Reimbursement

The National Organization of Rheumatology Managers (NORM) hosted a Centers for Medicare & Medicaid (CMS) webinar on the Quality Payment Program—which is based on the Medicare Access and CHIP Reauthorization Act (MACRA)—for NORM members.

Will CMS Delay the Implementation of MACRA?

By Jessica Miller

Reimbursement

While testifying before Congress recently, the Centers for Medicare & Medicaid Services Acting Administrator Andrew Slavitt said the agency would consider delaying the implementation of the Medicare Access and CHIP Reauthorization Act to address physician and stakeholder concerns. Read More ›

Implementation of ICD-10—Is That It?

By Karna W. Morrow, CPC, RCC, CCS-P, PCS

Reimbursement

The implementation date of the International Classification of Diseases, Clinical Modification, has come and gone, and we have survived what is arguably the most significant change for providers in the history of reporting healthcare services. As the dust settles, an assessment is recommended. Read More ›

Measuring Outcomes to Improve Quality

By Chase Doyle

Reimbursement

Medicare is poised to incorporate new quality metrics as a guide for payments. At ASH 2015, the CSO of the National Quality Forum discussed the need for measures and reporting systems that reflect patient care and care coordination. Read More ›

From MACRA to MIPS: The New Incentives System for Providers

By Chase Doyle

Reimbursement

Although it may have taken 17 years to repeal the sustainable growth rate formula, according to Lemeneh Tefera, MD, MSc, Medical Officer at the Center for Clinical Standards and Quality in the Centers for Medicare & Medicaid Services (CMS), it was, surprisingly, a bipartisan bill. Read More ›

CMS Reimbursement Policies Resulted in Overuse of Office-Based Cystoscopic Procedures

By Rosemary Frei, MSc

Reimbursement

After the Centers for Medicare & Medicaid Services (CMS) significantly increased physician fees for office-based minor cystoscopic procedures in 2005, there was a spike in this type of procedure. Read More ›

ASCO Calls for “Transformative Approach” to Resolve Site-Neutrality Reimbursement

By Charles Bankhead

Reimbursement

Discussions of site-neutrality reimbursement for oncology services have centered on flawed comparisons of Medicare reimbursement methodologies that would deprive patients of the best available care, according to the American Society of Clinical Oncology (ASCO) policy statement (ASCO. J Clin Oncol. 2015 Oct 26. Epub ahead of print). Read More ›

Medicare Will Begin Reimbursing for Advance Care Planning Discussions in 2016

By Rosemary Frei, MSc

Reimbursement

The Centers for Medicare & Medicaid Services (CMS)’s planned reimbursement of advance care planning services in 2016 is being greeted with enthusiasm by the oncology community. Advance care planning comprises the discussion of options for palliative care, end-of-life care, and advance directives. Read More ›

US Oncologists Favor Establishment of NICE-Like Body to Determine Medicare Reimbursement

By Rosemary Frei, MSc

Reimbursement

According to a recent study, 63.6% of oncologists surveyed favor the establishment of an independent panel of health experts to decide which treatments Medicare will pay for based on a cost-benefit analysis. Less than 50% of patients and members of the general public think this is a good idea. The United Kingdom’s National Institute for Health and Care Excellence (NICE) is one model for such a panel. Read More ›

Federal Government Broadens Reimbursement of PET Scans for Cancer Treatment Follow-up

By Rosemary Frei, MSc

Reimbursement

The recent decision by the Centers for Medicare and Medicaid Services (CMS) to broaden coverage of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) imaging in patients who have been treated for tumors has been welcomed by many in the oncology community, although the decision is not without its critics. Read More ›

Reimbursement

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December 2021, Vol 9, No 1