In Audit
Feb 13th, 2019
Right out of the gate, Medicare Incentive-based Payment System (MIPS) adjustments were incorrectly applied to nonphysician services and supplies. This error is being corrected by the Centers for Medicare & Medicaid Services (CMS), but what if no one caught it? MIPS eligible clinicians and clinician groups could have improperly lost or gained considerable revenue. This ...
A 7 percent payment update in your professional claims is at stake. That’s a nice bonus on top of the automatic 0.5 percent update to the Physician Fee Schedule (PFS). This is the last year for the automatic update, however. The only shot clinicians have at a PFS payment update in 2020 and beyond is ...
In CMS
Dec 28th, 2018
Will the latest regulations governing accountable care organizations (ACO) deliver favorable results for all? The Pathways to Success final rule, released by the Centers for Medicare & Medicaid Services (CMS) on Dec. 21, 2018, offers several new participation options and flexibility to healthcare organizations in the Medicare Shared Savings Program (MSSP). Participation options are meant ...
Nov 16th, 2018
A final rule released for public inspection Nov. 2 finalizes policy for Year 3 (2019/2021) of the Quality Payment Program (QPP). The Centers for Medicare & Medicaid Services (CMS) continues to implement the Merit-based Incentive Payment System (MIPS) and Advanced Alternate Payment Models (APMs), as required by law (i.e., MACRA), while working to reduce the ...
In Coding
Oct 5th, 2018
The Centers for Medicare & Medicaid Services (CMS) has identified four quality measures impacted by the Oct. 1 update to the ICD-10-CM code set. Providers submitting performance data under the Merit-based Incentive Payment System (MIPS) should limit data collection to the first nine months (Jan. 1 – Oct. 1) of the performance period for these ...