Tagged with Multi-Specialty-Billing

CMS Final Rule Blocks States from “Diverting” Provider Medicaid Payments to Third Parties

CMS, in early May, released the Medicaid Provider Reassignment Regulation final rule removing a state’s ability to divert portions of Medicaid provider payments to third parties outside of the scope of what the statute allows. Under the rule, CMS is revoking the authority of states to “divert” certain Medicaid provider payments to a third party to fund other costs on behalf of the provider “for benefits such as health insurance, skills training, and other benefits customary for employees.”

CMS Finalizes Rule to Streamline Medicare Appeals Process

CMS has issued a final rule clarifies changes it has made to the appeals process in the Medicare program for providers, beneficiaries, and suppliers, and streamlines the process for Medicare Parts A and B claims appeals and for Medicare Part D coverage determination appeals.

CMS Claim Status Category and Claim Status Codes Update

CMS has released updates to the claim status and claim status category codes used for the Accredited Standards Committee, Health Care Claim Status Request and Response and ASC Health Care Claim Acknowledgment transactions.

New York City to Implement Health Care Program for the Uninsured

The mayor of New York City has given his approval to move forward with implementation the state’s NYC Care program, an initiative to provide health care to individuals without insurance. NYC Care will be launched in the Bronx on August 1, and will be fully implemented across the city by the end of 2020.

Federal Judge Rules ACA is Unconstitutional

A federal judge in Texas has ruled that the entire Affordable Care Act (ACA) is unconstitutional on the grounds that its mandate requiring people to buy health insurance is unconstitutional and the rest of the law cannot stand without it.

New York – Anthem Reimbursement Policy Updates

Anthem has posted several reimbursement policy updates, including updates to its Rule of Eight” Reporting Guidelines, system updates for 2019, and updates to policy for Modifier 69.

AdvantEdge
AdvantEdge