The federal No Surprises Act (NSA) prohibits out-of-network health care providers and facilities from balance billing commercially insured patients, in certain circumstances. The NSA and its implementing regulations set a method for determining the patient cost-sharing for these out-of-network situations, and when state law does not establish a provider payment methodology, the NSA establishes an…
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For the public health emergency (PHE), CMS altered the definition of “direct supervision” to permit the presence and “immediate availability” of the supervising practitioner through “real-time audio and visual interactive telecommunications.” CMS will continue this policy through December 31, 2024 (it will also be extended to FQHCs and RHCs). (Reference Page, p. 167). Additionally, for…
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Remote Monitoring Services In the Final Rule, CMS provided a clarification on how remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) are addressed and billed. CMS clarified the following points: • After the PHE ends, RPM services are only for established patients. Patients who had received services during the PHE are considered established patients.…
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In late October, the Biden Administration unveiled an executive order aimed at prioritizing the responsible use of artificial intelligence (AI), focusing on safety, security, privacy, equity, and innovation across various sectors. Under the authority of the Defense Production Act, the executive order mandates that AI developers disclose safety test outcomes and relevant data to the…
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On November 1, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2024 Home Health Prospective Payment System (HH PPS) Rate Update final rule, which updates Medicare payment policies and rates for Home Health Agencies (HHAs). This rule includes routine updates to the Medicare Home Health PPS payment rates…
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