Medicaid Enrollees Struggle to Receive Psychiatric Care
HCPLive
AUGUST 5, 2024
In a "secret shopper" study, investigators posing as Medicaid enrollees found many clinicians in Medicaid provider directories do not accept Medicaid insurance.
Medicaid Related Topics 
Extending Postpartum Medicaid Linked to Increased Perinatal Mental Health Care
HCPLive
APRIL 12, 2024
A new study found extending postpartum Medicaid from 60 days to 12 months is linked to new mothers being more likely to seek mental health care for perinatal mood and anxiety disorders.
Medicaid 
105
105 Medicaid 105
105 
Medicaid Might Cut Cardiovascular Risk for This One Group
Med Page Today
SEPTEMBER 24, 2024
(MedPage Today) -- Getting onto Medicaid might not improve cardiovascular risk factors universally, but it did for some individuals, as secondary analysis of a randomized trial showed. Previously uninsured, low-income individuals who won a lottery.
Medicaid 102
102 
DAA Use Increased After State Medicaid Programs Eased HCV Treatment Restrictions
HCPLive
APRIL 18, 2024
The modified difference-in-differences analysis found notable increases in DAA use after state Medicaid programs relaxed certain coverage restrictions.
Medicaid 104
104 Medicaid 104
104 
Medicaid Expansion and Healthcare Workers; Cardiac Rehabilitation
Med Page Today
MARCH 2, 2024
(MedPage Today) -- TTHealthWatch is a weekly podcast from Texas Tech. In it, Elizabeth Tracey, director of electronic media for Johns Hopkins Medicine in Baltimore, and Rick Lange, MD, president of the Texas Tech University Health Sciences Center.
Despite Acceptance of Medicaid by Pediatric Dermatologists, Access Issues Remain
HCPLive
JULY 1, 2024
These data suggest differences in Medicaid-accepting pediatric dermatologist access based on such factors as geographic area and density of pediatric dermatologists per county.
Medicaid 69
69 
Medicaid Direct-Acting Antiviral Restrictions Linked to Reduced HCV Treatment Rates
HCPLive
JULY 17, 2024
The cross-sectional analysis found Medicaid nonexpansion status, fibrosis, and sobriety restrictions negatively impacted annual rates of DAA prescription fills.
Medicaid 52
52 Medicaid 52
52 
Heart Disease Outcomes Better When Anxiety, Depression Are Treated
Med Page Today
MARCH 21, 2024
(MedPage Today) -- In people with heart disease and comorbid anxiety or depression, mental health treatment showed strong links to better clinical outcomes in an observational analysis of the Ohio Medicaid database. Those hospitalized with coronary.
Heart Disease 124
124 
Abstract 4119868: Statin and PCSK9 Inhibitor Utilization and Spending in Medicaid between 2018 to 2022: A National Analysis
Circulation
NOVEMBER 11, 2024
Introduction:Low-income working-aged adults in the Medicaid program have a high burden of cardiovascular risk factors and disease, but often face barriers accessing necessary therapies. However, Medicaid spending on statins decreased by 7.1%, from $246.2 million statin prescriptions in 2018 compared to 20.3 million to $226.8
Medicaid 40
40 
Life After Change Cyber-attack: Without Payment for Claims, Physicians Struggle to Keep Practices Afloat
DAIC
APRIL 10, 2024
Respondents have received assistance from the Centers for Medicare & Medicaid Services (12 percent), state Medicaid plans (0.7 In addition to dipping into personal funds, respondents did report taking advantage of advance payments, temporary funding assistance, and loans.
Medicaid 105
105 
Health and Hope for Everyone, Everywhere, Starts With Access to Health Care: The Role of Medicaid Expansion
Circulation
JUNE 30, 2024
Circulation, Volume 150, Issue 1 , Page e1-e2, July 2, 2024.
Medicaid 49
49 
CMS Pauses AUC Program For Advanced Diagnostic Imaging, Rescinds Current Regulations
American College of Cardiology
DECEMBER 14, 2023
The Centers for Medicare and Medicaid Services (CMS) has paused the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging and rescinded any current regulations, according to the 2024 Medicare Physician Fee Schedule (PFS) final rule.
