Reminders: New Reimbursement Policies Going into Effect in August 2022

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Reminders: New Reimbursement Policies Going into Effect in August 2022

08/15/2022

New Readmission Policy

The new Readmission Policy (EmblemHealth and ConnectiCare) will go into effect Aug. 30, 2022. This policy governs when a readmission will be treated as a separately payable new admission and when it will be treated as a continuation of the first inpatient stay. We notified providers of this change in the May 2022 issue (Reimbursement Policy section) of Office Visit.

 

Durable Medical Equipment Reimbursement Policies

Starting Aug. 1, 2022, the following durable medical equipment (DME) reimbursement policies are being introduced for both EmblemHealth and ConnectiCare:

  • Durable Medical Equipment (DME) in Office / Non-Facility Place of Service (Commercial and Medicare) (EmblemHealth and ConnectiCare)
  • Durable Medical Equipment (DME) Rental vs. Purchase (Commercial and Medicare) (EmblemHealth and ConnectiCare)
Provider Update