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
Health care reform
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
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
Watch for your MIPS participation status letter
The Centers for Medicare & Medicaid Services is reviewing claims and letting practices know which clinicians need to take part in MIPS, the Merit-based Incentive Payment System. MIPS is an important part of the new Quality Payment Program. In late April through May, practices will get a letter from the Medicare Administrative Contractor that processes Medicare Part B … [Read more...] about Watch for your MIPS participation status letter
Repeal and Replace has failed. Now what?
By Ron Howrigon bio It's no secret that the healthcare environment is changing on a daily basis. As it stands today, it appears highly unlikely that the Republicans will be able to make good on their promise to repeal and replace the Affordable Care Act. This means Obamacare (or some form of it) will continue to be the law of the land. Many physicians and medical … [Read more...] about Repeal and Replace has failed. Now what?
CMS’ Accountable Health Communities Model selects 32 participants to serve as local ‘hubs’ linking clinical and community services
Last year, the Centers for Medicare & Medicaid Services (CMS) released a Funding Opportunity Announcement (FOA) for applications for the Center for Medicare and Medicaid Innovation's (Innovation Center) Accountable Health Communities (AHC) model. Over a five-year period, CMS will implement and test the three-track AHC model to support local communities in addressing the … [Read more...] about CMS’ Accountable Health Communities Model selects 32 participants to serve as local ‘hubs’ linking clinical and community services
Nearly $100 million awarded to help small practices succeed in the Quality Payment Program
The Centers for Medicare & Medicaid Services (CMS) has awarded approximately $20 million to 11 organizations for the first year of a five-year program to provide on-the-ground training and education about the Quality Payment Program for clinicians in individual or small group practices of 15 clinicians or fewer. CMS intends to invest up to an additional $80 million over the … [Read more...] about Nearly $100 million awarded to help small practices succeed in the Quality Payment Program
CMS extends 2016 PQRS EHR submission deadline
CMS is extending the submission deadline for 2016 Quality Reporting Document Architecture (QRDA) data submission for the Electronic Health Record (HER) reporting mechanism. Individual eligible professionals (EPs), physician quality reporting system (PQRS) group practices, qualified clinical data registries (QCDRs), and qualified EHR data submission vendors (DSVs) now have … [Read more...] about CMS extends 2016 PQRS EHR submission deadline