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'Meaningful Use' for Physician Practices: Is It Worth the Trouble? Print E-mail
Written by M. Alexandra Johnson, FACHE and Wilma N. Torres, CPC   
Tuesday, 31 July 2012 19:10

The foundation of the Medicare & Medicaid EHR Incentive Program is to improve quality of care. Facilitating documentation, enhancing provider communication and focusing on indicators that produce better outcomes necessitate an electronic solution for most providers. To achieve this, CMS has created significant and attractive financial incentives: a maximum payment of $44,000 per Eligible Professional (MD, DO, DMD, DDS, DPM, DC, OD) for Medicare, or up to $63,750 per EP for Medicaid. This means that a group with three EPs, could qualify for three distinct payments which are paid over a five-year period.

Eligibility is straightforward. The EP must:
  • Select an electronic health record system from the list of Certified EHR Technology
  • Decide for which incentives to apply; The Medicaid incentive payment is based on a volume of at least 30% Medicaid patients, while the requirement for the Medicare payment is contained in the volume requirements for the core and other measures
  • Register with CMS and receive an ID number
  • Complete an attestation each year. Keep in mind that a distinct attestation must be completed for each EP based on his/her use of the system

However, the hand that giveth, also taketh away, so it's important to understand the requirements that constitute 'Meaningful Use' and the attestation process that validates an EP's eligibility for payment. This is the point at which some of the clients we're coaching through the attestation process throw up their hands and say, "Maybe I don't really need the money." Click here to read more
 
About the authors: M. Alexandra Johnson, FACHE and Wilma N. Torres, CPC are principals at Coleman Consulting Group. The firm's services include:
· Risk Adjusted Reimbursement (MRA)
· Coding & Billing
· ICD-10-CM Consulting & Training
· EMR/Meaningful Use Attestation
· Credentialing & Contracting
For additional information about the firm or to request a complimentary no-obligation consultation, please call 954.578.3331 or email info@askccg.com.


Last Updated on Monday, 13 August 2012 07:23
 
Critical Conversations in Healthcare Print E-mail
Written by Jeffrey Herschler   
Friday, 27 July 2012 10:22

The South Florida Business Journal recently hosted a healthcare panel discussion featuring some of the biggest names in the local healthcare community.

Included on the panel were:
  • Jerry Fedele: President and CEO Boca Raton Regional Hospital
  • Brian E. Keeley: President and CEO Baptist Health South Florida
  • Jeffrey B. Kramer: CPA, Partner Goldstein Schechter Koch
  • Lee F. Lasris: Founding Partner Florida Health Law Center
  • Penny Shaffer: Market President, Florida Blue & immediate Past Chair of the Greater Miami Chamber of Commerce
  • Mike Segal: Partner Broad and Cassel
  • Dr. Fernando Valverde: CEO Florida International University College of Medicine Health Care Network
  • Dr. Steven G. Ullmann: Director of Programs University of Miami Center for Health Sector Management
Not surprisingly the discussion focused on the future of healthcare delivery in the post SCOTUS ACA decision world.  Refreshingly the conversation focused on the policy issues and challenges without overt political partisanship.

Editor's Note:  To save space, initials of panelists are used throughout. 

JF pointed out that there is profound pressure on the health industry regardless of the ACA.  He stated that end of life care is a critical issue left unaddressed by the new health law.  Mr. Fedele predicts "intense" consolidation of providers and insurers.

BK foresees a market-driven solution to the cost crisis, not an ACA solution.  His organization is focusing on four things to prepare for the future:

1.     Physician Integration (i.e. aligning incentives)

2.     Huge Investment in IT

3.     Commitment to Family Medicine

4.     Wellness and Prevention Initiatives  

JK observed that small groups struggle to cope with the rapid pace of change.  He cited as examples EHR adoption, myriad rules and regulations as well as payment reform.  Since solos and small groups can't afford the expertise necessary to affect necessary changes within their practices, they look to be employed or combine to form larger groups. 

LL sees contraction in the healthcare marketplace as well as increased use of physician extenders (nurse practitioners and physician assistants) and changes in physician compensation programs to control cost. 

PS asserted that true healthcare reform would address access, quality and cost.  She laments that the ACA deals with access pretty well but is deficient in solving the quality and cost issues.   

MS emphasized that Fee-for- Service is a thing of the past and solo docs are out of business.  He stated that ACO's are emergent, a "sea-change". Mr. Segal also pointed out that the ACA is only part of the massive transformation going on in the health industry currently. 
 
FV expressed a profound concern for an imminent physician shortage.  He predicts that ARNP's and PA's will assume a huge role in primary care with physicians migrating to the specialties.

