CMS

Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2018

7/21/2017

On July 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2018. Read more ...

CMS Proposes Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Changes for 2018, and Releases a Request for Information (CMS-1678-P)

7/21/2017

On July 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule (CMS-1678-P) that includes updates to the 2018 rates and quality provisions, and proposes other policy changes. CMS is proposing a number of policies that would support care delivery; reduce burdens for providers, especially in rural areas; lower beneficiary out of pocket drug costs for several drugs; enhance the patient-doctor relationship; and promote flexibility in healthcare. Read more ...

CMS Posts Guidance on Two-Midnight Policy, Audits

Centers for Medicare & Medicaid Services has released updated guidance on "probe and educate" audits related to the two-midnight rule. CMS is asking Medicare administrative contractors to re-review all claim denials to date under the agency's probe and educate process to ensure the claim decision and subsequent education is consistent with clarifications CMS released January 30 concerning the physician order and physician certification requirements for hospital inpatient admissions. Read more ...