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...
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...
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.
Potentially the most wide-reaching public insurance development of the quarter was the unanimous passage of Senate Bill 870, the Creating High-Quality Results...
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...
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...
May 11, 2017
Roy J.E.M. Raymann, who, as we reported yesterday, left Apple's sleep team a month ago, has moved to SleepScore Labs, a joint venture between ResMed, Dr. Oz Media, and Pegasus Capital Advisors. He will serve as Vice President of Sleep Science and Scientific Affairs.
First announced this year at CES, SleepScore Labs is "currently in the process of examining how people sleep by compiling and...
March 24, 2017
In January, the Centers for Medicare and Medicaid Services announced that it would cover continuous glucose monitoring for the first time; specifically it would cover therapeutic CGMs, of which the only one currently recognized is the Dexcom G5. That coverage officially kicks in today, now that CMS has issued the billing codes providers can use to get reimbursed.
“This is a new era and a huge win...
December 1, 2016
Digital health hires news has been on the slow side around the holiday season, but there is at least one big piece of personnel news: Lisa Suennen, a digital health-focused investor, has joined GE Ventures as Managing Director, focused on healthcare.
Suennen invested with Psilos Group from 1998 to 2014 and for the last two years has been doing deals and consulting at her own firm, Venture...
November 22, 2016
The Medicare Access and CHIP Reauthorization Act, or MACRA, is coming soon, and with it CMS's Quality Payment Program, which requires providers who bill Medicare more than $30,000 a year to report certain performance measures in order to adjust their payments based on performance.
For providers who don't have time to slog through the 2,400 page final rule, figuring out what those measures are...