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CMS Issues Slew of New Rules and Policies to Improve Patient Care, Boost Reimbursements Print E-mail
Written by FHInews   
Tuesday, 08 May 2018 15:20
 
The Centers for Medicare and Medicaid Services (CMS) has been busy pushing out proposed rules and policy changes that will impact healthcare providers and patients in a variety of ways. Among the proposals it has made is a Data Driven Patient Care Strategy that puts patients at the center of healthcare and makes data more accessible and usable in a way that not only enhances efficiency, but also improves quality while also reducing cost. As part of the strategy, CMS announced it is releasing encounter data from Medicare Advantage plans to researchers on everything from inpatient care to home health.

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Last Updated on Tuesday, 08 May 2018 15:55
 
OIG Report Finds Improper Billing for Telemedicine Services Print E-mail
Written by Vitale Health Law   
Tuesday, 24 April 2018 17:17

As the push to increase the use of telemedicine grows, so too do concerns over questionable billing practices.

In a recently released report, the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that the Centers for Medicare and Medicaid Services (CMS) paid practitioners for services that did not meet Medicare requirements.

To give you an idea of how much the use of telemedicine is growing, the OIG points out that in 2001, Medicare paid a total of $61,302 for telemedicine services. In 2015, that figure skyrocketed to $17.6 million.

Between 2014 and 2015 the watchdog agency reviewed 191,118 distant-site telemedicine claims that did not have corresponding originating site claims, totaling approximately $13.8 million.

Certain conditions must be met for providers to submit telehealth claims through Medicare Part B. For example, the originating site must be a practitioner's office or a medical facility, not in a patient's home, and the beneficiary must be located in a qualifying rural area.

OIG found that out of 100 sample claims reviewed, 31 claims did not meet Medicare requirements. It breaks down like this...

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Bipartisan Budget Act of 2018 Includes Significant Changes in Medicare, Other Federal Health Programs   Print E-mail
Written by FHI's Week in Review   
Monday, 12 February 2018 18:31

In the aftermath of the recent Federal budget approval on 2.9.18, analysts reveal the new budget's affect on the health sector. In addition to addressing a number of critical budget questions, the legislation includes significant health care policy changes impacting Medicare, Medicaid and...

Read more in the current issue of Week in Review>>

Last Updated on Monday, 12 February 2018 18:38
 
3 steps to avoid a penalty under MACRA Print E-mail
Written by Jeffrey Herschler   
Monday, 13 November 2017 00:00

Fierce Healthcare's Joanne Finnegan reports on Nov 9, 2017 that "the American Medical Association's president-elect, Barbara L. McAneny, MD, outlined several steps physicians can take to still participate under the Merit-based Incentive Payment System (MIPS), one of two available payment tracks under the Medicare Access and CHIP Reauthorization Act (MACRA)."

Read more in the current issue of Week in Review>> http://conta.cc/2yyRfDl

Last Updated on Tuesday, 14 November 2017 19:38
 
CMS Announces New TPE Audit Program Print E-mail
Written by Sharon Parsley | Florida Healthcare Law Firm   
Tuesday, 26 September 2017 19:05

The Centers for Medicare & Medicaid Services (CMS) relies on its Medicare Administrative Contractors (MACs) to serve as guardians of the Medicare trust fund through the MACs taking steps to prevent improper payments.  Despite that reliance, in its most recent report to the U.S. Senate Finance Committee, the Government Accountability Organization(GAO) reports that improper payments totaling $41.1 billion (no, that is NOT a typo, that is a "b") occurred during 2016 in the Medicare fee-for-service program. That figure represents an overall 11% percent improper payment rate.
 
How many of us would feel good about being "wrong" in our core job function 11% of the time? Not very many of us, I suspect.
 
The GAO report goes on to quote the MACs as generally having ongoing concerns about the following types of claims as those which pose the greatest financial risk to the Medicare trust fund.
Last Updated on Tuesday, 26 September 2017 19:07
 
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