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House kicks SGR to the curb, sets new payment path, eases quality reporting

03/30/2015

With an overwhelming majority, the U.S. House voted to banish the long-patched sustainable growth rate (SGR) formula instead of kicking it down the road again, sending it for a vote in the Senate at press time.

Meaningful use proposed rule: Providers face steep cuts if not in stage 3 by 2018

03/30/2015

by: Roy Edroso

Did you expect to be at stage 3 meaningful use by 2018? Now you may have to be or face an up to 4% pay cut, according to a CMS proposed rule released March 20. And part of the requirement will be an unprecedented increase in patient engagement with your electronic health record (EHR).

MedPAC: Overhaul primary care incentives, E/M fees, reporting measures

03/30/2015

You’ll see a substantial change to several Medicare payment methodologies — from E/M services to expiring physician incentives — should the nation’s largest insurer follow the policy recommendations of its congressional watchdog agency.

Plan superbill transition now as ICD-10 makes paper versions hard to use

03/30/2015

by: Roy Edroso

If you’re using a paper superbill that is manageable under the limited number of ICD-9 codes, be ready for an adjustment to a potentially unwieldy document, charge capture tools or an electronic health record (EHR) system when ICD-10 kicks in Oct. 1.

PQRS, social trends spur big utilization hikes in some codes

03/30/2015

by: Roy Edroso

Code use by Medicare providers fluctuates from year to year, sometimes widely. In fact, 319 codes showed increases of more than 1,000% between 2008 and 2013, the most recent year for which Medicare data is available.

With 2% sequester cut extended, make sure non-Medicare plans don’t try it on you

03/30/2015

by: Roy Edroso

As CMS re-ups the 2% sequestration cut on provider payments, now is a good time to check your private and Medicare Advantage contracts to make sure those payers aren’t taking that cut without cause.

Court: Recovery auditor (RAC) contract payment change violates federal law.

03/30/2015

by: Roy Edroso

Expect the new recovery audit contracts to be delayed further. The U.S. Court of Appeals for the Federal Circuit has ruled that a new provision that would delay paying the auditors their contingency fees until the second level of the appeal process violates federal contracting requirements.

CMS eases burden for voluntary disclosure of one category of Stark law violation.

03/30/2015

by: Roy Edroso

Physicians who violate the Stark law only by not disclosing their ownership or investment interest in a hospital can now voluntarily disclose the violation using new instructions that require less information.

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