CMS

By Jonah Comstock April 17, 2018
Medicare reimbursement for telehealth services is notoriously patchy. Much to the chagrin of telehealth vendors and healthcare providers, and despite many attempts to change the status quo through legislation, CMS still has a lot of restrictions on the geography of users and provider (rural versus urban, at home versus at a clinic, etc.) and on the technology used (video is reimburseable, for...
By Jonah Comstock January 26, 2018
Last week, we published part 1 of our digital health trends and predictions piece, covering big picture trends like vertical integration and healthcare consumerization, as well as some of the buzzy tech trends of voice, AI, and blockchain. This week, with the help of a range of expert stakeholders, we’re zooming in on four specific areas in digital health to look at what we can expect in the year...
By Dave Muoio January 2, 2018
Following some confusion, a Survey & Certification Letter sent last week has reaffirmed CMS’s stance on texting patient information, specifying that messages sent among clinicians are permissible so long as healthcare teams use a secure platform. Texting patient orders, however, is still prohibited across all platforms. CMS’s clarification comes shortly after a December 18th report from the...
By Jonah Comstock December 26, 2017
Member engagement was the watch word for health insurers in the fourth quarter, as we saw consumer-facing app launches or related moves from Humana, Anthem, Cigna, and UnitedHealthcare. The quarter also saw some big moves from CMS and some interesting developments in the realm of employee wellness. Check out our roundup of Q4 payer news below. If you want to take a look at the whole year, check...
By Jonah Comstock December 13, 2017
As announced in the final rule in November, starting in 2018, a new reimbursable Improvement Activity is being added to the Centers for Medicare and Medicaid Services' Merit-based Incentive Payment System (MIPS), which encompasses using digital tools to monitor patients outside the hospital. Three digital health companies that worked with the CMS to bring about the change weighed in today on the...
November 20, 2017
The U.S. Department of Health and Human Services’ Office of the Inspector General will audit Medicaid payments for telemedicine and telehealth payments to ensure compliance with reimbursement requirements. The report is scheduled for 2019, given the breadth and scope of the project. The audit was added to OIG’s work plan this week, as the agency noted a “significant increase in claims for these...
By Mike Miliard November 6, 2017
As the Quality Payment Program enters its second year, the Centers for Medicare and Medicaid Services issued its 1,653-page final rule on Nov. 2, with an array of implications for the ways physician practices use information technology in 2018. Among the biggest provisions is to allow doctors to use either 2014 or 2015 Edition certified electronic health record technology in Year 2 of the program...
By MobiHealthNews October 20, 2017
This quarter’s news from digital health payers consisted of CMS updates, new information on a few tech-centric insurer deals, and a spattering of employer insurance headlines. Read on for MobiHealthNews’ full roundup for Q3 2017. CMS news Potentially the most wide-reaching public insurance development of the quarter was the unanimous passage of Senate Bill 870, the Creating High-Quality Results...
By Jonah Comstock September 26, 2017
Last week, Centers for Medicare and Medicaid Services Administrator Seema Verma revealed — in a Wall Street Journal editorial and an informal request for information (RFI) — that CMS would be heading in a “new direction” with the Center for Medicare and Medicaid Innovation (CMMI). Primarily, Verma’s CMS seems interested in dropping the mandatory adoption of new payment methods in favor of a...
By Jonah Comstock August 2, 2017
It was good news for Dexcom in January when the Centers for Medicare and Medicaid Services announced they would reimburse for Dexcom’s — and initially only Dexcom’s — continuous glucose monitor. Now the rollouts to Medicare patients are starting, although the company isn’t exactly rolling in that government money. In fact, CEO Kevin Sayer said on a recent earnings call that they’ve yet to see a...