CMS has finalized changes to the Physician Self-Referral Law. The law prohibited physicians from making referrals to an entity, for certain health care services, if the physician had a financial relationship with the entity. The Centers for Medicare & Medicaid Services announced the changes to outdated federal regulations it says have burdened health care providers with … [Read more...] about CMS announces historic changes to physician self-referral regs
Health care reform
2018 performance info now available on Medicare Care Compare and in Provider Data Catalog
The Centers for Medicare & Medicaid Services (CMS) has added new performance information to the Doctors & Clinicians section of Medicare Care Compare and in the Provider Data Catalog (PDC), the successor websites to Physician Compare and the Physician Compare Downloadable Database. Medicare patients and caregivers can use the Care Compare website to search for and … [Read more...] about 2018 performance info now available on Medicare Care Compare and in Provider Data Catalog
Clinicians in three disaster-struck states get MIPS break
If your medical practice is located within the disaster-struck states of Louisiana, California or Oregon you may be eligible for a payment adjustment. In response to the Federal Emergency Management Agency (FEMA) designation of Hurricane Laura and the California and Oregon wildfires as national disasters, CMS has determined that the automatic extreme and uncontrollable … [Read more...] about Clinicians in three disaster-struck states get MIPS break
Resource ready for next year’s QRDA Implementation
The Centers for Medicare & Medicaid Services (CMS) has published the Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG), Schematron, and Sample Files for Eligible Clinicians and Eligible Professionals Programs. The 2021 CMS QRDA III IG outlines requirements for eligible clinicians and eligible professionals to report electronic clinical … [Read more...] about Resource ready for next year’s QRDA Implementation
Physician Compare Preview Period open until Aug. 20
The Physician Compare 60-day Preview Period is officially open as of June 22. You can now preview your 2018 Quality Payment Program performance information before it will appear on Physician Compare profile pages and in the Downloadable Database. You can access the secured Preview through the Quality Payment Program website. Access the resource below on how to preview your … [Read more...] about Physician Compare Preview Period open until Aug. 20
Feds Take Down $2.1 Billion Medicare Genetic Test Fraud Scheme
You know that a branch of lab testing has gone from fad to mainstream when it becomes the subject of a major federal enforcement takedown. Accordingly, the newly announced breakup of a $2.1 billion genetic billing fraud scam, one of the largest Medicare frauds ever undertaken, signifies that genetic testing has officially arrived. Operation Double Helix Known as Operation … [Read more...] about Feds Take Down $2.1 Billion Medicare Genetic Test Fraud Scheme
HIPAA enforcement takes a dramatic new direction
Historically, HIPAA enforcement has focused predominantly on the failure of covered entities to keep protected health information (PHI) private and secure; but now the scope is broadening to encompass keeping PHI too private and too secure. The HHS Office for Civil Rights (OCR), the agency that enforces HIPAA rules, has broken new ground by fining a Florida hospital for failing … [Read more...] about HIPAA enforcement takes a dramatic new direction
Getting that new patient info into EHR before appointment
Here are some reader tips for getting new patient information into the electronic health records prior to an appointment. They come from Tina Wheeler, Practice Manager for General and Laparoscopic Surgical Associates in Maryville, Il. This busy multi-physician general surgery office has four physicians and one nurse practitioner, with patients scheduled among these five … [Read more...] about Getting that new patient info into EHR before appointment
CMS releases 2020 Proposed Rule for the Quality Payment Program
The Centers for Medicare & Medicaid Services (CMS) has released its proposed policies for the 2020 performance year of the Quality Payment Program via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). Key proposals for 2020 performance year of the Quality Payment Program include: Increasing the performance threshold from 30 points to … [Read more...] about CMS releases 2020 Proposed Rule for the Quality Payment Program
MIPS bonuses are easy to earn—IF you can get into the program
The Centres for Medicare and Medicaid Services (CMS) has announced the results of 2018, Year 2 under the Merit-based Incentive Payment System (MIPS). Bottom line: The total number of clinicians participating declined from 1.06 million to 916,058. However, the success rate of participants was higher with 97.6% earning an upward payment adjustment on their Medicare Part B claims … [Read more...] about MIPS bonuses are easy to earn—IF you can get into the program