April 2021
Gore and Associates recently announced the first use of the FDA-approved Excluder Conformable AAA endoprosthesis with active control system in cases outside of clinical trials. This device was FDA-approved in January 2021, and was supported by findings in a clinical trial. This device introduces the company’s active control system in AAA treatment. It offers a conformable stent graft; enhanced device positioning; and optional […]
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March 2021
The onset of the COVID-19 pandemic led to emergency temporary flexibilities granted for telehealth services which included traditional fee-for-service reimbursement, relaxation of allowable platforms to be utilized, and the suspension of originating sites and geographic requirements. These temporary expansions are scheduled to expire with the public health emergency (PHE). While discussions of permanent telehealth expansion […]
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In the Centers for Medicare and Medicaid Services (CMS) ongoing effort to maintain budget neutrality, providers have traditionally seen an automatic sequestration of 2% in Medicare payments since implemented by the Budget Control Act of 2011. The Act set the 2% automatic and uniform reduction of Medicare payment cuts for a period of nine years. […]
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CMS is delaying the start date of the first year for its Kidney Care Choices (KCC) payment model until January 1, 2022. The first performance year was to begin April 1, 2021. CMS stated it is extending the model’s implementation period to allow participants more time “to prepare to take on financial and population health […]
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February 2021
As part of the Consolidated Appropriations Act of 2021, Congress extended the moratorium on the 2 percent sequestration which was initiated as part of the Interim Final Rules for Covid-19 in March and April 2020. At that time, the moratorium on the sequestration was to end on 12/31/20; however, due to the law signed on […]
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CMS will reduce 774 hospitals’ Medicare payments in fiscal year 2021 for having the highest rates of patient injuries and infections by 1%. These penalties are based on inpatient hospital admissions from mid-2017 to 2019 before the COVID-19 pandemic. Under the Affordable Care Act, the Hospital-Acquired Conditions Reduction Program was created to prevent harm to […]
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Medicare covers cardiovascular disease screening tests and intensive behavioral therapy for cardiovascular disease. Patients pay nothing when providers accept assignment. Preventative services for cardiovascular disease include: Intense Behavioral Therapy (IBT) for Cardiovascular Disease, AKA CVD risk reduction visit (code G0446) Ultrasound Screening for AAA (code 76706) Cardiovascular Disease Screening Tests (code 80061) To review the […]
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In the Medicare Physician Fee Schedule (MPFS) final rule, CMS created add-on code G2211 to report visit complexity for E/M services. This is based on their on the belief that codes 99202-99215 do not adequately capture the resources associated with patient care in some specialties: +G2211 – Visit complexity inherent to evaluation and management associated […]
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January 2021
Gore and Associates recently announced FDA approval for the GORE® EXCLUDER® Conformable AAA Endoprosthesis with Active Control System for endovascular aneurysm repair (EVAR). The device “builds on the proven clinical performance of the GORE® EXCLUDER® AAA Device and incorporates design elements similar to the Conformable GORE® TAG® Stent Graft.” The new device introduces the company’s […]
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CMS has revised the ERSD PPS CY 2021 final rule by rescinding the requirement for ESRD facilities to report total time of dialysis provided during the billing period by the dialysis machines. All the other finalized policies remain the same, including: Implementation of the ESRD Treatment Choices (ETC) payment model, which mandates adjustment of Medicare […]
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