Clinical Resources Articles
These sleep medicine articles include updates about coding and reimbursement, new practice guidelines, and telemedicine. To view our case study of the month, visit the AASM sleep medicine case studies page.
The Centers for Medicare & Medicaid Services (CMS) has released a new version of the form required for submission of paper claims. CMS will begin to accept the new CMS-1500 form (version 02/12) on January 1, 2014.
The practice management section of the AASM website has been updated to include archived copies of letters sent to private payers regarding their sleep medicine policies. Recent letters now available for download include a policy comment letter sent to Humana and letters sent to MVP and Cigna regarding their preauthorization protocols.
On Aug. 27 the AASM sent a letter to the Centers for Medicare & Medicaid Services (CMS) outlining our concerns about proposed payment cuts to sleep medicine services in the 2014 Medicare Physician Fee Schedule proposed rule.
On Aug. 15 the Institute of Medicine (IOM) of the National Academies posted the proceedings from a February 2013 workshop, “Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement.” Attendees discussed how patients and families can be empowered to become active partners in their health care.
After two program implementation delays, mandatory reporting under the Physician Payment Sunshine Act, now known as Open Payments began on August 1, 2013. The Open Payments program is a provision under the Affordable Care Act which requires disclosure of transfer of value such as payments, gifts and investments made by medical device manufacturers and drug companies to physicians.
On July 8 the Centers for Medicare & Medicaid Services (CMS) issued the display copy of the 2014 Medicare Physician Fee Schedule proposed rule, which reflects proposed updates to payment policies and payment rates for services billed on or after Jan. 1, 2014. The field of sleep medicine is projected to experience cuts to payment for all services in 2014. CMS will modify and finalize policies and rates for 2014 in a subsequent final rule with an expected publication date of Nov. 1, 2013.
Newly released data from the Centers for Medicare & Medicaid Services (CMS) show that the number of physicians opting out of Medicare rose from 3,700 in 2009 to 9,539 in 2012. Low reimbursement rates and burdensome rules were the key reasons cited for opting out of the Medicare program.
On July 8 the Centers for Medicare & Medicaid Services (CMS) issued the display copy of the 2014 Medicare Physician Fee Schedule proposed rule. The rule reflects proposed updates to payment policies and payment rates for services billed on or after Jan. 1, 2014.
The AASM has heard from members around the country experiencing issues related to utilization management review and preauthorization for diagnostic sleep testing, including the credentialing and appeals processes. Leadership and staff are taking action on your behalf and working with carriers to ensure their processes are centered on quality care for our patients.
Last week, the White House issued a final rule detailing which individuals could obtain exemptions from penalties for noncompliance with the Affordable Care Act's individual mandate.