Physician Payment & Practice

PULSE 6/27/2025: CMS Alert Highlights Medicare Fraud Scheme Involving Phishing Fax Requests

CMS Alert Highlights Medicare Fraud Scheme Involving Phishing Fax Requests Click to Enlarge The Centers for Medicare & Medicaid Services (CMS) published an alert on fraud schemes that are increasingly targeting Medicare providers that involve bad actors impersonating CMS and sending phishing

PULSE 6/13/2025: Certification of Additional Federal Independent Dispute Resolution (IDR) Entities

Certification of Additional Federal Independent Dispute Resolution (IDR) Entities Click to Enlarge The Departments of Health and Human Services, Labor, and the Treasury (the Departments) are announcing the certification of two additional independent dispute resolution (IDR) entities, Capitol Bridge, LLC and Livanta LLC

PULSE 6/13/2025: Dispute Closure Error Technical Assistance

Dispute Closure Error Technical Assistance Click to Enlarge The Departments of Health and Human Services, Labor, and the Treasury published the Dispute Closure Error Technical Assistance (TA) to the Overview of Rules & Fact sheets page under the Guidance &

PULSE 6/6/2025: Nomination Period Open for PCMP Breast Cancer Screening Clinician Expert Workgroup

Nomination Period Open for PCMP Breast Cancer Screening Clinician Expert Workgroup Click to Enlarge The Centers for Medicare & Medicaid Services (CMS) and its measure developer are seeking nominations for the Clinician Expert Workgroup that will provide input on the development

PULSE 6/6/2025: Action Required: NYS Mandates Electronic CMS-1500 Billing by August 1

Action Required: NYS Mandates Electronic CMS-1500 Billing by August 1 Click to Enlarge Effective August 1, 2025, the NYS Workers’ Compensation Board (Board) will require health care providers to submit the CMS-1500 universal billing form electronically, through a Board-approved electronic

PULSE 5/16/2025: NGS Medicare Part B 2025 Spring Virtual Conference

NGS Medicare Part B 2025 Spring Virtual Conference Click to Enlarge The National Government Services (NGS) Medicare Part B 2025 Spring Virtual Conference, scheduled for June 3–5, 2025, offers a comprehensive series of sessions aimed at enhancing Medicare compliance for Part

PULSE 5/16/2025: Help Transform the Medicare Beneficiary Health Care Experience with Modern Technologies

Help Transform the Medicare Beneficiary Health Care Experience with Modern Technologies Click to Enlarge Help create modern digital technologies to empower seniors to manage their health journey. We want YOUR ideas. Please join us for a Q&A session on the recent CMS

PULSE 5/16/2025: MSSNY Advocacy Halts New Fidelis Appeals Consent Rule

MSSNY Advocacy Halts New Fidelis Appeals Consent Rule Click to Enlarge It was recently brought to the attention of the Payment and Practice Division that Fidelis was planning to implement a new consent requirement for appeals starting June 1. In

PULSE 5/9/2025: NYRx to Launch Electronic Prior Authorization via CoverMyMeds This Summer

NYRx to Launch Electronic Prior Authorization via CoverMyMeds This Summer Click to Enlarge Beginning this summer, NYRx, the Medicaid Pharmacy Program, will accept electronic prior authorization (ePA) requests via CoverMyMeds® in addition to phone and fax requests. CoverMyMeds is a

PULSE 4/18/2025: NYRx Program Updates Aim to Strengthen Support for Foster Care Youth

NYRx Program Updates Aim to Strengthen Support for Foster Care Youth Click to Enlarge The latest NYRx Education & Outreach Foster Care Agency Newsletter outlines key updates for healthcare providers working with vulnerable populations, including foster care youth. Among the

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