Reimbursement and Payment Methodologies

CMS is seeking comments on a proposed coverage with evidence development for chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory cancer when prescribed by the treating oncologist.

Learn how you can make an impact on revenue integrity through advocacy.

Experts offer perspective and advice on responding to CMS’ price transparency requirements.

Check your processes to implement E/M documentation changes, code updates, and expanded laboratory reporting requirements.

Understand how payment policy changes, C-APC changes, and more will impact your organization.

Hospital stakeholders "immeasurably pleased" with the court's "carefully reasoned decision."  HHS says the ruling could harm funding for other vital healthcare programs.

A proposed rule that would expand the use of prior authorization and step therapy for Part D and Medicare Advantage beneficiaries has earned criticism from patient advocacy groups and praise from pharmacy groups.

CMS’ latest payment system changes and the implications for 2019 and beyond made waves on day one of the 2018 Revenue Integrity Symposium in Litchfield Park, Arizona. Attendees at the back-to-back general sessions on October 16 had the opportunity to ask revenue integrity experts questions about the 2019 outpatient prospective payment system (OPPS) and Medicare physician fee schedule (MPFS) proposed rules and revenue integrity hot topics, including price transparency, Medicare Advantage contracting, noncovered services, and more.