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All posts by John Aldover

CMS Takes Further Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment

The U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the investigational monoclonal antibody therapy, bamlanivimab and etesevimab, administered together, for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients with positive COVID-19 test results who are at high risk for progressing to severe COVID-19...

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HHS Proposes Changes To The HIPAA Regulations

On January 21, 2021 the Office of Civil Rights (OCR) of the Department of Health & Human Services (HHS) issued proposed changes to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to support individuals’ engagement in their care, remove barriers to coordinated care, and reduce regulatory burdens on the...

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PFS Payment for Office & Outpatient E/M Visits

Effective January 1, for Physician Fee Schedule (PFS) payment of office and outpatient Evaluation and Management (E/M) visits (CPT codes 99201 through 99215), Medicare generally adopted the new AMA coding, language, and interpretive guidance framework. See the fact sheet (PDF) for more information, including: PFS payment of Medicare’s add-on codes for prolonged...

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Improving Accuracy of Medicare Payments

The U.S. Bureau of Labor Statistics (BLS) conducts numerous surveys of hospitals and health care providers that are used by the government to make economic decisions that affect the entire medical care system. Key users include CMS, the Federal Reserve Bank, and the U.S. Congress.  CMS uses these surveys...

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COVID-19 Vaccination FAQs for Employees and Employers

Reference these documents below as you navigate COVID-19 vaccination guidelines. Covid-19 Vaccination FAQs for Employers Covid-19 Vaccination FAQs for Employees   Related links: Covid-19 Related Products Latest News Information provided by CHAP (Community Health Accreditation Partner) on January 26, 2021

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CMS Finalizes Definition of “Reasonable and Necessary”

A definition of “reasonable and necessary” is part of the recently finalized rule,  Medicare Program; Medicare Coverage of Innovative Technology (MCIT) and Definition of ‘‘Reasonable and Necessary’’. As previously reported this rule also establishes a Medicare coverage pathway to provide Medicare beneficiaries nationwide with faster access to new, innovative medical devices designated...

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