CMS 66
66 
Blood-Based Colorectal Cancer Screening Projected to Fall Short Compared to FIT, Colonoscopy
HCPLive
MARCH 26, 2024
A hypothetical triennial blood-based screening test meeting Centers for Medicare and Medicaid Services coverage criteria was cost-effective versus no screening but not compared to FIT, sDNA-FIT, or colonoscopy.
Medicaid 59
59 
CMS Releases Proposed 2025 Medicare Physician Fee Schedule and Hospital OPPS Rule
American College of Cardiology
JULY 10, 2024
The Centers for Medicare and Medicaid Services (CMS) has released the proposed 2025 Medicare Physician Fee Schedule (PFS). Of note, the PFS conversion factor has been updated from $33.2875 to $32.3562, a 2.80% cut.
CMS 63
63 
ACC 2025 Medicare Physician Fee Schedule Final Rule Calculator Now Available
American College of Cardiology
DECEMBER 2, 2024
Work, practice, expense and liability relative value units (RVUs) are updated annually through the Centers for Medicare and Medicaid Services' Medicare Physician Fee Schedule (PFS) rulemaking.
Medicare 45
45 
Stephen Congly, MD: Impact of Generic Nucelos(t)ide Analogues on HBV Treatment Spending
HCPLive
JUNE 10, 2024
Congly explains key findings from his cross-sectional study of costs associated with HBV treatment in patients on Medicaid and the economic impact of generic versus originator use.
Medicaid 52
52 Medicaid 52
52 
Depression Screening Rates during COVID-19 Low Among Telehealth Appointments
HCPLive
FEBRUARY 13, 2024
Telehealth appointments, patients who prefer speaking non-English, older adults, and patients on Medicaid had lower odds of having a depression screening during the early COVID-19 pandemic.
COVID-19 52
52 
Initial Antihypertensive Prescribing in Relation to Blood Pressure Among Florida Medicaid and Medicare Recipients in the OneFlorida+ Research Consortium
Hypertension Journal
JANUARY 16, 2024
Hypertension, Volume 81, Issue 2 , Page e7-e9, February 1, 2024.
Medicaid 45
45 
CMS Releases 2025 Medicare Physician Fee Schedule and Hospital OPPS Final Rules
American College of Cardiology
NOVEMBER 1, 2024
The Centers for Medicare and Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (PFS) final rule and the 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) final rule on Nov. Of note, the 2025 PFS conversion factor is $32.3465, a reduction of 2.83% from $33.2875 in 2024.
CMS 60
60 
Heart of Health Policy | 2025 Medicare Physician Fee Schedule Final Rule: What CV Clinicians Need to Know
American College of Cardiology
DECEMBER 2, 2024
The Centers for Medicare and Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (PFS) final rule on Nov. Of note, the 2025 PFS conversion factor is $32.3465, a reduction of 2.83% from $33.2875 in 2024.
Medicare 45
45 
AUC Program Penalty Phase Suspended Indefinitely: We Answer Your Frequently Asked Questions
Cassling
JANUARY 10, 2023
UPDATE: The penalty phase of the Centers for Medicare & Medicaid Appropriate Use Criteria (AUC) program has been suspended until further notice. A major goal of the AUC is to help providers order the most appropriate test for their patients by using a Clinical Decision Support Mechanism (CDSM).
Medicaid 52
52 
ACC Submits Comments on 2025 Hospital OPPS Proposed Rule
American College of Cardiology
SEPTEMBER 5, 2024
The ACC submitted formal comments to the Centers for Medicare and Medicaid Services (CMS) on Sept. 4, providing feedback and raising concerns on several issues of relevance to the cardiovascular community in the 2025 Hospital Outpatient Prospective Payment System (OPPS) proposed rule.
Hospital 49
49 
ACC Grassroots Efforts Usher in Major Prior Auth Win
American College of Cardiology
JANUARY 24, 2024
The final Centers for Medicare and Medicaid Services (CMS) Interoperability and Prior Authorization (PA) Rule released this month marks a major milestone in reforming prior authorization practices and reflects the ongoing work of ACC Advocacy to reduce prior authorization burden on clinicians.
