CMS moved ahead with significant expansions to its site neutral payment policies, including reductions to payments for certain services at expected off-campus provider based departments (PBD), additional price transparency requirements, changes to its methodology for setting MS-DRG rates, and...Read More »
Speaking at the Revenue Integrity Symposium (RIS) is a major professional milestone in the revenue integrity field. RIS speakers gain enormous professional benefits from being recognized as experts in their field,
After receiving negative feedback from industry stakeholders on its new reimbursement approach for certain inpatient Medicare Advantage (MA) claims, Aetna recently extended the policy’s implementation date.Read More »
Part B reimbursement is set for significant changes starting January 1, 2026, according to the 2026 Medicare Physician Fee Schedule (MPFS) final rule, released October 31. The final rule includes numerous major changes to how CMS will calculate reimbursement, updates to telehealth services, and...Read More »
CMS directed Medicare Administrative Contractors (MAC) to lift the claims processing hold issued earlier this month for certain services impacted by the government shutdown.Read More »
Medicare could have saved over $300 million if bundled payments for opioid use disorder (OUD) treatments more accurately reflected the services provided, according to a recent Office of Inspector General (OIG) audit report.Read More »
