Medicare coverage updates include revised criteria for lung cancer screening and a code for a newly approved COVID-19 treatment
CMS in February amended its coverage requirements for lung cancer screening and issued a code for a new COVID-19 treatment.
Healthcare stakeholders are invited to contribute suggestions for improving prior authorization
A two-month comment period is available for healthcare stakeholders to suggest electronic standards that would make the prior authorization process more efficient.
News Briefs: Federal vaccination requirements finalized for hospitals and most other healthcare settings
If a hospital’s staff aren’t fully vaccinated by Jan. 4, the organization will be deemed noncompliant with Medicare and Medicaid regulations, according to a new federal rule.
CMS cancels regulations that would ensure coverage of breakthrough medical devices, but new legislation could fill the void
Citing patient safety concerns among other issues, CMS formally canceled a Trump administration rule that would have required Medicare to cover breakthrough medical devices.
AMA releases 2022 CPT code set with new options that apply to COVID-19 vaccination, digital care services and more
The new set features more than 400 CPT code changes from 2021.
In 2022 OPPS rule, CMS plans to reinstate policies pertaining to the inpatient-only and ASC covered-procedures lists
The 2022 proposed rule for the Outpatient Prospective Payment System would reverse 2021 policies that began to phase out the inpatient-only list of procedures and expand the covered-procedures list for ambulatory surgical centers.
HHS sends letter to providers, insurers reinforcing requirements for COVID-19 vaccination and testing to be free for all recipients
Xavier Becerra, secretary of HHS, issued a letter emphasizing that out-of-pocket fees for COVID-19-related services are prohibited.
UnitedHealthcare reverses course on new approach to emergency department claims, but perhaps only temporarily
UHC had announced this week that it would evaluate claims starting July 1 to determine whether ED visits were for emergent or nonemergent events.
Looming UnitedHealthcare policy on coverage of emergency department care draws opposition from hospitals, physicians
In a move strongly opposed by provider associations, UnitedHealthcare soon will start denying coverage of ED care that it deems to have been nonemergent.
New federal guidance seeks to clarify reimbursement of COVID-19 testing and vaccinations
Federal agencies have issued new guidance intended to make it easier for healthcare providers to receive reimbursement for administering COVID-19 tests to insured individuals and for giving vaccinations to the uninsured.