Medical Billing Blog

CMS to Release MIPS Exemption Notifications Soon

Posted by Scott Shatzman on Mon, Apr, 10, 2017 @ 13:04 PM

Under the Merit-based Incentive Payment System (MIPS) eligible clinicians (EC) are to report quality and cost data to CMS starting this year (2017). This data will be used to determine Medicare Quality Payment Program (QPP) adjustments (positive or negative) in 2019. Because 2017 has been designated as a “transition” year, the amount of reporting required of ECs is minimal.

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MACRA: Might Face Challenge with Trump

Posted by Scott Shatzman on Mon, Apr, 03, 2017 @ 10:04 AM

President Trump promised repeatedly during the campaign to crack down on government waste, fraud and abuse, and the $590 billion a year Medicare program is a good place to start.

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Medicare Payment Advisory Commission: Skeptical of MIPS

Posted by Scott Shatzman on Thu, Mar, 23, 2017 @ 09:03 AM

Medicare’s nascent value-based measurement system may not be a good indicator of which doctors provide high-quality medical care.

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Physician Groups Ask CMS for MIPS Guidance...Quickly!

Posted by Scott Shatzman on Wed, Mar, 22, 2017 @ 14:03 PM

Physicians participating in the Merit-based Incentive Payment System have yet to receive eligibility notifications that the Centers for Medicare and Medicaid Services should have sent in December, according to the Medical Group Management Association.

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CMS Bundled Payment Programs: Delayed

Posted by Scott Shatzman on Tue, Mar, 21, 2017 @ 07:03 AM
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CMS Offers Insights on MIPS, MACRA and APMs

Posted by Scott Shatzman on Wed, Feb, 22, 2017 @ 09:02 AM

A large crowd filled a ballroom at the HIMSS Annual Conference & Exhibition on Monday to hear from the Centers for Medicare and Medicaid Services on how to handle payment reform under the Medicare Access and CHIP Reauthorization Act and the law's mandate to rid Medicare cards of Social Security numbers.

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Healthcare Industry Celebrates Trump's Executive Order

Posted by Scott Shatzman on Wed, Feb, 01, 2017 @ 07:02 AM

Healthcare industry stakeholders are lauding President Donald Trump's latest executive order, which requires executive departments or agencies to remove at least two previously implemented regulations for every new one issued.

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Tom Price: HHS Pick Favored Drugmakers, Device Makers and Doctors

Posted by Scott Shatzman on Tue, Jan, 31, 2017 @ 09:01 AM

As Cabinet nominee Tom Price faces a Senate confirmation hearing Tuesday, a newly released trove of documents sheds further light on how he interacted as a congressman with the Centers for Medicare and Medicaid, the massive agency he may soon oversee.

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MedPAC approves a Number of New Recommendations

Posted by Scott Shatzman on Tue, Feb, 10, 2015 @ 08:02 AM

The Medicare Payment Advisory Commission (MedPAC) is a nonpartisan legislative branch agency that provides the U.S. Congress with analysis and policy advice on all aspects of the Medicare program (cost, reimbursement, access, quality, etc.).  MedPAC issues two annual reports to Congress, one in March and another in June. These reports contain the policy recommendations of the Commission. 

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CMS Shifts Strategy to Combat Fraud

Posted by Scott Shatzman on Fri, Jan, 09, 2015 @ 08:01 AM

Dr. Shantanu Agrawal, MD, the Director of CMS’ Center for Program Integrity (CPI) stated that CPI is going to shift its focus to preventing fraud rather than chasing overpayments down after they have already been paid.  In a speech to the American Bar Association’s Health Law Summit, Agrawal said that “preventative actions have a greater return on investment than the pay and chase model, in which the government seeks the return of overpayments it has already made”.   

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