…payment disputes over out-of-network billing. A lawsuit filed on December 8, 2021, by a coalition of stakeholders representing hospitals, health systems, and physicians sued the federal government today over…

…in a manner identical to the 3.5% and 3.0% increases for 2021 and 2022 that were included in the CARES Act) As previously mentioned, pushing PAYGO sequestration reductions for…

…recommended that CMS direct Medicare administrative contractors to recover improperly paid facet joint intervention payments. A recent OIG audit found that from August 1 through October 31, 2021, Medicare…

…with the parent codes. CMS had previously attempted a similar edit in 2021 and ISASS and other stakeholders succeeded in reversing that attempt. In response to the rapid response,…

…with the parent codes. CMS had previously attempted a similar edit in 2021 but ISASS and other stakeholders succeeded in reversing that attempt. In response to the challenge to…

…Society for Advanced Spine Surgery (ISASS) and the Society of Lateral Access Surgery (SOLAS) and has been the Program Chair for CSRS Annual meeting. In 2021 he received the…

…among hospitals would compromise the operational effectiveness of this regulation. Understanding hospitals’ compliance status has important implications for its enforcement effort and effectiveness assessment. In November 2021, CMS finalized…

CPT Adds a Modifier for Audio-Only TeleMedicine Encounters At the September 2021 CPT Editorial Panel Meeting, a new Modifier was accepted to describe real-time telemedicine services between a patient…

CMS Issues Guidance on Omnibus COVID-19 Vaccination Rules On December 28, 2022, CMS issued an interim rule on COVID-19 vaccination requirements for hospitals. The emergency regulation requires vaccinations for…

…not official, CMS believes implementation of this plan is within its existing authority. This comes after the Biden administration in 2021 repealed the rule that had provided expedited coverage…

…patients. CMS estimates that since January 2019, the healthcare system will save an estimated 40 million hours and $5.7 billion through 2021 from reduced administrative burdens. These estimated savings…

…Patients and Communities Act. The proposed standards would begin in January 2021. If finalized, all Medicare Part D plans would be required to support electronic prior authorization transaction standards…