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Spotlight

  • Expired Medicare Legislative Provisions

    CMS is committed to implementing the Medicare program in accordance with all applicable laws and regulations, including timely claims processing.  Several Medicare legislative provisions affecting providers and beneficiaries recently expired, including exceptions to the outpatient therapy caps, the Medicare physician work geographic adjustment floor, add-on payments for ambulance services and home health rural services, payments for low volume hospitals, and payments for Medicare dependent hospitals.  CMS is implementing these payment policies as required under current law. 

    However, CMS is taking steps to limit the impact on Medicare beneficiaries by holding claims affected by the therapy caps exceptions process expiration for a short period of time beginning on January 1, 2018. 

    CMS is not holding any other claims except those affected by the therapy caps.  If legislation regarding the therapy caps is not enacted in this short period of time, then CMS will release and process the therapy claims accordingly.  Under current law, CMS may not pay electronic claims sooner than 14 calendar days (29 days for paper claims) after the date of receipt, but generally pays clean claims within 30 days of receipt.

  • January 2018 Average Sales Price Files Now Available 

    CMS posted the January 2018 Average Sales Price (ASP) and Not Otherwise Classified (NOC) pricing files and crosswalks on the 2018 ASP Drug Pricing Files webpage. 

  • Register for upcoming MLN Connects® Calls. Space may be limited, register early.

  • Follow us on Twitter!  CMS has added the social media site Twitter to our communication and outreach program. Our main goal is to reach providers, suppliers, health professionals, and others interested in current and up-to-date information on the Medicare Fee-For-Service program. Messages on Twitter will include updates to rules & regulations, MLN products, notices of upcoming National Provider Calls, new web postings, and more.
    • #CMSMLN for all MLN tweets,
    • #CMSNPC for all National Provider Call tweets, or
    • #MLNProducts for all tweets related to MLN products.

MLN Connects Spotlight

  • Subscribe now to receive the weekly MLN Connects for the latest Fee-For-Service program information, event announcements (including National Provider Call announcements), claims and pricer information, and MLN educational product updates.

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