The Centers for Medicare & Medicaid Services finalized several changes in Medicare Advantage and Part D on Friday.
The Trump administration has finalized several changes in Medicare Advantage (MA) and Part D in anticipation of bid submissions on June 1.
The Centers for Medicare & Medicaid Services (CMS) released Friday that includes technical changes mandated by the 21st Century Cures Act and the 2018 Bipartisan Budget Act, notably targeting telehealth.
CMS will offer MA plans greater flexibility to offer and discount telehealth for specialty care, which will allow them to grow their benefits while meeting network adequacy standards.
“CMS’s rapid changes to telehealth are a godsend to patients and providers and allows people to be treated in the safety of their home,” said CMS Administrator Seema Verma in a statement. “The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”
In the new rule, the agency also finalized changes to MA and Part D Star Rating methodology to incorporate member feedback to a greater degree.
"One of the best indicators of a plan’s quality is how its enrollees feel about their coverage experience," CMS said in a release. "This decision reflects CMS’s commitment to put patients first and improves incentives for plans to focus on what patients value and feel is important."
CMS estimates the changes will save the government $3.65 billion.
If you have questions or comments about this article please contact us. Comments that provide additional related information may be added here by our Editors.
Have you ever wondered why you were unable to find a particular product/code with our DMEPOS search? When looking for HCPCS Level II codes, there are several kinds of codes and not all HCPCS codes were created for the same purpose. If you are searching for a certain HCPCS product ...
While you likely find yourself focusing on fewer patients and more on emergency care, it’s a good time to understand how medical billing can allow patients with active infection in the oral cavity to seek the treatment they need.
Forms need to be filled out correctly, and you must carefully follow ...
Our newest feature launch offers UCR pricing for Outpatient Facility. We recently released pricing information based on databases of insurance claims from private-sector health care providers.Usual, customary, and reasonable charges (UCR) are medical fees used when there are no contractual pricing agreements and are used by certain healthcare plans and third-party payers to generate ...
Medical Necessity using Soap can prevent a future audit!
How Do I Correctly Document all my notes on every patient regardless of the insurance I am billing?
Medically necessary care is the reasonable and essential diagnostic, preventive, and treatment services (including supplies, appliances, and devices) and follow-up care as determined by qualified ...
There was no huge announcement when CMS released new files in April. The files that were released on April 7, 2020, actually replaced files to update the NCCI edits on Procedure to Procedure (PTP) edits and Medically Unlikely Edits (MUE). The updated files included;
291,902 Deleted Procedure to Procedure (PTP) edits
197 Deleted Medically Unlikely ...