonstration in Washington D.C.

6NovemberBehavioral Health Today

Today CMS announced the approval of a first-of-its-kind Medicaid demonstration project that broadens treatment services available to Medicaid beneficiaries living in the District of Columbia diagnosed with serious mental illness (SMI) and/or serious emotional disturbance (SED). At the same time,

CMS Releases the 2020 Physician Fee Schedule Final Rule

4NovemberMedical Billing & Collections

CMS has released the finalized 2020 Physician Fee Schedule. The final rule is mostly unchanged from the proposed rule that was released in July. The most significant new policies are outlined below. Several specialists, including psychologists and physical therapists face

Updated Information on Health Insurance Responsibility Disclosure (HIRD) Filing Period

1NovemberTax

An important update for all Massachusetts employers from Mass Tax Connect: “Update on the correct dates for the HIRD filing for 2019 We recently sent out a notice to you on the filing of the Health Insurance Responsibility Disclosure (HIRD)