Tagged with Surgery Billing News

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.

CMS Introduces New Cost Comparison Tool

In an effort to improve healthcare price transparency, CMS launched a tool that allows consumers to compare Medicare payments and copayments for certain procedures that are performed in both hospital outpatient departments and ambulatory surgical centers.

Illinois Legislature Overrides Veto of Short-Term Health Plan Limit

State legislators in Illinois have voted to override the Governor’s veto of a bill intended to place restrictions on short-term health insurance plans sold in in the state, which are exempt from offering certain protections required under the Affordable Care Act (ACA).

CMS Finalizes 2019 Medicare Clinical Lab Payment Determinations

CMS has released its final 2019 Medicare clinical laboratory fee schedule (CLFS) payment determinations for new and reconsidered clinical lab test codes. Specifically, CMS finalized the basis for establishing the payment rate (crosswalking or gapfilling), along with the agency’s rationale for the decision.

UnitedHealthcare Medical Policy Updates

UnitedHealthcare (UHC) has released its most recent medical policy updates for November 2018 which includes complete details on UHC medical policy, medical benefit drug policy, coverage determination guideline), utilization review guideline, and/or quality of care guideline updates, as well as new, updated, revised, replaced and retired health services policies.

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