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CMS Issues Proposed Rule with Significant Revisions to the Medicare Physician...

On July 12, 2018, the Centers for Medicare & Medicaid Services ("CMS") issued a proposed rule that includes proposals to update payment policies and rates for services furnished under the Medicare...

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CMS Announces Proposed Calendar Year 2019 Physician Fee Schedule with...

On July 12, 2018, CMS released the unpublished version of the Calendar Year (CY) 2019 Proposed Physician Fee Schedule (PFS). The CY 2019 Proposed PFS reflects a response by CMS to stakeholder feedback...

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Medicare’s New Virtual Care Codes: A Monumental Change and Validation of...

The Centers for Medicare and Medicaid Services just issued a proposed rule introducing monumental changes to the physician fee schedule, paving the way for asynchronous telemedicine and new...

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Federal Regulatory Developments Brewing in Telehealth

Two federal agencies – the Centers for Medicare and Medicaid Services (“CMS”) and the Federal Communications Commission (“FCC”) – announced separate initiatives last week that stand to increase patient...

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CMS Proposes Changes to ESRD Prospective Payment System and DMEPOS Fee...

On July 19, 2018, The Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar...

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CMS Focuses on a Modern Medicare

Earlier this month, CMS proposed changes to the Medicare Physician Fee Schedule and Quality Payment Program with the goal of “modernizing Medicare and restoring the doctor-patient relationship.” The...

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CMS Issues Proposed Rule on Medicare Physician Payment in 2019

The Centers for Medicare & Medicaid Services (CMS) on July 12, 2018, published the CY 2019 Proposed Rule for the Medicare Physician Fee Schedule (PFS). While in previous years regulations for the...

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Medicare’s Proposal to Streamline Evaluation and Management Documentation and...

Responding to input from stakeholders who have long maintained that evaluation and management documentation guidelines are too complex and fail to meaningfully distinguish differences among code...

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Something Old, Something New: The Proposed Medicare Physician Fee Schedule Rule

Mixing innovative change with standing policy, the proposed physician fee schedule rule for CY 2019 highlights a Medicare payment system in transition. Clinicians and groups focused solely on driving...

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

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...

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‘Text Me Your Symptoms’: CMS Proposes Expanding Coverage for Digital Health...

In what can only be described as “out of the box” thinking, the Centers for Medicare and Medicaid Services (CMS) is proposing to pay physicians for virtual check-ins, and for asynchronous interactions...

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CMS proposes to limit the expansion of excepted services at off-campus PBDs

On July 25, 2018, the Centers for Medicare & Medicaid Services (CMS) released the proposed Calendar Year (CY) 2019 Hospital Outpatient Prospective Payment (OPPS) Rule proposing, among other...

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CMS Proposes Expansion of Telehealth Reimbursement

On July 27, 2018, the Centers for Medicare & Medicaid Services (CMS) published its proposed annual update to the Medicare Physician Fee Schedule, which includes proposals that would give a big...

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Potential Changes to PAMA Reporting in Medicare Physician Fee Schedule Rule

Clinical laboratories and hospitals should note the potential changes to the Protecting Access to Medicare Act of 2014 (“PAMA”) reporting requirements tucked into the 1,400 page Physician Fee Schedule...

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Mid-Year Digital Health Report: Focus on Medicare - July 2018

Where Things Stood - Understanding the impact of what we have seen so far this year first requires an understanding of where we were at the end of 2017, with respect to both Medicare reimbursement and...

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Stark Law Clarifications in Proposed CY 2019 Physician Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) included two Stark Law clarifications in its proposed CY 2019 Physician Fee Schedule (Proposed Rule). The first change is with respect to the...

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

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...

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Medicare Telehealth Services

Just as a point of providing information, please note that CMS has revised its Medicare Learning Network (MLN) booklet for telehealth services. The February 2018 edition is included in this link....By:...

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Proposed 2019 Payment Rules Contain Notable Changes to Medicare's Telehealth...

CMS has issued proposed payment rules for CY 2019 that hold significant implications for telehealth coverage and reimbursement. In the Proposed 2019 Home Health Prospective Payment System Rule...

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2019 Proposed Medicare Fee Schedule

The 2019 proposed Medicare Fee Schedule was published on July 27, 2018 by CMS at https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14985.pdf. Pages 61 through 91 of the Executive...

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