Tag: Medicare
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CMS Reveals New Medicare Card Design; Strengthens Fraud Protections
The Centers for Medicare & Medicaid Services has redesigned its Medicare card to remove Social Security numbers and use a unique, randomly-assigned number in an effort to better protect users from identity theft and fraud. CMS will begin mailing the new cards to people with Medicare benefits in April 2018 to meet the statutory deadline…
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Fewer Physicians Could Be Audited under a New CMS Program
Fewer physicians will undergo audits under a new Medicare claims review process, according to a Centers for Medicare & Medicaid Services announcement. CMS will roll out a new approach to claims review nationwide targeting fewer providers and requiring review of fewer claims. The new policy, to take effect later this year, makes it less likely…
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Physicians Maintain High Standards
By the time this article goes to print, a lot could change, so there’s no apparent use in guessing what will come of the next Repeal and Replace efforts or what’s happening at Main Justice. Nobody knows. The only certainties from Washington are that there will be change in the payment and insurance models, and…
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Medical Association Joins 132 Medical Groups to Oppose H.R. 2276
The inclusion of audiologists in Medicare’s definition of “physician” will create confusion. In May, legislation (H.R. 2276) was reintroduced in the U.S. House of Representatives that would inappropriately provide audiologists with unlimited direct access to Medicare patients without a physician referral and amend Title XVIII of the Social Security Act to include audiologists in the…
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Free AQAF Assistance: Transition to MACRA’s Quality Payment Program
The Alabama Quality Assurance Foundation (AQAF), located in Birmingham, is a nonprofit consulting firm providing quality improvement assistance to the health care provider market through contract arrangements. Part of AQAF’s contract with CMS is to provide training to clinicians on the Medicare Access and CHIP Reauthorization Act (MACRA), the Merit-based Incentive Payment System (MIPS) or an…
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New Video Shows Physicians How to Avoid Medicare Payment Penalties
The Quality Payment Program (QPP) is the new physician payment system created by MACRA and is administered by the Centers for Medicare and Medicaid Services (CMS). Because the QPP is new this year, the Medical Association of the State of Alabama and the AMA want to make sure physicians know what they have to do…
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CMS Proposes 2018 Payment and Policy Updates for the Physician Fee Schedule
The Centers for Medicare & Medicaid Services issued a proposed rule that would update Medicare payment and policies for doctors and other clinicians who treat Medicare patients in the calendar year 2018. The proposed rule is one of several Medicare payment rules for CY 2018 that reflect a broader strategy to relieve regulatory burdens for…
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Taking CDI Into the Physician Office Setting
CDI, or Clinical Documentation Improvement, is as familiar to physicians who practice in the hospital as other acronyms such as ICU, OR, ED – but in the physician office, CDI is relatively unknown. However, with the implementation of the Merit-Based Incentive Payment System, or MIPS, CDI in the physician office will become imperative. Most…
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CMS Updates Proposed Rule for MACRA; Eases Burden for Some Physicians
The Centers for Medicare & Medicaid Services has unveiled a 1,058-page proposed rule updating the Medicare physician payment system implemented under the Medicare Access and CHIP Reauthorization Act of 2015 with changes to make it easier for small independent and rural practices to participate. The proposed rule would make changes in the second year of…
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A Refresher in the Medicare Claims Appeals Process…
With the increased audit activity we are seeing among the alphabet soup of Medicare contractors – RACs, ZPICs, SMRCs, CERTs, etc. – now appears to be a good time for a refresher on the Medicare claims appeals process. Due to this increased audit activity, more and more claims are being denied, both under pre-payment review…