CMS 49
49 
ACC 2025 Medicare Physician Fee Schedule Proposed Rule Calculator Now Available
American College of Cardiology
JULY 31, 2024
Work, practice, expense and liability relative value units are updated annually through the Centers for Medicare and Medicaid Services’ Medicare Physician Fee Schedule (PFS) rulemaking.
Medicare 53
53 
ACC Grassroots Drives Momentum For Federal Prior Auth Reform
American College of Cardiology
JULY 17, 2024
The legislation builds on regulatory action taken by the Centers for Medicare and Medicaid Services earlier this year, requiring the use of electronic prior authorization, tightening response timelines and updating transparency requirements. The Improving Seniors’ Timely Access to Care Act of 2024 (H.R.
Medicaid 53
53 
CMS Releases FY 2025 IPPS Proposed Rule With Mandatory Hospital Episode-Based Payment Model For CABG
American College of Cardiology
APRIL 12, 2024
The Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2025 Inpatient Prospective Payment System (IPPS) proposed rule, proposing a 2.6% increase in operating payment rates for applicable hospitals. This represents a 3% projected increase in the hospital market basket update with a projected 0.4%
CMS 49
49 
Highlights From the Proposed 2025 Hospital OPPS Rule
American College of Cardiology
JULY 18, 2024
The Centers for Medicare and Medicaid Services (CMS) released the proposed 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rule on July 10. CMS proposes a 2.6% increase to OPPS payment rates that reflects a market basket update of 3.0%
Hospital 49
49 Advanced Medicare Payments Now Available to Clinicians in Response to Cyberattack
American College of Cardiology
MARCH 11, 2024
The Centers for Medicare and Medicaid Services (CMS) announced on March 9 a new opportunity to request advanced Medicare payments for clinicians impacted by the cyberattack and resulting claims disruptions with Change Healthcare.
Medicare 49
49 New CV ASC Registry Suite Tracks Cardiac Procedures and Provides Benchmarks For ASCs
American College of Cardiology
FEBRUARY 15, 2024
The number of cardiac procedures being performed in ambulatory surgery centers (ASCs) has grown significantly over the last decade, and third-party payer reimbursement, led by the Centers for Medicare and Medicaid Services, have resulted in continued trends of minimally invasive cardiac procedures on stable patients increasingly being performed outside (..)
Proposed 2025 Medicare Physician Fee Schedule Deep Dive
American College of Cardiology
JULY 16, 2024
The Centers for Medicare and Medicaid Services (CMS) released the proposed 2025 Medicare Physician Fee Schedule (PFS) on July 10, addressing Medicare payment and quality provisions for physicians in the coming year. Under the proposal, physicians will see a decrease to the conversion factor of 2.80% on Jan.
Medicare 49
49 
CMS Updates Medicare Conversion Factor For Remainder of 2024
American College of Cardiology
MARCH 21, 2024
The Centers for Medicare and Medicaid Services (CMS) has increased the Medicare Physician Fee Schedule (PFS) conversion factor by 1.68% – from $32.74 for services rendered Jan. 1 through March 8 to $33.07 for services rendered March 9 through Dec. 31 – in response to the Consolidated Appropriations Act, 2024 signed into law on March 9.
CMS 49
49 
AliveCor's Kardia 12L ECG System Receives Category III CPT Codes
DAIC
JULY 18, 2024
CPT codes are widely used by government payers, including Medicare and Medicaid, and commercial insurance companies to identify healthcare services and procedures for reimbursement. In accordance with the AMA semi-annual early release schedule, the new codes will be effective January 1st, 2025 and published in the 2025 CPT Code book.
Reimbursement 105
105 
HeartFlow AI Plaque Analysis Achieves Major Milestone Towards Medicare Coverage
DAIC
JUNE 4, 2024
HeartFlow’s accurate and actionable Plaque Analysis aligns with the Centers for Medicare & Medicaid Services (CMS) commitment to supporting technologies that enhance diagnostic accuracy and patient care: HeartFlow Plaque Analysis is the only FDA cleared plaque analysis with a reported 95% agreement prospectively compared to the gold standard, IVUS.¹
Medicare 104
104 CMS Releases the FY 2025 IPPS Final Rule, Finalizes TEAM Program
American College of Cardiology
AUGUST 7, 2024
The Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2025 Inpatient Prospective Payment System (IPPS) Final Rule on Aug. 1, including a 2.9% increase in operating payment rates for general acute care hospitals, representing a 3.4% increase in the hospital market basket with a 0.5%
CMS 49
49 
Lower Prices For Medicare Drug Negotiation Program’s First 10 Drugs Announced
American College of Cardiology
AUGUST 15, 2024
The Centers for Medicare and Medicaid Services (CMS) on Aug. 15 announced the results of price negotiations for the first 10 drugs selected for the Medicare Drug Negotiation Program, made possible by the passage of the Inflation Reduction Act in 2022.
