Provider CSAO的动态

The Centers for Medicare & Medicaid Services (CMS) have announced key changes for 2025. These updates, which affect Part D of the drug benefit program, are crucial for anyone involved with Medicaid, Medicare, and CHIP. To understand these regulatory requirements and their impact, head over to our blog for more details! https://bit.ly/3RJdbWF

Every year, Medicare’s open enrollment period, according to the Centers for Medicare & Medicaid Services (CMS), is October 15 through December 7. That starts TOMORROW! If you are turning 65 in the next 3 months, or are already 65, you need to be considering signing up for a Medicare plan for 2025. Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs. For general information about Medicare, you can find that available by phone or online at either 1-800-MEDICARE or Medicare.gov.??Take some time to educate yourself or a loved one who is going to need Medicare. As a licensed agent, I can talk with you about options for Medicare. Contact me to have a conversation about what may work best for you.

Every year, Medicare’s open enrollment period, according to the Centers for Medicare & Medicaid Services (CMS), is October 15 through December 7. That starts TOMORROW! If you are turning 65 in the next 3 months, or are already 65, you need to be considering signing up for a Medicare plan for 2025. Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs. For general information about Medicare, you can find that available by phone or online at either 1-800-MEDICARE or?Medicare.gov.??Take some time to educate yourself or a loved one who is going to need Medicare. As a licensed agent, I can talk with you about options for Medicare. Contact me to have a conversation about what may work best for you.

Centers for Medicare & Medicaid Service Notices Publication Date: 4/23/2024 Comments Close: 5/23/2024 Agency Information Collection Activities; Proposals, Submissions, and Approvals Medicaid and CHIP Program (MACPro) FedRegDoc#:2024-08658 FRDoc@89 FR 30377 (3 pgs) Agency/Document Identifier: CMS-10434 At this time, MACPro is made up of the main umbrella (see collection number 1 in the following list) and nine individual generic collections of information (see collection numbers 2 through 10 in the following list). Details such as the collection's requirements and burden estimates can be found in the collection's supporting statement and associated materials (see ADDRESSES for instructions for obtaining such documents). William N. Parham, III Director, Division of Information Collections and Regulatory Impacts, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2024-08658 Filed 4-22-24; 8:45 am] https://lnkd.in/e6_BuZe8

Docs Speak Out: Medicare Reimbursement Woes What are physicians' biggest business challenges with accepting Medicare and Medicaid? “Be considerate of our time. Your Medicaid program pays low fees. Do not put our staff through the grinder,” shared one doc. Discover more insights in the Medscape Doctors Evaluate Medicare and Medicaid Report 2024. https://lnkd.in/eJwie7XU

While I tend to focus more on Medicare issues, my colleagues at HMA have broad and deep expertise in Medicaid. Hot off the presses: a comprehensive report on state approaches to managing Medicaid drug benefits. Let me know if you'd like to learn more! https://lnkd.in/e7X-eF3Z

October 2024 ASP Pricing Online Now at?BuyandBill.com The preliminary October 2024 ASP file was published by the Centers for Medicare and Medicaid Services (CMS) on September 11th. Updated average sales price information is published every quarter by the Centers for Medicare and Medicaid Services (CMS). ASP is used as the primary reimbursement benchmark by government payers, as well as many commercial plans. It is crucial for healthcare providers to monitor ASP closely as quarterly fluctuations will directly influence reimbursement. The below table shows some of the most prominent quarterly ASP changes from July to October. Please note that this list is not exhaustive, and only represents a small number of the averages sales price changes that occurred from quarter three to quarter four. *Please note that the ASP is not the same as the Medicare Payment Limit*

?? Navigating Medicare & Medicaid Updates: Ensuring Compliance, Enhancing Profitability ?? The healthcare landscape is constantly shifting, and Medicare & Medicaid updates are no exception. In an environment where regulations change at lightning speed, staying compliant while keeping operations profitable isn’t just challenging—it’s crucial. At AcceleRev, we make it our mission to simplify this process for our clients. Here’s how we help you stay ahead: ? Proactive Policy Monitoring – Our team keeps a pulse on every new Medicare & Medicaid guideline, so you don’t have to. We distill the changes and deliver what matters most to your organization.? ? Strategic Adjustments – We don’t just follow compliance updates; we analyze their impact on your operations, ensuring that shifts are opportunities, not setbacks.? ? Customized Support – Every client is unique. We tailor our guidance to fit your organization’s specific needs, so compliance aligns seamlessly with profitability. The bottom line? You focus on patient care; we’ll handle the regulations. ?? Want to learn more about maximizing compliance without sacrificing profitability? Let’s connect!

On June 28, the Centers for Medicare & Medicaid Services (CMS) announced a Proposed Rule titled Medicare Program: Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023 (CMS-1799-P). While CMS touts this rule as a step forward in addressing billing abuses within the Medicare Shared Savings Program, it raises questions about the agency’s historical efficacy and commitment to combating fraud. The Shared Savings Program is designed to promote accountability for the healthcare of Medicare beneficiaries and encourage efficient service delivery. However, recent trends in billing activities, specifically concerning durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), have prompted concerns about the integrity of financial calculations. In the 2023 calendar year (CY), CMS observed a spike in billing for specific intermittent urinary catheter supplies, identified by HCPCS codes A4352 and A4353. This surge in billing could, if not addressed, distort the accuracy of expenditure and revenue calculations critical to the program.

The Centers for Medicare & Medicaid Services (CMS) have announced a proposed rule titled “Medicare Program: Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023” (CMS-1799-P). SAHS billing activity is defined by significant, unexplained increases in claims volume or dollars that deviate from historical trends. The proposed rule aims to counteract such activities by excluding payments for the identified HCPCS codes from various financial calculations. The Shared Savings Program is designed to promote accountability for the healthcare of Medicare beneficiaries and encourage efficient service delivery. However, recent trends in billing activities, specifically concerning Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS), have prompted concerns about the integrity of financial calculations. In CY 2023, CMS observed a spike in billing for specific intermittent urinary catheter supplies, identified by HCPCS codes A4352 and A4353. This surge in billing could, if not addressed, distort the accuracy of expenditure and revenue calculations critical to the program