The update includes a revised MUE value for certain HCPCS codes, retroactive to October 1, 2024.
The update includes a revised MUE value for certain HCPCS codes, retroactive to October 1, 2024.
Employers or insurers would be required to provide immediate medical treatment. If a claim is not compensable, they could seek reimbursement.
Healthesystems attended the meeting to capture key discussion updates.
These disputes would qualify for independent bill review, and contracts must be presented when justifying payments below fee schedule.
Key provisions address billing disputes over contractual discounts.
Among other changes, the bill would ban effective rate contracts, making it difficult to forecast drug costs.
Timelines for bill submission and payment would begin only after a claim is accepted as compensable.
