Determine how the program will affect your practice. The Centers for Medicare & Medicaid Services (CMS) is slowly implementing the value-based payment modifier, starting with groups that include 100 or more eligible professionals (EPs) and working down to solo practitioners. Providers who deliver high-quality care at a low cost will be eligible for a positive ...
Jul 30th, 2014
The Patient Protection and Affordable Care Act of 2010 (ACA) requires healthcare providers to return overpayments to government payers, with an explanation of why the payment is being returned, within 60 days from the time that the provider identifies the overpayment. According to regulation, an “identified” overpayment occurs when “a person has actual knowledge of ...
Nov 1st, 2012
By Stephen C. Spain, MD, FAAFP, CPC Angela “Annie” Boynton, BS, CPC, CPC-H, CPC-P, CPC-I, RHIT, CCS, CCS-P, CPhT Editor’s note: Health care reform brings a number of new concepts to coding, billing, compliance, and practice management. The most far reaching—especially from an organizational point of view—are accountable care organizations (ACOs). Below is the first ...
In Audit
May 11th, 2012
The Centers for Medicare & Medicaid Services (CMS) is postponing until 2013 the collection of data mandated by the Physician Payments Sunshine Act. CMS missed the implementation deadline of October 2011, and instead released draft regulations that solicited strong reactions from stakeholders. Dawn of Sunshine Act Postponed to 2013 was last modified: January 17th, 2015 ...
In CMS
Mar 16th, 2012
Do you have the most up-to-date information for coding and billing preventive services to Medicare? Since the passage of the Patient Protection and Affordable Care Act of 2010, numerous changes have been made to covered benefits for Medicare beneficiaries. The Centers for Medicare & Medicaid Services (CMS) posted on Jan. 24 “The Guide to Medicare Preventive ...