John and John discuss HCPCS application deadlines, the new review process, and implications for manufacturers.

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Find out how your product will be affected by the new MIPPA legislation, enacted on July 15. CMS made changes to the physician payment cut planned for 2008, the physician quality reporting initiative (PQRI), drug compendia, and Part D.

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Learn about the new policy for using CPT codes for drug administration and the reimbursement implications for manufacturers with non-oncology drugs.

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Find out about the comments submitted so far on the new drug compendia, who has submitted them, the deadline for public comments, and implications for private payers.

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Learn about the current landscape of drug compendia, including their role in Medicare drug coverage, the difference between the DRUGDEX and DrugPoints compendia, the status of USPDI, and the comparative role of medical journals.

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Medicare experts discuss the newly released CAP enrollment data, which includes how many physicians enrolled for 2008, participation rates by specialty and by state, and which drugs are most commonly provided through CAP.

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Covance explains the major changes to the Medicare hospital inpatient prospective payment system for 2008. Find out how CMS?s final rule will affect your products.

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Covance explains proposed changes to the hospital outpatient and ambulatory surgical center payment systems. Find out how CMS?s proposed rules will affect your products.

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CMS proposed a new physician rule to change how it manages the drug compendia. Learn the criteria for evaluating requests for additions to the compendia list, MedCAC?s recommended ?desirable characteristics,? and how CMS will handle internal requests.

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John and John provide background on the role compendia play in coverage of drugs and how it differs for cancer care, why CMS is addressing choice of compendia now, and the status of the USPDI compendium.

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Hear MedPAC?s recommended solutions for more efficient Medicare coverage for ?overlap drugs,? which could be covered under either Part B or Part D.

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In Part IV of our Hospital IPPS series, find out how to use the 2006 MEDPAR (Medicare Provider Analysis and Review) file of Medicare inpatient claims to support your comments to CMS, due June 12th, 2007.

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In Part III of our Hospital IPPS series, our Medicare policy experts discuss the details of charge compression and cost-based relative weights. What is the cost-to-charge ratio and where does it come from? Why is charge compression an important issue?

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In Part II of our Hospital IPPS series, our Medicare policy experts discuss the details of charge compression and cost-based relative weights. What is the cost-to-charge ratio and where does it come from? Why is charge compression an important issue?

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Covance?s Medicare experts break down CMS?s hospital inpatient proposed rule for 2008, which includes changes to severity-adjusted DRGs, cost-based relative weights, charge compression, payments per case, and hospital quality reporting.

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Discover the new PQRI initiative and the bonus payment that physicians can receive to participate. You?ll learn what the initiative is, the eligibility requirements, how providers can participate, and much more.

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CMS is revisiting coding for drugs and biologicals. John and John discuss the newest notice from CMS, what it means, what kinds of manufacturers have a stake in the latest decisions, when the new codes would go into effect, and next steps in the process.

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The issue of brown bagging injectable drugs under Part D is back in the headlines. Find out where CMS currently stands on the issue and why they have been denying claims. Includes guidelines for coverage and reimbursement of Part B drugs under Part D.

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Get a recap of Medicare changes to payments in the hospital setting, including Diagnosis Related Groups (DRGs), the Outpatient Prospective Payment System, and the new Ambulatory Surgical Center (ASC) payment system.

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Get a recap of Medicare changes to payments in the physician office, including Part D vs. Part B, the Competitive Acquisition Program (CAP), and the first Medicare Administrative Contractor (MAC).

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Learn about changes in the physician fee schedule final rule from the proposed rule and the most important rule changes for manufacturers in 2007.

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Get information about the interesting changes in the new hospital outpatient final rule as compared to the proposed rule.

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MMA has instructed CMS to reduce the number of contractors that process Medicare claims and that make local medical decisions down to 15 Part A and Part B entities. Find out more about this substantial change.

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Discover why the transition from Medicaid to Medicare was such a high profile issue, whether it is complete, and what will be different in future transitions, including autoenrollment and involuntary plan reassignment.

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Expert Jane Totten discusses the new payment system for hospital outpatient departments and ambulatory surgical centers, why CMS is proposing changes now after so many delays, and next steps in rulemaking. Comments are due to CMS in October!

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Hospital Outpatient Prospective Payment System proposed rule analysis, part II, includes changes to drug administration in the outpatient setting. Find out the difference in payment and hear examples of what payments might look like next year.

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Hospital Outpatient Prospective Payment System proposed rule analysis, part I, includes changes in reimbursement for separate payable drugs, pass-through drugs, and new drugs that do not yet have codes.

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New calculation methodology for DRG weights, changes for 2007 fiscal year, problems with CMS?s proposed methodology, how these changes will affect DRG payments and what CMS is proposing to address these issues.

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Discussion of CMS transmittal #968 regarding billing, coding, and drug administration in the physician office setting. Find out what was important about the transmittal, what new information it contained, and the major MMA provisions it summarizes.

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Changes to the local coverage determination (LCD) process, which types of local policies will be affected, which kinds of products will be affected, should you seek a national coverage determination (NCD)?

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Medicare Part D vs CAP - how physicians decide which to use, trends among drugs available under both systsms, patient cost sharing, will private payers create a similar program, and advice to manufacturers on customer support for providers under CAP.

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In Part I, John and John discuss the administrative burdens of CAP for physicians, reasons for program delays, who the CAP vendors are, and National Drug Code (NDC) availability.

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The second episode on the Medicare hospital inpatient proposed rule. John and John discuss severity-adjusted diagnosis-related groups (DRGs). Find out what CMS has proposed and why, and how to determine future DRG assignments for different patients.

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The first in a series on the Medicare hospital inpatient proposed rule. John and John discuss major proposed changes to cost-based relative weights. Find out how payments may change for medical and surgical diagnosis-related groups (DRGs).

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Preliminary HCPCS coding decisions for 2007 were recently released. Get information about the May 11-12 meetings on HCPCS coding decisions for drugs and biologicals, including who should attend and how to prepare.

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The Part D enrollment deadline for non-dual-eligibles has changed. Find out how CMS defines non-dual-eligibles, their new enrollment deadline, and the impact of their enrollment on CMS?s enrollment goal.

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Straightforward and succinct expert analysis of the report on Average Sales Price calculation from the Office of the Inspector General (OIG).

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Learn from the policy experts about one of the most frequently misunderstood provisions of the Medicare Reform Act, Part D vs. Part B.

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Looking ahead at Medicare issues in 2006. Topics include Part D, physician payment, competitive acquisition program (CAP), hospital outpatient payment, and CMS?s 2006 rulemaking calendar.

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Insights and analysis of Medicare Part D formularies. Topics include average sales price (ASP), Part B and Part D, Medicare Advantage prescription drug plan (MAPDP), and formulary tiers.

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