Medicare Reimbursement News and Resources for Healthcare

CMS Cuts Medicare Pay, AHA Sues HHS on Tracking Technology Policy

November 9, 2023 - In its calendar year (CY) 2024 Medicare Physician Fee Schedule (PFS), CMS announced it will slash Medicare payments by 1.25 percent. Primary care and direct patient care providers received an increase in pay while other specialties will take a decrease to maintain budget neutrality. The American Hospitals Association (AHA) took legal...

Geisinger to Pay $18M for Alleged Medicare Billing Violations

November 05, 2021 by Kyle Murphy, PhD

Hello darkness, my old friend. It's time to turn the clocks back and bid an early goodnight to the sun. Geisinger Settles Allegations for Medicare Billing Violations The US Attorney’s...

Pfizer’s COVID-19 Vaccine Granted Full FDA Approval As CMS Ups Its Reimbursement

August 25, 2021 by Emily Sokol, MPH

COVID-19 remains in the spotlight of this week’s policy recap as Pfizer-BioNTech’s COVID-19 vaccine is granted full FDA approval. And CMS boosts reimbursement rates for COVID-19 vaccines...

Marketing Linked to Billions in Medicare Drug Spending; AHA to Square Off Against HHS Before SCOTUS

July 06, 2021 by Kyle Murphy, PhD

Welcome back to work after a long (and for many in the Northeast rainy) weekend. Direct-to-consumer marketing appears to be paying off for pharma companies as far as Medicare drug spending is...

Humana’s Bold Goal Benefitting Members; Healthcare CIOs Eye Patient Engagement Technology

May 20, 2021 by Kyle Murphy, PhD

Happy Thursday. A downward trend in COVID-19 cases and deaths is good news as reopening moves forward across the nation. Patient Engagement Technology a Top CIO Priority in 2021 Patient engagement...

Healthcare Artificial Intelligence Faces Concerns Over Bias; Merck Advances Treatment of Breast Cancer

May 18, 2021 by Kyle Murphy, PhD

Happy Thursday and hold onto your masks (depending on where you reside). BIAS HOLDING BACK HEALTHCARE ARTIFICIAL INTELLIGENCE To ensure the safe and effective use of artificial intelligence in...

HHS Supports Community-Based Organizations, Changes to Title X; CMS Delays Reimbursement Cuts

April 21, 2021 by Emily Sokol, MPH

HHS announced funding to support community-based organizations in their battle against COVID-19 and proposed changes to Title X to promote more equitable care delivery. Meanwhile, CMS delays...

Pfizer/BioNTech Vaccine Safe for More Teens; AHA Challenging CMS Over Site-Neutral Payments

April 01, 2021 by Kyle Murphy, PhD

As the vaccine rollout moves forward for American adults and older teens, new research shows that the Pfizer/BioNTech vaccine is safe and effective for younger teens. AHA is pushing back against a move...

COVID Relief Bill Could Mean Medicare Cuts; Patient Financial Literacy Impacts Revenue

March 23, 2021 by Kyle Murphy, PhD

Industry groups are keeping a close eye on both chambers of Congress as a federal relief bill could seriously impact Medicare reimbursement. Meanwhile, new data highlights the connection between...

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