How to Search for Medicare Local Coverage Determinations Medicare Local Coverage Determination (or Medicare LCD) categorizes medical procedures and diagnoses of the patient. In short, claim adjudication systems use business…
Medicare Coverage Requires two Fundamental Things from the Healthcare Provider Medicare requires two things. Medical providers need to ensure that two things are in their medical claims submitted to Medicare…
Medicare Advantage Hospice Carve Ins Medicare Advantage hospice care beneficiaries may enroll into Medicare Advantage (MA) have access to all original Medicare benefits plus additional supplemental benefits beyond what original…
What is Promoting Interoperability? Promoting interoperability was formerly known as "Meaningful Use" under the ARRA HITECH Act of 2009. Promoting interoperability promotes patient engagement and electronic exchange of information using…
Medicare Part D and the Affordable Care Act Medicare Part D first covered Americans in 2005. The Patient Protection and Affordable Care Act (“ACA” or “PPACA”) of 2010 brought noteworthy…
Medicare Local Coverage Determinations for Genetic Testing Medicare Technical Assessment for Molecular Assays To determine coverage for genetic test Medicare LCD, the Centers for Medicare and Medicaid (CMS) requires a…
PAID Act Plus SMART Act Requires NGHPs to Report or Pay Penalties The Medicare, Medicaid and SCHIP Extension Act (MMSEA) of 2007 contains mandatory insurer reporting in Section 111 for…
1. What Does Medicare Cover under Part B? What does Medicare cover? Medicare is health insurance for: People 65 or older Under 65 with certain disabilities People of any age…
Use of Telemedicine During a Public Health Emergency DISCLAIMER This information and compliance guidance has been gathered and interpreted by No World Borders from various resources, including CMS, and Medicare…
Hospice Nursing Labor Shortages, Quality Measures Reporting, and Aggregate Cap Calculations Create Hospice Reimbursement Conundrum DISCLAIMER This Compliance Guidance has been gathered and interpreted by No World Borders from various…
Under Medicare, payments for services performed in provider-based facilities may be fifty (50) percent higher than payments for the same services performed in a freestanding facility. This increased cost is…
Medicare Inpatient Rehabilitation Facility (IRF) Coverage Medicare Part A (Hospital Insurance) covers medically necessary care that insured patients receive in an inpatient rehabilitation facility or unit (‘ inpatient ‘rehab facility, IRF, acute care…