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When coding under a risk-adjustment paradigm, capturing the full range of a patient’s chronic conditions takes on elevated importance. That’s because your payments, and ultimately your coding compliance, may be impacted.

CMS has published feedback and issued a new RFI on proposed "Direct Provider Contracting Models" — which sound a lot like direct primary care, but with CMS paying the bills .

A little-noted feature of the recent U.S. budget law gives a break to radiation therapy providers.

Providers in Harrisburg, Pa., Cincinnati, Ohio, Gainesville, Fla. And Lubbock, Tex., may not be applauding a new CMS final rule that scales back Medicare’s Comprehensive Care for Joint Replacement (CJR) program next year. That’s because in those localities — as well as 30 other high-cost areas — the CJR program continues to be mandatory next year.
CMS is preparing to cancel four mandatory episode payment models for common cardiac and orthopedic conditions that were due to begin in January, according to a proposed rule issued Aug. 15.


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