Medicare Part B provides reimbursement at a rate of the average sales price (ASP) plus a 6% add-on fee (ASP 6), a methodology that relies on market-based prices to set reimbursement rates. 6 The 6% is ...
With the shift to value-based healthcare, more procedures are being performed in ambulatory surgery centers (ASCs). In fact, according to the United States Ambulatory Surgery Center Market Report 2019 ...
As reimbursement methodologies continue to evolve in the transition to value-based care, hospitals and health systems are having to rethink their strategies toward financial sustainability. New ...
As managed care contracts move away from grouper-based methodologies, it’s common for payers to casually refer to their new methodology as “Medicare-based;” in reality, however, it is very rare that a ...
On Friday, June 24th, the Supreme Court unanimously agreed with the American Hospital Association (AHA) and 340B hospitals regarding their challenge to outpatient prescription drug reimbursement ...
The Centers for Medicare and Medicaid Services (“CMS”) published an Interim Final Rule in the Federal Register on September 2, 2020 to supplement and strengthen the agency’s enforcement of COVID-19 ...
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