CMS is weighing an expansion of the hospital outpatient department prior authorization program, changes to 340B reimbursement in the wake of the Supreme Court’s decision, and alternative rate setting data among other proposals in the 2023 Outpatient Prospective Payment System (OPPS) proposed...Read More »
Payment cuts are in the offing for Part B providers in 2023, along with a series of other projected changes targeting E/M services, COVID-19-related billing flexibilities, and value-based care, according to the 2023 Medicare Physician Fee Schedule (MPFS) proposed rule released July 7.Read More »
After a hospital gave an incorrect price estimate to a patient, the Colorado Supreme Court ruled that the patient should not have to pay the amount reflected in the hospital’s chargemaster.Read More »
Medicare Advantage Organizations (MAO) sometimes inappropriately delay or deny beneficiaries’ access to medically necessary care, according to a recent OIG report. The OIG conducted a study and found that Medicare Advantage beneficiaries were denied access to services such as advanced imaging...Read More »
