Riding the Silver Tsunami: Demographics Drive Home Health Revolution The term 'Silver Tsunami' is often treated as a distant metaphor, but for the healthcare industry, it is a looming economic…
Little-known facts about Medicare Qualifying for Medicare is Not Automatic, and Not All Over-65-Year-Olds Meet the Minimums. Medicare Part B is Not Free, Not Every Type of Medical Care is…
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 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…
CPT Test Procedure Codes for COVID-19 Testing COVID-19 testing and diagnosis codes are an essential component to collecting and analyzing data to understand the pandemic. U.S. Health and Human Services…
Important Update Notice This article was originally published on June 29, 2020. Eligibility limits, covered benefits, billing rules, program names, and source links change over time. Always verify current requirements…
The Medicare Beneficiary Identifier (MBI) is now required for all Medicare transactions. In other words, for medical billing use of the MBI is essential. The Centers for Medicare & Medicaid…
Home Health Patient Driven Groupings The Centers for Medicare and Medicaid (CMS) announced a new Patient-Driven Groupings Model for Home Health that replaces the Prospective Payment System effective January 1,…
Forbes published an article on December 11, 2019, after interviewing the Administrator of the Centers for Medicare and Medicaid Services (CMS), Seema Verma. Ms. Verma itemized three focus areas: the lack…
What is OIG Regulatory Guidance in Healthcare? OIG Regulatory Guidance has seven elements and is divided by the healthcare industry sector. The U.S. HHS Office of the Inspector General (OIG)…
The Centers for Medicare & Medicaid Services (CMS) has issued the federal fiscal year (FFY) 2020 final rule for the skilled nursing facility prospective payment system (SNFPPS). Highlights of the…