SU foresees increased demand for well educated and trained practice and facility administrators.  He warned that Medicare's survival relies on reimbursement cuts that may be draconian. 

Last Updated on Friday, 10 August 2012 10:18
 
CMS names 89 new Medicare accountable care organizations serving beneficiaries in 40 states and the District of Columbia as of July 1 Print E-mail
Written by Jeffrey Herschler   
Friday, 27 July 2012 10:17

Below is a list of the new Florida ACOs:

Accountable Care Coalition of Northwest Florida, LLC, located in Pensacola, Florida, is comprised of networks of individual ACO practices, with 60 physicians. It will serve Medicare beneficiaries in Alabama and Florida.

Accountable Care Partners, LLC, located in Jacksonville, Florida, is comprised of ACO group practices and networks of individual ACO practices, with 65 physicians. It will serve Medicare beneficiaries in Florida and Georgia.

Allcare Options, LLC, located in Parrish, Florida, is comprised of ACO group practices and networks of individual ACO practices, with 198 physicians. It will serve Medicare beneficiaries in Florida.

Florida Medical Clinic ACO, LLC, located in Zephyrhills, Florida, is comprised of networks of individual ACO practices, with 153 physicians. It will serve Medicare beneficiaries in Florida.

FPG Healthcare, LLC, located in Orlando, Florida, is comprised of ACO group practices, with 142 physicians. It will serve Medicare beneficiaries in Florida.

HealthNet LLC, located in Boynton Beach, Florida, is comprised of networks of individual ACO practices, with 55 physicians. It will serve Medicare beneficiaries in Florida.

Integrated Care Alliance, LLC, located in Gainesville, Florida, is comprised of networks of individual ACO practices, with 115 physicians. It will serve Medicare beneficiaries in Florida.

Medical Practitioners for Affordable Care, LLC, located in Melbourne, Florida, is comprised of networks of individual ACO practices, with 126 physicians. It will serve Medicare beneficiaries in Florida.

Palm Beach Accountable Care Organization, LLC, located in West Palm Beach, Florida, is comprised of networks of individual ACO practices, with 337 physicians. It will serve Medicare beneficiaries in Florida.

Reliance Healthcare Management Solutions, LLC, located in Tampa, Florida, is comprised of networks of individual ACO practices, with 36 physicians. It will serve Medicare beneficiaries in Florida.
 
New State Laws Affect Docs and other Healthcare Pro's Charged in Criminal Matters Print E-mail
Written by Elizabeth Perez   
Friday, 27 July 2012 10:13

The war on health care fraud continues to be front and center in Florida. Effective as of July 1, 2012, laws enacted this legislative session amend the draconian licensure penalties (enacted in 2009) for health care professionals who are convicted of certain criminal charges. Currently, licensing boards within the Department of Health must refuse to issue or renew the license of health care professionals if they have been convicted of certain enumerated crimes within 15 years from the date of application. This change relaxes this penalty, but expands the reach of the criminal convictions to similar laws in other jurisdictions.

Click HERE to read the entire article.

Elizabeth Perez is Of Counsel in the Fort Lauderdale office of the statewide law firm Broad and Cassel. A health law attorney, she is a member of the firm's Commercial Litigation, Health Law and White Collar Criminal and Civil Fraud Defense Practice Groups. She may be reached at (954) 764-7060 or epperez@broadandcassel.com.
Last Updated on Friday, 10 August 2012 10:28
 
Saving the Medicaid Expansion Print E-mail
Written by Paul Gionfriddo   
Sunday, 22 July 2012 10:13

Our Health Policy Matters        
 

A column focusing on federal, state and local health policy  

Within days of the Supreme Court's ACA ruling that made the Medicaid expansion optional, the governors of Florida, South Carolina, Iowa, and Louisiana all announced that they wanted to opt out of it

The governors of six other states were considering the same thing.

However they frame their views for the media, they are in fact an attack on two different constituencies.  The first is lower income uninsured families, elders, and single adults, 17 million of whom expected to become insured as a result of the expansion.  The second is safety net providers - nursing homes, hospitals, community health centers, mental health facilities, and others - who need Medicaid dollars to offset the costs of caring for people who have no insurance.

But there could be a very simple way for the federal government to save the Medicaid expansion in those states - and the Supreme Court hinted at it in its majority decision two weeks ago.  This week's Our Health Policy Matters column, Saving the ACA Medicaid Expansion, explains how. 

Click HERE to read the entire blog post.

Last Updated on Sunday, 22 July 2012 10:15
 
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