CMS Update on Change Healthcare Security Incident The Centers for Medicare & Medicaid Services (CMS) and National Government Services, Inc. (NGS) are aware that Change Healthcare recently suffered a cyber-attack. Change Healthcare is a clearinghouse vendor that connects providers with insurance payers and has operations that impact the submission of Medicare claims, including NGS. At […]
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Clarification on the New G2211- Are You Billing Correctly? National Government Services (NGS) addresses critical questions and clarifies the new G2211 code to ensure healthcare providers are billing accurately. As part of the Evaluation and Management Services, understanding the nuances of G2211 is crucial for compliance and optimal reimbursement.
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The Cigna Group Announces Plan to Divest Medicare Advantage and CareAllies Businesses The Cigna Group announced an agreement to divest its Medicare Advantage, Cigna Supplemental Benefits (which includes Medicare Supplemental Benefits), Medicare Part D, and CareAllies businesses to Health Care Service Corporation (HCSC). This includes all their Medicare plans, networks, and customers, as well as […]
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2024 Deleted CPT Codes Do you need a copy of the 2024 deleted CPT codes? Send an email requesting it, and we will send it to you. You will receive the codes and the AMA’s recommended replacement code in this Excel sheet. Please contact MSSNY Payment & Practice with any questions you may have.
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CMS Interoperability and Prior Authorization Final Rule CMS-0057-F The Centers for Medicare & Medicaid Services (CMS) affirms its commitment to advancing interoperability and improving prior authorization processes by publishing the CMS Interoperability and Prior Authorization final rule (CMS-0057-F). Through the provisions in this final rule, Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance […]
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New Federal Independent Dispute Resolution (IDR) Administrative Fee and Certified IDR Entity Fee Ranges Posted The Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury (collectively, the Departments) updated the No Surprises Act website to reflect upcoming changes to the Federal Independent Dispute Resolution (IDR) certified […]
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NYRx E&O Update Flovent® and Advair® products continue to be included in the NYRx Brand Less Than Generic Program (BLTG). Due to recent changes announced by the manufacturer including the discontinuation of Flovent® and the decreased production of Advair®, effective December 21, 2023, the NYRx Medicaid Pharmacy Program will allow for the generics to these […]
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Do You Have Unpaid Claims from NYC Law? If you have unpaid claims from NYC Law, please contact Heather Lopez to get additional information that could assist with this issue.
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NYRx Preferred Drug Quick List For NYRx, the Medicaid Pharmacy Program, prescribers should review and prescribe preferred products whenever possible. The preferred drugs generally do not require prior authorization when prescribed according to FDA labeling, unless otherwise indicated. Please refer to the NYRx Preferred Drug Quick List for a resource containing only preferred drugs. The […]
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NYRx Preferred Drug Quick List For NYRx, the Medicaid Pharmacy Program, prescribers should review and prescribe preferred products whenever possible. The preferred drugs generally do not require prior authorization when prescribed according to FDA labeling, unless otherwise indicated. Please refer to the NYRx Preferred Drug Quick List for a resource containing only preferred drugs. The […]
