Payments for Healthcare: A New Day Is Coming

In late January, the Department of Health and Human Services (HHS) announced that it would fundamentally reform how it pays providers for treatingMedicare patients in the coming years. Speeding up the transition from fee-for-service to pay-for-performance and forcing Medicare to commit to this payment

OPPS 2015 Final Rule: Impact from a Pharmaceutical Perspective

On Oct. 31, the Centers for Medicare and Medicaid Services (CMS) issued the calendar year 2015 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory SurgicalCenter Payment System Policy Changes and Payment Rates final rule [CMS-1613-FC].

Reimbursement FAQs

There’s no doubt that complexity is the operational word for reimbursement, and this includes the rules and nuances that govern drugs and biologicals. Even though some healthcare practitioners’ sites may contract with an outside provider of billing services, it’s incumbent on the providers and their office staffs to know the background information on the requirements of what’s reimbursable.