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On Jan. 4 CMS issued new guidelines for the use of non-medical services under Medicaid managed care programs and the Children’s Health Insurance Program (CHIP) – further advancing the agency’s agenda to use such means to meet beneficiaries’ social determinants of health (SDOH).
In what looks to be the last iteration of Congress’ year-end appropriations bill for 2023, the daunting 4.5% conversion factor cut to Medicare providers’ reimbursement has been slightly eased with a 2.5% increase to 2023 rates and a 1.25% increase to 2024 rates – trimming but not totally erasing the drop to about 2% for CY 2023.  
Just a few weeks after closing out a Request for Information on its No Surprises Act (NSA) rules, CMS has given anxious providers an early holiday gift: An extension of its enforcement discretion on the convening provider requirements that are part of the Good Faith Estimates (GFE) providers must create for patients.
Help your staff connect E/M visits in the nursing facility and home with the correct place of service (POS) code with an E/M-family-to-POS crosswalk.
An orthopedic surgeon had to pay back millions and was sentenced to years in prison in a case involving compounded drugs – a recurrent theme in recent DOJ health care prosecutions.

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