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CMS issued a proposed rule outlining plans to place new limitations on Medicaid state-directed payments (SDP) to reduce federal costs and better align Medicaid payments with Medicare standards.
After the FDA recently reclassified osteogenesis stimulators as class II devices, claims with certain HCPCS codes should no longer include modifier -KF.
UnitedHealthcare recently announced its plans to cut prior authorization requirements for 30% of services that previously required insurer approval by the end of 2026.
In the latest update to its Vaccine Administration National Fee Schedule, CMS established three Level II Healthcare Common Procedure Coding System (HCPCS) codes for billing a biosimilar used to treat COVID-19.
The Office of Inspector General (OIG) recently conducted an audit to identify potential vulnerabilities in the Medicare program that could be contributing to improper payments for virtual check-in and e-visit services.
CMS is weighing an expansion of the Comprehensive Care for Joint Replacement (CJR) model as well as cuts to disproportionate share hospital (DSH) payments, according to the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule.
