April 30, 2021

ISASS Provides Comments to CMS on Medicare Prior Authorization Policies

ISASS Provides Comments to CMS on Medicare Prior Authorization Policies ISASS jointed a broad coalition, included the Medical Device Manufacturing Association, in submitting a letter on April 7, 2021, to CMS on growing concerns over the expansion of “prior authorization” requirements in Medicare. This letter echoed concerns conveyed in a bipartisan letter sent to CMS late last year. More than 40 organizations signed the letter representing a large segment of patient and physician organizations, including the American Medical Association, the Federation of American Hospitals, and the American College of Surgeons. The letter from a broad coalition of health care stakeholders highlights the ongoing concern about how the growing use of prior authorization by Medicare and other payers is imposing unnecessary burdens on patients and delaying […]
April 30, 2021

ISASS Comments on Payer Coverage Policy on New Spine Technology

ISASS Comments on Payer Coverage Policy on New Spine Technology ISASS submitted comments to Health Care Services Corporation (HCSC) on a draft coverage policy for Basivertebral Joint Ablation (BVN). ISASS’ comments reviewed the literature on BVN and included the ISASS policy statement on BVN. ISASS advocated for coverage for BVN under the patient standards outlined in the ISASS policy statement. The letter was submitted on April 11, 2021. The HCSC will review comments and input and issue a final policy in the coming months. The ISASS BVN policy statement can be viewed here: https://www.ijssurgery.com/content/14/1/18  
April 30, 2021

Congress Extends Medicare Physician Payment Relief Through the End of 2021

Congress Extends Medicare Physician Payment Relief Through the End of 2021 The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the sequestration payment adjustment percentage of 2% applied to all Medicare Fee-for-Service claims from May 1 through December 31, 2020. The Consolidated Appropriations Act, 2021, extended the suspension period to March 31, 2021. An Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes, signed into law on April 14, 2021, extends the suspension period to December 31, 2021. Medicare administrative contractors will: Release any previously held claims with dates of service on or after April 1 Reprocess any claims paid with the reduction applied Provider don’t need to take any action as CMS will automatically process payments to […]
April 30, 2021

CMS Announces Additional COVID-19 Provider Relief

CMS Announces Additional COVID-19 Provider Relief On March 28, 2020, CMS expanded the existing COVID-19 Accelerated and Advance Payments (CAAP) Program to a broader group of providers. Accelerated and advance payments are payments intended to provide necessary funds to Part A providers and Part B suppliers, respectively, when there is a disruption in claims submission and/or claims processing. CMS can also offer these payments in circumstances such as national emergencies or natural disasters in order to accelerate cash flow to the impacted health care providers and suppliers. In accordance with the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136), the expanded CAAP program provided additional flexibilities for a specific subset of providers, including inpatient hospitals, children’s hospitals, certain […]