Tag: CMS

Five common misconceptions about the transition to ICD-10

To help dispel some of the myths surrounding ICD-10, the Centers for Medicare & Medicaid Services (CMS) recently talked with providers to identify common misperceptions about the transition to ICD-10. These five facts address some of the common questions and concerns CMS has heard about ICD-10: The ICD-10 transition date is October 1, 2015. The […]

CMS proposes new rule for Medicare program

According to the Federal Register, CMS is proposing a rule that would update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2016. In addition, it includes a proposal to specify a SNF all-cause all-condition hospital readmission measure, as well as a proposal to adopt […]

CMS released final Medicare Advantage and Part D prescription drug program changes

The Centers for Medicare & Medicaid Services (CMS) released final Medicare Advantage (MA) and Part D Prescription Drug program changes for 2016 that provide fair and accurate payments to plans, and encourage the delivery of high-quality care for all populations. The Medicare Advantage and the Part D Prescription Drug programs’ enrollments and quality continue to […]

CMS introduced star ratings at Hospital Compare

On April 16, 2015, the Centers for Medicare & Medicaid Services (CMS) introduced star ratings on Hospital Compare, the agency’s public information website, to make it easier for consumers to choose a hospital and understand the quality of care they deliver. This announcement builds on a larger effort across HHS to build a health care […]

Senate votes to repeal SGR formula

On Tuesday, April 14, 2015, the Senate voted 92-8 to permanently repeal Medicare’s sustainable growth rate (SGR) formula for paying doctors. The legislation now heads to President Obama’s desk. If Obama signs the legislation, it will end the cycle of short-term fixes for this unsuccessful payment system. The new SGR package sets up a two-track […]

Ask the expert: Ambulance billing

Q: I work in ambulance billing.  I know that under Original Medicare, many non-emergent transports of bed confined and non-wheelchair patients is billable to the SNF.  Is the same true for Medicare Advantage plans? Also, is there some way to tell when to bill the SNF?   A:  Medicare Advantage plans are not subject to consolidated billing […]

CMS five star quality rating system discussed on NPR

In mid-March, the Diane Rehm program on National Public Radio held a discussion regarding the Centers for Medicare & Medicaid Services (CMS) Five Star Quality Rating System for nursing homes. The discussion included Patrick Conway, CMS Chief Medical Officer and Deputy Administrator for Innovation and Quality, Center for Medicare Advocacy Senior Policy Attorney Toby S. […]

SGR proposal is gaining support

The American Health Care Association (AHCA) announced its support for the sustainable growth rate (SGR) proposal currently in Congress, joining Leading Age. The proposal seeks to replace the Medicare sustainable growth rate (SGR) formula tied to physician compensation with a payment system that is designed to improve value and return stability to physician payment. Congress […]

Next generation ACO model launched from CMS innovation center

On March 10, the U.S. Department of Health and Human Services launched a new Accountable Care Organization (ACO) initiative from the Centers for Medicare & Medicaid Services (CMS) Innovation Center known as the Next Generation ACO Model. This model builds on the successes of earlier ACO models, such as the Pioneer ACO Model, and further […]