Important QPP Updates- CMS Releases 2024 MIPS Final Scores Click to Enlarge The Centers for Medicare & Medicare Services (CMS) has released Merit-based Incentive Payment System (MIPS) payment adjustment information for the 2024 performance period/2026 MIPS payment year. Physicians’ 2024 MIPS final score determines the MIPS payment
CMS Confirms IDR Process Active, During Shutdown Click to Enlarge The federal government shutdown is sending ripples across healthcare, but some critical processes remain intact. The Centers for Medicare & Medicaid Services (CMS) has confirmed that the Independent Dispute Resolution (IDR) process—a key mechanism for settling
Manufacturers No Longer Participating in Medicaid Drug Rebate Program Click to Enlarge Effective October 1, 2025, select manufacturers will discontinue participation in the Medicaid Drug Rebate Program (MDRP). NYRx, the Medicaid Pharmacy Program, will no longer cover products made by these manufacturers. Salix Pharmaceuticals, the manufacturer of
Update on Medicare Operations: Telehealth, Claims Processing, and Medicare Administrative Contractors Status During the Shutdown Click to Enlarge As of October 1, 2025, Medicare telehealth flexibilities granted during the COVID-19 Public Health Emergency have expired, rolling coverage back to pre-pandemic rules. MSSNY urges New York physicians
You Asked, NGS Listened – Introducing the Modifier Lookup Tool Click to Enlarge National Government Services (NGS) values the feedback of our providers and uses it to improve your experience continuously. NGS is excited to announce the launch of the Modifier Lookup Tool, designed to give
HHS Drives Reform to Restore Patient-Centered Care, Announces Request for Nominations of Members to Serve on Federal Healthcare Advisory Committee Click to Enlarge The U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) are establishing the Healthcare Advisory Committee—a
NYRx Expands Brand Less Than Generic Program: Key Updates for Prescribers and Pharmacists Click to Enlarge New York’s Medicaid program, NYRx, is implementing important changes to its Brand Less Than Generic (BLTG) Program effective August 21, 2025. This program ensures patients receive the most cost-effective option—sometimes
CMS-1500 Mandate August 1 Deadline: What NY Physicians Need to Know Click to Enlarge New York physicians treating workers’ compensation patients must prepare for a critical regulatory shift. Effective August 1, 2025, the NYS Workers’ Compensation Board will require all CMS-1500 forms to be submitted electronically via a Board-approved submission partner. Failure
CMS-1500 Mandate August 1 Deadline: What NY Physicians Need to Know Click to Enlarge New York physicians treating workers’ compensation patients must prepare for a critical regulatory shift. Effective August 1, 2025, the NYS Workers’ Compensation Board will require all CMS-1500 forms to be submitted electronically via a Board-approved submission partner. Failure
NYRx Now Accepts ePA Requests via CoverMyMeds® Starting July 15 Click to Enlarge As of July 15, 2025, NYRx, the Medicaid Pharmacy Program now accepts electronic prior authorization (ePA) requests via CoverMyMeds® in addition to the current phone and fax submission methods. For more information, please
