Log In

2025-06-18-MLNC | CMS

Published 6 hours ago3 minute read

MLN Connects logo

The Doctors and Clinicians Preview Period is open until Wednesday, June 25 at 8 pm ET. Securely preview your 2023 Quality Payment Program performance information before it appears on clinician and group profile pages on the Medicare.gov compare tool and in the Provider Data Catalog.

For more information, visit the Care Compare: Doctors and Clinicians Initiative webpage.
 

CMS issued a Request for Information (RFI) seeking public input on whether and how we can improve hospital price transparency (HPT) compliance and enforcement processes to ensure that the hospital pricing data in the machine-readable file is accurate and complete. This RFI relates to the President’s Executive Order 14221, to ensure compliance with the transparent reporting of complete, accurate, and meaningful HPT data.

More Information:

Respond by 11:59 pm ET on July 21, 2025.
 

CMS updated the Discarded Drugs webpage for the 2024 program year. We added educational materials and made changes to the:

For more information, visit the Average Sale Price Education & Outreach webpage.
 

CMS released guidance for manufacturers on the Average Sales Price Billing Resources webpage. Learn how to determine the blood clotting factor furnishing fee reflected in the 2025 Physician Fee Schedule final rule. 

CMS released guidance for manufacturers on the Average Sale Price Education & Outreach webpage. Learn how to:

    MLN Matters® Articles

    Learn about changes (PDF) effective January 1, 2025:

    • Clarification of policy that applies to complete CRC screening
    • Expanded coverage and changes to billing policies for the hepatitis B vaccine

    From Our Federal Partners

    The U.S. Department of Veterans Affairs (VA) incorrectly processed claims when beneficiaries had more than one other health insurance. They’re recovering more than $41 million from overpaid claims to providers who accept payment under the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).

    The overpayments were caused by an error in the claims adjudication system. From October 2021 – December 2024, the adjudication system incorrectly processed claims when CHAMPVA beneficiaries had more than one other health insurance. This resulted in overpayment to many providers. 

    If you were affected, VA will send you a letter showing the overpaid amount and bill of collection number 741-K5T. You can only make payments online at the Pay.gov Claim Overpayment portal.  

    After recovering overpayments, you can still send the claims to the secondary payer. If the secondary payer doesn’t pay the claim in full, you can resubmit the claim to VA with both explanations of benefit for tertiary payment. 

    Reach out to VA’s Debit Collection Contact Center at 833-930-0816 and follow the prompts if you have questions or need help.
     


    Subscribe to the MLN Connects® newsletter, or read past editions.

    View the Medicare Learning Network® Content Disclaimer and Department of Health & Human Services Disclosure.

    The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health & Human Services (HHS).

    Medicare Learning Network logo

    Origin:
    publisher logo
    cms
    Loading...
    Loading...
    Loading...

    You may also like...