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  • Could 340B Cuts Hurt Facilities?

    The Hospital Outpatient Prospective Payment System (OPPS) proposed rule for 2018 includes a change in the 340 B program payment rate for certain Medicare Part B drugs purchased by hospitals, and it asks for comment. The Centers for Medicare & Medicaid Services (CMS) say the proposal has the potential of cutting drug costs by approximately $180 […]... Read more »

  • Getting Plugged In

    Do you ever feel like you are working in a void with no one to go to when you have a coding (or billing, compliance, etc.) question? I travel a lot, for work, and almost as much for fun, and the number of people I’ve met in the healthcare community who’ve expressed feeling alone and […]... Read more »

  • 2018 MPFS Proposed Rule Eases Reporting Criteria

    There’s a definite theme seen throughout the 2018 Medicare Physician Fee Schedule (MPFS) proposed rule: The Merit-based Incentive Payment System (MIPS) is referred to in nearly every section. In reading the proposed rule, it becomes evident that the Centers for Medicare & Medicaid Services (CMS) is clearly working toward aligning all Medicare Part B payment […]... Read more »

  • Proposed 2018 Hospital Outpatient, ASC Payment Released

    The Centers for Medicare & Medicaid Services (CMS) released the proposed policy and rate changes for the Hospital Outpatient, Ambulatory Surgical Center Payment Systems.  Commonly called OPPS and ASC, these systems are updated annually and the proposed version, “reflects a broader strategy to relieve regulatory burdens for providers; support he patient-doctor relationship in healthcare; and […]... Read more »

  • CMS to Implement Advanced Diagnostic Imaging Monitoring Program

    The Centers for Medicare & Medicaid Services (CMS) has a date in mind for implementing the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging services. In the 2018 Medicare Physician Fee Schedule (MPFS) proposed rule, CMS proposes Jan. 1, 2019, as the date when ordering professionals would need to consult specified applicable AUC using a qualified clinician […]... Read more »

  • National Minority Health Month: Bridging Observance and Action to Achieve Health Equity

    By Cara V. James, PhD, Director, CMS Office of Minority Health  Each April we observe National Minority Health Month. This year’s theme is, Bridging Health Equity Across Communities. This theme acknowledges the important role that social determinants of health play in individual and community well-being. It also evokes action and activity  around health equity. For it is not enough for us to simply observe National Minority Health Month and share statistics on long-standing health and health care disparities. We should strive to move the needle by reducing these disparities and improving health care quality and outcomes for all. As this National Minority... Read more »

  • CMS’ Ongoing Commitment to Minority Health

    April 26, 2017 By: Seema Verma, Administrator, Centers for Medicare & Medicaid Services (CMS) As many of you know, April is National Minority Health Month, and it’s a privilege to be Administrator at the Centers for Medicare & Medicaid Services (CMS) and take part in the observance. This year’s theme is “Bridging Health Equity Across Communities”. At CMS we have an extraordinary opportunity to improve health outcomes for the over 100 million people that we serve every day. Our primary mission is to make healthcare accessible and affordable for all Americans. During this important month, we continue our efforts to raise awareness about... Read more »

  • Supporting Comprehensive and Innovative Care for Children: Request for Information on a Potential Pediatric Alternative Payment Model

    February 27, 2017 By Patrick Conway, M.D., M.Sc., Acting Administrator, Centers for Medicare & Medicaid Services; Deidre Gifford, M.D., M.P.H., Deputy Director, Center for Medicaid and CHIP Services; Ellen-Marie Whelan, N.P., Ph.D., Chief Population Health Officer, Center for Medicaid and CHIP Services; and Alex Billioux, M.D., D.Phil., Director, Division of Population Health Incentives and Infrastructure, Center for Medicare & Medicaid Innovation In partnership with states and providers, the Centers for Medicare & Medicaid Services (CMS) plays a leading role in safeguarding the health of America’s future by providing coverage for more than one in three American children[1]. Through Medicaid and the Children’s... Read more »

  • Mark Your Calendars: January 31st is quickly approaching

    If you still need health coverage for 2017, you have until January 31st to sign up for coverage through Through the website you can review your choices and see if you qualify for financial help. Issuers have confirmed that consumers who select a plan and pay their first premium will have coverage for 2017. And, insurers have signed contracts to provide coverage through 2017. Consumers who want coverage – whether you are new to the Health Insurance Marketplace or have previously enrolled in health coverage – can visit, update your information, or add it for the first time, and... Read more »

  • Data Brief: Sharp reduction in avoidable hospitalizations among long-term care facility residents

    By Niall Brennan, Director of the CMS Office of Enterprise Data and Analytics, and CMS Chief Data Officer; and, Tim Engelhardt, Director of the Federal Coordinated Health Care Office at CMS   Data Brief: Sharp reduction in avoidable hospitalizations among long-term care facility residents For long-term care facility residents, avoidable hospitalizations can be dangerous, disruptive, and disorienting. Keeping our most vulnerable citizens healthy when they are residents of long-term care facilities[1] and reducing potentially avoidable hospital stays has been a point of emphasis for the Centers for Medicare & Medicaid Services (CMS). Over the last several years, with the help from the Affordable Care... Read more »

  • AMA Insurance

    AMA InsuranceGet Coverage... Read more »

  • Interim Meeting of the House of Delegates

    Short description: Find information about the AMA Interim Meeting of the House of Delegates (HOD), where officials and members gather to address policy.Disable social sharing: Add category highlights: Hide short description: Related Content Override: Related Content for 2016 AMA Interim Meeting is underway—get daily updatesRelated Content for Federal funding for Medicaid program should not be capped: AMAAudience: Medical StudentPhysicianResident/Fellow... Read more »

  • Home page: AMA works to protect patients

    On health reform, patients should come before politics Join the AMA in urging senators to VOTE NO on current health care legislation. Contact Congress AMA Vision on Health Reform ... Read more »

  • CPT® Code Applications & Criteria

    Short description: Review the criteria for CPT® Category I, Category II and Category II codes, access applications and read frequently asked questions. Disable social sharing: Add category highlights: Hide short description: Audience: Physician... Read more »

  • CPT® (Current Procedural Terminology)

    Use the Current Procedural Terminology (CPT®) code set to bill outpatient & office procedures. CPT® Overview CPT® Editorial Panel Upcoming Meeting & Calendar Finding Coding Resources FAQ: Editorial Panel & CPT® Overview Applying for CPT® Codes Apply for CPT® Codes Code Change Instructions Statement on Lobbying FAQ: Code Change Application CPT® Changes & Licenses Summary of Panel Actions Apply for a CPT® License Errata & Technical Corrections Newly Released Codes Related Content for WIRE: Get support from CPT®... Read more »