Wednesday, June 18, 2025
News
- 2023 Doctors & Clinicians Preview Period Open Until June 25
- Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21
- Medicare Part B Discarded Drug Program: Get the Latest Updates
- Medicare Part B Blood Clotting Factor Furnishing Fee Guidance
- Medicare Part B Average Sales Price Guidance
MLN Matters® Articles
From Our Federal Partners
News
2023 Doctors & Clinicians Preview Period Open Until June 25
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.
Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21
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.
Medicare Part B Discarded Drug Program: Get the Latest Updates
CMS updated the Discarded Drugs webpage for the 2024 program year. We added educational materials and made changes to the:
- Calculation to include updated refund quarters
- Timeline for this program year
- Payment portal screens
For more information, visit the Average Sales Price Education & Outreach webpage.
Medicare Part B Blood Clotting Factor Furnishing Fee Guidance
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.
Medicare Part B Average Sales Price Guidance
CMS released guidance for manufacturers on the Average Sales Price Education & Outreach webpage. Learn how to:
- Correct data submission errors
- Handle restatement for inaccurate data
MLN Matters® Articles
Updates to Colorectal Cancer Screening & Hepatitis B Vaccine Policies
Learn about changes (PDF) effective January 1, 2025:
- Coverage changes for colorectal cancer (CRC) screening tests
- 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
VA Recovering Overpaid Claims from Some CHAMPVA Providers
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).
What Happened
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.
What This Means for You
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.
What’s Next for Affected Claims
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.
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