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Murray-Alexander bill seeks return of CSR payments, but it may already be doomed
10/30/2017
by: Roy Edroso

A Senate bill seeks to restore the cost-sharing reduction (CSR) payments that President Donald Trump stripped from the Affordable Care Act (ACA) — but Trump’s erratic response, not to mention Congressional leadership politics, make its passage extremely difficult. The result: A 20% boost to Obamacare premiums are more likely than not.

Let your PQRS, value modifier scores guide you to early success under MIPS
10/30/2017
by: Richard Scott

Even if you’ve avoided a pay cut under the value modifier program for payment year 2018, don’t disregard your practice-specific quality resource and use report (QRUR). The details inside about your cost performance may steer you to success under the merit-based incentive payment system (MIPS).

Cost-category field testing underway for eligible providers.
10/30/2017
by: Richard Scott

Practices that want to catch a glimpse of how the merit-based incentive payment system’s (MIPS) cost category will work in future years are eligible to participate in a CMS field-testing program

Slight uptick in reimbursement for top codes in 2016
10/30/2017
by: Roy Edroso

It looks like things were a little bit better for providers in 2016 than in 2015 as they got more reimbursement with fewer denials.

Specialists who claimed millions in drug payments could face fluctuating rates
10/23/2017
by: Richard Scott
Do a quick calculation on your drug-code billing; some groups that bill a lot of Part B-covered drugs may see wild swings in their Medicare payment rates under the merit-based incentive payment system (MIPS) in future years.
Look at strength of your case before accepting Medicare’s appeals time-saving suggestions
10/23/2017
by: Roy Edroso

Some alternatives in the Medicare appeals process may save you time and money once you get to the third level – but if you’re not bringing a strong enough case, that savings may vanish.

Obamacare subsidies cut as insurance markets face added volatility
10/23/2017
by: Richard Scott
Some of your patients may face significant rises in insurance premiums, and perhaps a loss of coverage, after HHS cut off subsidies that help low-income individuals.
2 tips for busy practices to keep up with Medicare’s reimbursement rules
10/23/2017
by: Julia Kyles, CPC
You don’t need TIA — total information awareness — to avoid money-draining changes to Medicare’s reimbursement rules. However, a couple of recently submitted subscriber questions demonstrate that you need QIA — quarterly information awareness — and to know how to read Medicare’s files to take advantage of new revenue opportunities and succeed during audits.
Proposal to include Part B drug charges under MIPS scoring elicits concerns
10/23/2017
by: Richard Scott
Providers who routinely administer expensive prescription drugs that are billable to Medicare should keep a close eye on the pending Quality Payment Program (QPP) final rule — your future revenue may shrink or rise more dramatically than previously anticipated.
From the Part B News blog
10/23/2017
by: DecisionHealth staff
Take note of the news that happens between Part B News issues by checking out the free Part B News blog at https://pbn.decisionhealth.com/Blogs/default.aspx. Here’s a sampling from this week.
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