The CMS (Centre for Medicare and Medicaid Services) released its final rules and guidelines governing the Medicare system of payment for 2021, thus affirming a radical cut in the reimbursement of radiology in 2021, which was proposed early in 2020. However, some surprises sprung in the MPFS (Medicare Physician Fee Schedule) Final Rule, which was […]
CDS, AUC, PAMA, and Patients over Paperwork. One-year CDS with no penalties. Education or enforcement?
The Centre for Medicare and Medicaid Services (CMS) released PAMA (Protecting Access to Medicare Act), according to which ordering providers are now required to consult AUC (Appropriate User Criteria) CDS (Clinical Decision Support) tool while ordering advanced imaging and diagnostic equipment for patients of Medicare. American College of Radiology (ACR) appreciated this announcement, as a […]
According to a report published by RAND, private health insurance plans covering the majority of the population of America paid higher rates of insurance to hospitals compared to similar public plans like Medicaid and Medicare. Going by facts, in 2017, mix-adjusted hospital rates were at 241 percent of Medicare prices, as per findings. The study also considered a negotiated amount of hospital prices relative to Medicare reimbursements for the procedures as well as facilities. People who were enrolled in private healthcare plans were employer-sponsored. If hospital rates to Medicare costs were cut from 2015 to 2017, it would have easily saved $7.7 billion in overall healthcare expenditure for employers, reports RAND. Key Considerations – RAND Report As large discrepancies […]