Expenditures are expected to reach more than $6 trillion by 2028. Quoting from a recent press release, I noted that the Centers for Medicare & Medicaid Services (CMS) said, reflected by the below bullet points, that: Major Findings for National Health Expenditure Projection: 2019-2028: National health spending is projected to…
This is updates an ICD10monitor story posted in September 2020. The repayment began March 30, 2021. In March 2020, the Centers for Medicare and Medicaid Services (CMS) expanded the Accelerated and Advanced Payment Program (AAP) due to the COVID-19 Public Health Emergency (PHE), in an effort to increase cash flow to…
As vaccination rates slowly rise, federal officials are urging the pace to quicken. As COVID-19 vaccination rates slowly creep higher in jurisdictions across the country, federal officials are seeking to give the numbers a shot in the arm. The Centers for Medicare & Medicaid Services (CMS) announced Monday that this…
Phone call codes during the PHE range from 99441 to 99443, and are all based on time. In response to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) made a number of changes that allowed Medicare beneficiaries to access a wider range of telehealth services without having…
Moderna’s vaccine is expected to be shipped to providers nationwide, on the heels of Pfizer’s. A reeling nation couldn’t have asked for a better Christmas present. The Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine for individuals 16 and older last week…
The hiatus of audits was short-lived.  The ongoing COVID-19 pandemic and resulting public health emergency (PHE) has brought about massive and quick changes in the healthcare industry, notably among them the temporary suspension of Medicare Fee-For-Service (FFS) audits. The Centers for Medicare & Medicaid Services (CMS) suspended most audits on…
As payors both in government (Medicare) and the commercial arena (private plans) see the recoupment rate of services billed incorrectly or non-compliantly skyrocket, the payor audit is not going away anytime soon. This awareness is now producing more audits of physicians than ever before, directly contributing to higher rates of denials. Audits take time…
The U.S. healthcare system is facing a critical shortage of supplies, including ICU beds. With the rising concern over COVID-19, I decided to look at data to see what our current shortage of ICU beds could be, comparing census data in Medicare cost reports with U.S. Centers for Disease Control…
Hospitals need to submit Medicare bad debt lists on their cost reports. I was working on a project recently, reviewing bad Medicare debts for a client. I noticed a reduction for a code I do not see a lot on a claim with Medicare primary and Medicaid secondary. It was…
It’s a move sure to stir up controversy.  Under a recently passed Centers for Medicare & Medicaid Services (CMS) Final Rule, your Medicare enrollments will be judged not necessarily on your performance but based on your affiliations with other providers and suppliers. Yes, you read that right: “other providers and…