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Health Care Providers HCPCS

Hogan Lovells

When being a little bit square is a good thing: CMS AppliedVR decision shows how innovative technology can secure a payment...

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While the Medicare statute provides access to healthcare services for our nation’s elderly and disabled populations, it also can serve to foreclose access for those populations when an item or service does not fall within one...more

Rivkin Radler LLP

CMS Adds New Billing Code for Dental Surgeries

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The American Dental Association (ADA) announced on November 15 that the Centers for Medicare & Medicaid Services (CMS) has agreed to create a new Healthcare Common Procedure Coding System (HCPCS) code G0330 for dental...more

Manatt, Phelps & Phillips, LLP

Audio Telehealth Services Post-Pandemic—An Update on Emerging Policy Trends

As highlighted in our September 2020 article, “Frequently Asked Questions: Telephonic Services as a Form of Telehealth,” in response to the COVID-19 pandemic, federal and state policy makers have significantly increased...more

Bricker Graydon LLP

CMS to begin reprocessing hospital claims for 2019 clinic visits provided at excepted off-campus provider-based departments

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Buried within the latest issue of the Centers for Medicare and Medicaid Services’ (CMS) MLN Connects, dated January 14, 2021, is an announcement from the agency that hospitals with excepted hospital outpatient departments...more

Ward and Smith, P.A.

Time for a Checkup: Recent Federal Efforts Regarding Telehealth - Part I

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The public health emergency (PHE) for COVID-19 has brought about many changes to the way healthcare is practiced, delivered, and reimbursed. This article will discuss some of the major recent changes to telehealth on the...more

Bricker Graydon LLP

D.C. Circuit upholds Medicare policy of paying hospital outpatient provider-based locations and physician offices the same,...

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On July 17, 2020, the D.C. Circuit Court found that the Department of Health and Human Services’ (HHS) and the Centers for Medicare & Medicaid Services’ (CMS’) policy of paying grandfathered off-campus provider-based...more

Bricker Graydon LLP

Medicare to require prior authorization for certain outpatient department services starting July 1, 2020

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In the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (2020 OPPS Final Rule), the Centers for Medicare and Medicaid Services (CMS) established a prior authorization process and...more

Brownstein Hyatt Farber Schreck

Health Plan Coverage of Coronavirus Testing and Treatment

With the news about the spread of the 2019 novel coronavirus (“COVID-19”) in the U.S. and the world rapidly evolving, group health plan sponsors need to address how the plan will provide virus-related benefits. ...more

Holland & Knight LLP

CMS Issues New Medicare Reimbursement Guidance for Diagnosis and Treatment of Coronavirus

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The Centers for Medicare and Medicaid Services (CMS) has issued new guidance for frequently asked questions related to Medicare reimbursement for items and services provided in connection with the diagnosis and treatment of...more

ArentFox Schiff

CMS Issues A Second Billing Code for COVID-19 Testing

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The Centers for Medicare and Medicaid Services (CMS) issued a second Healthcare Common Procedure Coding System (HCPCS) code to be used by laboratories for the testing and tracking of new cases of the 2019-Novel Coronavirus...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 4. News Briefs: February 2020

Report on Medicare Compliance 29, no. 4 (February 3, 2020) - ? Central Coast Inpatient Consultants Inc. in California has agreed to pay $750,000 in a civil monetary penalty settlement with the HHS Office of Inspector...more

Husch Blackwell LLP

Hospitals React Strongly To CMS’ Changes To Hospital Outpatient Payments

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Hospitals are not happy with CMS’ recent changes to hospital outpatient payments. Two hospital associations and three hospitals claim in a federal lawsuit filed December 4, 2018, that CMS had no authority to change the...more

Baker Donelson

CMS Adopts Important "Site-Neutral" Changes to Payment Rules

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CMS took another step in its campaign to impose "site neutrality" on hospital outpatient payments with its recently published final Medicare hospital Outpatient Prospective Payment System (OPPS) rule for CY 2019. The final...more

Cozen O'Connor

Medicare’s New Virtual Check-In Code: 7 Things You Need To Know

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On November 1, 2018, CMS issued a 2,379 page final rule titled “Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2019.” While there are...more

Foley & Lardner LLP

Understanding Medicare’s New Remote Evaluation of Pre-Recorded Patient Information (Asynchronous Telemedicine)

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Starting January 1, 2019, the Medicare program will cover certain medical services delivered via asynchronous telemedicine technologies. The Centers for Medicare and Medicaid Services (CMS) just published the final rule for...more

Foley & Lardner LLP

Top 10 FAQs on Medicare’s Virtual Check-In Codes: The New Brief Communication Technology-Based Service

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Telemedicine providers rejoice: Medicare will cover new virtual care services starting January 1, 2019. The Centers for Medicare and Medicaid Services (CMS) just published the final rule for the 2019 Physician Fee Schedule,...more

Foley & Lardner LLP

Medicare Proposes (and Rejects) New Telehealth Services for 2019

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The telemedicine industry was pleased to learn CMS recently proposed adding new services to its list of Medicare-covered telehealth services. But what may be more interesting are the services CMS declined to add, and why....more

Bradley Arant Boult Cummings LLP

CMS Proposes Significant E/M Coding and Documentation Changes - Healthcare Alert

On July 27, 2018, the Centers for Medicare & Medicaid Services (CMS) published its proposed annual update to the Medicare Physician Fee Schedule, which proposes changes to the E/M coding and documentation process that CMS...more

Foley & Lardner LLP

INSIGHT: CMS’s Virtual Care Codes Pave New Avenues for Telemedicine Services Delivery

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The Centers for Medicare & Medicaid Services issued a proposed rule introducing monumental changes to the physician fee schedule, paving the way for asynchronous telemedicine and new technologies through a new set of virtual...more

Alston & Bird

Alston & Bird Healthcare Week in Review

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Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Alston & Bird

Alston & Bird Healthcare Week in Review

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Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Alston & Bird

Alston & Bird Healthcare Week In Review

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Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Alston & Bird

Alston & Bird Healthcare Week In Review

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Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Goodwin

CMS Considers New Billing Code Policy for Biosimilars

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Last week, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule regarding payment policies. Among other things, the proposed rule included a request for comment on the policy for biosimilar...more

Alston & Bird

A&B Healthcare Week in Review

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I. REGULATIONS, NOTICES, & GUIDANCE - On April 21, 2016, CMS issued a proposed rule entitled, “Medicare Program: FY 2017 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements.” This...more

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