Reimbursement FAQs Articles
In light of the angst and hand-wringing over the soaring costs of biologic drugs that are alleged to be contributing to the unsustainability of biologic treatments, the U.S. Food and Drug Administration (FDA) approval of the first biosimilar in the U.S. was welcome news to many.
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
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].
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.
Complexity is the operational word for reimbursement, and this includes the rules and nuances that govern drugs and biologicals. Here is a summary of important 2014 issues.
