Category: Reimbursements - CLAIMSMED

VT Legislature Gives Approval To The Bill of Telemedicine Reimbursement

5/29/2017

Approved by the Vermont House and Senate, legislation aims to extend and regulate telemedicine reimbursement within the state. The telemedicine reimbursement bill involves new requirements for payers to reimburse telemedicine services, and enhances regulations regarded to how payers could charge beneficiaries.

CMS Asserted To Reverse the Policy of Obama-Era Biosimilar Reimbursement

5/23/2017

An effort of bipartisan congressional system is underway to convince Centers for Medicare & Medicaid Services (CMS) to reverse its policy of biosimilar reimbursement executed under the administration of Obama.

FamilyCare Health Files a Lawsuit Again Against Oregon Health Authority over Reimbursement Rates

3/1/2017

A lawsuit has been filed against the state by one of the Oregon’s largest Coordinated Care Organizations for having an “unsound rate-setting process.”
About 120,000 Portland residents are being served by the FamilyCare Health on the Oregon Health Plan.

21st Century Cures Act: Small Employers Have New Health Reimbursement Choice Under the Act

1/5/2017

The latest Act i.e. 21st Century Cures Act (Cures) signed by President Barack Obama on the day of Dec. 13, 2016, contains a smorgasbord of health-related provisions and regulations, from reforming federal mental health plans to increasing funding for medical research. Tucked away near the end of the voluminous law is a significant provision that permits small employers to assist their workers with the charges of medical-care expenses, involving premiums for individual health policies, through the utilization of Health Reimbursement Arrangements (HRAs).

Obama Administration Abandons Medicare Drug-Reimbursement Policy

12/17/2016

A controversial proposal has been dropped by the Obama administration to overhaul how Medicare reimburses doctors for drugs, after pharmaceutical groups and physicians rallied against it.
Several doctors who dispense drugs in their offices or outpatient environments, like oncologists, said they stood to lose under the proposal. In Medicare Part B, which covers care in offices and outpatient settings of doctors, doctors are paid 6 percent above average wholesale prices of drugs. The administration proposed decreasing that percentage in few cases and adding a flat fee to its payments to doctors, with the target of decreasing the financial incentive to prescribe more-costly medicines.

Medicaid Reimbursement and Admissions Generate Hospital Profit, says recent studies

12/7/2016

Medicaid reimbursement and admissions can produce hospital profits but charity care and taxes can lower revenue, in accordance to the two recent studies.
Do Medicaid reimbursement amounts and federal uncompensated care payments actually cover the healthcare prices of treating larger proportions of Medicaid beneficiaries and uninsured individuals?

90 percent Report CDI Empowered Revenue

12/6/2016

At least $1.5 million were gained by most of the hospitals in healthcare revenue after clinical documentation improvement (CDI) implementation, a Black Book survey discovered.
In accordance to Black Book Market Research, almost 90% of hospitals with 150 or more beds and outsourced clinical documentation functions recognized at least $1.5 million in suitable healthcare revenue and claims reimbursement following clinical documentation improvement (CDI) implementation.

VCYT Declares CMS To Maintain Medicare Reimbursement Rate for Afirma GEC

11/22/2016

In accordance to Veracyte, Inc. (VCYT), Centers for Medicare and Medicaid Services (CMS) has issued its revised final 2017 Medicare reimbursement rate for the Afirma Gene Expression Classifier (GEC) of the company. The organization has enabled the genomic test's current rate of $3,200 will be maintained in the year of 2017 as a result of Veracyte’s reconsideration appeal or request. This ultimate Medicare reimbursement rate replaces the earlier released lower "gap fill" amount and will go into effect on the day of January 1, 2017.

Medi-Cal reimbursement has been permitted by New Bill for therapists

11/21/2016

In accordance to the legislation signed by the California governor previous month, several North State health centers will be capable to expand on mental health services by employing Licensed Marriage and Family Therapists to offer counseling.

Overview of the EHR Incentive Programs

10/27/2016

The Medicare and Medicaid EHR Incentive Programs was set by the Stage 1 Final Rule by developing requirements for the electronic capture of clinical information, involving giving sufferers with electronic copies of health data.