Healthcare Business Monthly
Get Ready for MIPS in 4 Steps

Are you ready for the first performance year of the Merit-based Incentive Payment System (MIPS)? Do you even need to get ready? The Centers for Medicare & Medicaid Services conducted a webinar on Nov. 29 that lays it all out for you in four steps.

What to Expect from the Value Modifier in 2017

The Centers for Medicare & Medicaid Services (CMS) has implemented value-based programs to measure quality and cost of care provided to Medicare patients. The Value Modifier (VM) is a value-based payment adjustment mechanism that CMS has been phasing in since 2015, which means the rules change every year. Here is how the VM might apply to your practice in 2017, and beyond.

High Deductibles Prompt a "Pay Upfront” Approach to Hospital Surgeries

Many physicians and hospitals are asking patients for "estimated" out-of-pocket costs before their care. It ensures payment for doctors who may not receive payment for their services. The hospital push for point-of-service payment is to reduce high deductible healthcare debt from patients who now pay out-of-pocket for services not covered by insurance because the deductible is not met.

Inducement Threshold Updated by OIG

The Department of Health and Human Services Office of Inspector General (OIG) issued a policy statement December 7 increasing what constitutes a gift of "nominal value" to Medicare and Medicaid beneficiaries for purposes of avoiding civil monetary penalties.

Changes to Modified Stage 2 for 2017 Affect Hospitals
All eligible hospitals, critical access hospitals (CAHs), and dual-eligible hospitals seeking to demonstrate meaningful use of certified electronic health record technology (CEHRT) for the first time in 2017 must attest to Modified Stage 2 or Stage 3 objectives and measures. The EHR reporting period is a minimum of any continuous 90 days between Jan. 1, 2017, and Dec. 31, 2017.
Once Read, Imaging Studies Can’t Be Re-Billed

Question: Can a physicians code separately for reading X-rays or imaging studies taken elsewhere? For instance, could we report the appropriate X-ray CPT® code with modifier 26 Professional component attached?

Annual Clearance Sale