Tag: Payment

WASHINGTON – CMS has established a higher rate of $750 to administer monoclonal antibody treatment to Medicare beneficiaries with COVID-19 in their homes, including permanent residences or temporary lodgings.  The new rate accounts for the increased costs associated with the one-on-one nature of this care model and reflects additional information provided to CMS about providing these services in a safe and timely manner.  “CMS’s...

ALEXANDRIA, Va. - The National Home Infusion Association says CMS's interim final rule doesn't go far enough to preserve access to home infusion therapy.“In our view, the CMS interim final rule does not establish a practical path forward for the thousands of patients who depend on IV therapies to manage their clinical conditions at home,” the association states.The NHIA argues that the IFR's expansion of telehealth and broadening of clinical indications for a limited number of Part B...

Dan_Fedor.jpg Many Medicare beneficiaries are being enticed by celebrities on TV to select a Medicare Advantage (MA) plan over original Medicare fee for service (FSS) with all the standard benefits of Medicare at a lower out-of-pocket cost. These plans often state they provide additional benefits, such as gym memberships, transportation and eyeglasses, so how can they provide more benefits with a lower cost? Seems too good to be true, doesn't it? How can these private, for-profit insurance...

ALEXANDRIA, Va. - A proposed rule published last week fails to address a “deeply flawed policy” that reimburses home infusion services only on days when a nurse is present in the patient's home, says the National Home Infusion Association. “This policy fundamentally misunderstands how home infusion is delivered, could jeopardize patient safety and creates barriers that have already inhibited patient access to these services,” said Logan Davis, PharmD, chairman of NHIA's board...

MINNETONKA, Minn. - An alternative to CPAP therapy has been approved by CMS for a new technology add-on payment to hospitals. The NTAP program will provide additional reimbursement on top of the standard Medicare Severity Diagnosis Related Group payment to hospitals under the Medicare Hospital Inpatient Prospective System for Respicardia's remed? System, an implantable device that treats the effects of central sleep apnea by restoring a more normal breathing patter during sleep. The add-on payment...

BANNOCKBURN, Ill. - Option Care and other leading home infusion providers, as well as the National Home Infusion Association, have formed a coalition to advocate for Medicare patients who are losing access to their treatment. Keep My Infusion Care at Home will press legislators to change a provision in the 21st Century Cures Act that modifies the payment structure for certain infusion drugs under the Part B benefit, drastically reducing their reimbursement. The modification, which went into effect...

WASHINGTON - CMS has reversed a small cut to 2016 payments to Medicare Advantage plans. The agency in February stated payments would decline 0.95%, but this week it stated they would go up 1.25%. “The final revenue increase is larger than the February advance notice largely because the Medicare actuaries recently updated Medicare per capita spending estimates for 2014 and 2015,” CMS stated in a press release. “Medicare per capita spending in 2014, 2015 and 2016 is still expected...

CHICAGO - The American Medical Association (AMA) voted this week at its annual meeting to approve a list of guiding principles to ensure the appropriate coverage and payment for telemedicine services. “The principles aim to help foster innovation in the use of telemedicine, protect the patient-physician relationships and promote improved care coordination and communication with medical homes,” according to a press release. The principles stem from a policy report developed by the AMA's...

ATLANTA - Patientco has entered into a partnership with Medical Services of America (MSA), with a goal of increasing the provider's patient payments, according to a press release. Patientco's cloud-based technology will enable MSA to consolidate patient payment methods and payment data. Patientco's platform works seamlessly with MSA's Brightree system. Patientco's platform was originally created for hospitals and physicians groups.