On April 27, 2021, the Centers for Medicare & Medicaid Services (CMS)  released a proposed rule for the fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The proposed rule includes...

Since the World Health Organization (WHO) announced the release of the International Classification of Diseases, Eleventh Edition (ICD-11) in 2019, the opinion among industry insiders regarding U.S. adoption of the new...

CMS has raised the Medicare payment rate for certain COVID-19 antibody infusions and included a new payment policy for at-home administration, which will have a higher payment rate compared to other healthcare settings.

The term “medical necessity” is used far and wide in medical care. But medical necessity is not a singular concept, like gravity, nor is it completely undefinable, like love. As a broad definition, it means that the plan of care is going to benefit...

Many nursing home COVID-19 patients would have benefited from daily, reimbursed-for physician visits in their skilled nursing facilities, but they were not entitled to them. 

The Centers for Medicare & Medicaid Services (CMS) has issued its first proposed payment rules under the Biden Administration. While these rules are required to update Medicare payment rates for different provider types, they...