House Passes Bill to Streamline Medicare Advantage Prior Authorization On September 12, 2022, the U.S. House of Representatives passed the Improving Seniors’ Timely Access to Care Act (H.R. 3173). If approved, the legislation  would streamline prior authorization requirements under Medicare Advantage plans. According to the American Hospital Association, the bill would “establish an electronic pri...

Several Spine Surgery Procedure RVUs Reviewed With Medicare Physician Fee Schedule 2023 Proposed Rule As part of the 2023 Medicare Physician Fee Schedule proposed rule, CMS reviewed new codes for arthrodesis decompression when performed with fusion, fusion with minimal decompression to prepare the interspace, and lumbar laminotomy codes. The table below shows the CMS proposed...

2023 Outpatient Prospective Payment System/Ambulatory Surgical Center Proposed Rule Released On July 15, 2022, the CMS released the calendar year (CY) 2023 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule, which includes proposals to update payment rates, policies, and regulations affecting Medicare services furnished in hospital outpatient and...

2023 Medicare Physician Fee Schedule Proposed Rule Released On July 7, 2023, the CMS released the proposed 2023 Medicare Physician Fee Schedule rule. Under the proposal, on January 1, 2023, physicians will see a decrease to the conversion factor from $34.6062 to $33.0775. As noted by the American Medical Association, “This rule represents the continuation of...