The Centers for Medicare & Medicaid Services (CMS) is deeply committed to ongoing data transparency and creating a patient-centered healthcare system, where clinicians are challenged to lower costs and increase the quality of care they provide. At the same time, we want to empower patients to make more informed healthcare decisions by providing meaningful information about their healthcare providers. The Quality Payment Program (QPP) is a key component of these efforts.

History tells us that when monopolies form prices rise, innovation sputters, and consumers suffer.  It is curious why advocates for single-payer, government-run solutions ignore this reality, as if healthcare is somehow exempt from economic forces.  Turning our healthcare payment system into a government-run monopoly is a recipe for high costs and long wait times.

One of my commitments as the Administrator of the Centers for Medicare & Medicaid Services (CMS) is to ensure we remain steadfast in our commitment to strengthen Medicare by making sure that tax dollars are spent appropriately.
Transmittal #
R199SOMA
Issue Date
2020-01-17
CR #
N/A
Subject
Revisions to State Operations Manual (SOM) Chapter 6 - Special Procedures for Laboratories and Chapter 9 Exhibits
Implementation Date
2020-01-17
Publication #
100-07

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Bill Correctly for Polysomnography Services

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anonymous
Submitted by FHNX on Thu, 01/16/2020 - 20:08
Title
Bill Correctly for Polysomnography Services
Date

In a recent report, the Office of Inspector General (OIG) determined that CMS improperly paid practitioners for some claims associated with polysomnography services that did not meet Medicare requirements. We revised the Provider Compliance Tips for Polysomnography (Sleep Studies) (PDF) Fact Sheet to help you bill correctly. Additional resources:

Transmittal #
R198SOMA
Issue Date
2020-01-17
CR #
N/A
Subject
Revisions to the State Operations Manual (SOM) Chapter 2 and Chapter 3
Implementation Date
2020-01-17
Publication #
100-07

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Medicare HETS 270/271 - System Availability Resolution - 11:15 PM ET - January 15, 2020

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anonymous
Submitted by B41Z on Thu, 01/16/2020 - 16:38
Date
2020-01-15
Subject
Medicare HETS 270/271 - System Availability Resolution - 11:15 PM ET - January 15, 2020
User Community
HETS 270/271

Medicare HETS 270/271 Submitters:

The Medicare HETS 270/271 system is now responding normally to eligibility requests.  Connections are available and average response times are within normal tolerance.

CMS IT will continue to monitor the situation closely.  We apologize for the inconvenience.  Please contact the Help Desk if you have any questions.