Medicare 45
45 
ONC Releases HTI-2 Proposed Rule to Improve Health IT Interoperability, Update Standards For EHRs, More
American College of Cardiology
JULY 10, 2024
The Office of the National Coordinator for Health Information Technology (ONC) released on July 10 the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule, building on the HTI-1 final rule released in 2023 and additional information blocking rules released (..)
CMS 45
45 
First-of-its-kind ACC Registry Tracks Cardiac Procedures Performed in Ambulatory Surgical Settings
DAIC
FEBRUARY 14, 2024
Recent shifts in third-party payer reimbursement, led by the Centers for Medicare and Medicaid , have resulted in continued trends of minimally invasive cardiac procedures on stable patients increasingly being performed outside of a hospital setting.
Outpatient 105
105 ACC Submits Comments on FY 2025 IPPS Proposed Rule
American College of Cardiology
JUNE 6, 2024
The ACC submitted formal comments on June 5 to the Centers for Medicare and Medicaid Services (CMS) regarding the Fiscal Year (FY) 2025 Inpatient Prospective Payment System (IPPS) proposed rule.
BioCardia Announces CMS Approval of Coverage for CardiAMP Cell Therapy Confirmatory Phase III Heart Failure Study
DAIC
MARCH 13, 2024
Getty Images milla1cf Wed, 03/13/2024 - 16:49 March 13, 2024 — BioCardia, Inc. ,
CMS 111
111 
CMS Seeks Feedback on Cardiac CT Billing and Payment
American College of Cardiology
AUGUST 22, 2024
The Centers for Medicare and Medicaid Services (CMS) summarized a recent billing edit change in the 2025 Hospital Outpatient Prospective Payment System (OPPS) proposed rule, which fixes an issue that previously prevented hospitals from reporting costs for cardiac computed tomography (CT) as cardiology services.
CMS 40
40 
Trends in direct health care costs among US adults with atherosclerotic cardiovascular disease with and without diabetes
Cardiovascular Diabetology
JULY 7, 2024
The costs were direct total health care expenditures (out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources) from various sources (office-based visits, hospital outpatient, emergency room, inpatient hospital, pharmacy, home health care, and other medical expenditures).
Diabetes 72
72 CV Highlights From the 2025 Hospital OPPS Final Rule
American College of Cardiology
NOVEMBER 12, 2024
The Centers for Medicare and Medicaid Services (CMS) released the 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) final rule on Nov. The rule will implement a 2.9% increase to OPPS payment rates that reflects a market basket update of 3.4% reduced by a productivity adjustment of 0.5%.
Hospital 40
40 
PO-06-102 COMPARING ABLATIONS TO ABLATIONS: ARE MANDATED HOSPITAL PRICING LISTS USEFUL FOR COMPARING THE COST OF CARDIAC ABLATION PROCEDURES AT PEER HOSPITALS?
HeartRhythm
APRIL 30, 2024
As of 2019, the Center for Medicare and Medicaid Services requires that each hospital publish the standard prices of the procedures it offers in a document called a chargemaster. The stated purpose of this rule is to promote pricing transparency and help patients and health plans make informed healthcare decisions.
Hospital 40
40 
How to Get Free or Lower Cost Insulin for Your Medicare and Non-Medicare Patients: Shattering Barriers to Insulin Access
Cardiometabolic Health Congress
JANUARY 26, 2024
Get more information about this new insulin benefit Learn more about insulin costs in Part D and Part B Read the FAQ on Medicare insulin cost-sharing changes (January 2023) How to Get Insulin for Your Medicaid Patients Most Medicaid patients receive insulin for free or at a nominal cost.
Medicare 59
59 
Let's personalize your content