The Centers for Medicare & Medicaid Services (CMS) has recently posted the following new and updated resources on the Quality Payment Program website: 2018 Self-Nomination Toolkit for QCDRs & Registries:Offers step-by-step instructions for potential Qualified Registry and Qualified Clinical Data Registry (QCDR) vendors to self-nominate to qualify for the 2018 … [Read more...] about New Quality Payment Program resources are now available
Billing & collections
CMS reveals new Medicare Card design
The Centers for Medicare & Medicaid Services (CMS) recently gave the public its first look at the newly designed Medicare card. The new Medicare card contains a unique, randomly assigned number that replaces the current Social Security-based number. CMS will begin mailing the new cards to people with Medicare benefits in April 2018 to meet the statutory deadline for … [Read more...] about CMS reveals new Medicare Card design
The countdown for MACRA data collection is ON
By Tina Colangelo bio The last day to start collecting data is October 2, 2017. That is less than a month away. It is crucial to take action now and schedule a MACRA practice assessment. At the very least, these four questions need to be answered: Which payment track will I participate in in 2017, the Merit-based Incentive Payment System (MIPS) or an Advanced … [Read more...] about The countdown for MACRA data collection is ON
2018 Health Insurance Exchanges Issuer County Map
The Centers for Medicare and Medicaid Services has posted an update to the Health Insurance Exchanges Issuer County Map. This map is of projected issuer participation on the Health Insurance Exchanges in 2018 based on the known issuer public announcements through August 23, 2017. Participation is expected to fluctuate and does not represent actual Exchange application … [Read more...] about 2018 Health Insurance Exchanges Issuer County Map
OIG Report: CMS dished out $729.4 million in wrongful EHR incentive payments & we’re going to get that money back
Wrongful payments of Electronic Health Records (EHR) incentives are at the focus of two of the month's biggest stories in health care compliance. The first came down on May 31 when the Justice Department announced that one of the biggest EHR software vendors in the country, eClinicalWorks, had settled false claims charges stemming from allegedly overstating the capabilities of … [Read more...] about OIG Report: CMS dished out $729.4 million in wrongful EHR incentive payments & we’re going to get that money back
Now available: 2017 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals, Schematron, and sample files
The Centers for Medicare & Medicaid Services (CMS) has published the 2017 CMS Quality Reporting Document Architecture Category III (QRDA III) Implementation Guide (IG) Version 1.0 (7/07/2017) for Eligible Clinicians and Eligible Professionals (EPs) Programs with Schematron and sample files. This version replaces the 2017 CMS QRDA III IG for Eligible Clinicians Reporting … [Read more...] about Now available: 2017 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals, Schematron, and sample files
AMA launches campaign to maximize physician success in MACRA
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) promises to reshape how Medicare pays physicians under the Quality Payment Program (QPP). Yet, a survey of 1,000 practicing physicians who have been involved in practice decision-making related to QPP shows that fewer than one in four physicians feel well prepared to meet its requirements in 2017, according to a … [Read more...] about AMA launches campaign to maximize physician success in MACRA
5 ways for healthcare providers to get ready for new Medicare cards
By Dr. Richard E. Wild, M.D., FACEP Chief Medical Officer Centers for Medicare and Medicaid Region IV (AL, Fl, GA, KY, MS, NC, SC, TN) Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft, and protect essential program funding and … [Read more...] about 5 ways for healthcare providers to get ready for new Medicare cards
Pain clinic agrees to pay $1.78 million to settle whistleblower lawsuit
Ross Feller Casey, LLP, recently announced that the Atlantic Spine & Joint Institute and its owners, Robert C. McGrath, Sr., D.O., and Robert C. McGrath, Jr., have agreed to pay $1.78 million to settle a whistleblower lawsuit alleging they billed Medicare for procedures that were not medically necessary or were not actually performed. The father and son also pleaded guilty … [Read more...] about Pain clinic agrees to pay $1.78 million to settle whistleblower lawsuit
How to determine your MIPS participation status
Are you unsure of your participation status in the Merit-based Incentive Payment System (MIPS)? Clinicians can now use an interactive tool on the CMS Quality Payment Program website to determine if they should participate in the MIPS track of the Quality Payment Program in 2017. To determine your status, enter your national provider identifier (NPI) into the entry field on … [Read more...] about How to determine your MIPS participation status