Articles related to CMS


New CMS system changes focus from punitive to education
New CMS system changes focus from punitive to education

The Centers for Medicare & Medicaid Services (CMS) unveiled a new protocol this year that shifts the focus from punitive to educational in terms of proper coding of Medicare claims.

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Proposed Changes to MIPS Are Tame this Year
Proposed Changes to MIPS Are Tame this Year

"The new changes in the 2018 reporting period are actually not terribly drastic," says Joni Wyatt, MHA, MHIA, CPHIMS, FHIMSS, with Kassouf & Co about the Merit-based Incentive Payment System (MIPS).

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Understanding the Merit Based Incentive Payment System
Understanding the Merit Based Incentive Payment System

Starting in 2019, Medicare's push toward value-based reimbursements will be within reach of the finish line. "It can sound terrifying," says Joni Wyatt, MHA, MHIA, CPHIMS, FHIMSS with Kassouf & Co. "But most practices have already done the work."

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Easing into MACRA
Easing into MACRA

On September 8th, Medicare announced two more ways to participate in the upcoming shift to the Medicare Access and CHIP Reauthorization Act (MACRA). "There are four different payment programs now, since the release of the pick-you-pace model," says Carrie Gulledge, RHIA, director of EHR with MediSys. "They allow providers to test the waters with their toe or jump all in."

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X-ray Reimbursements Will Bring an End to Analog and CR
X-ray Reimbursements Will Bring an End to Analog and CR
Medicare has begun the push toward purely digital radiography (DR). Starting next year, reimbursements for exams preformed on film-based x-ray machines will radically decline. The following year, reimbursements involving computed radiography (CR) equipment will get hit.
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CMS Finalizes the 60 Day Overpayment Rule
The Department of Health and Human Services’ (HHS) Center for Medicare and Medicaid Services (CMS) published its final rule on Friday, February 12, 2016.  The final rule clarifies two key sections of the often described 60-Day Overpayment Rule.
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CMS Final Rules Strip Down Meaningful Use
CMS Final Rules Strip Down Meaningful Use
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MACRA: What’s Replacing the Sustainable Growth Rate
MACRA: What’s Replacing the Sustainable Growth Rate
The annual nail-biting over potentially drastic cuts in Medicare physician fees ended last April with the repeal of the Sustainable Growth Rate. In its place will be the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).
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Regional Care Organizations on Track to Take Over Medicaid
Regional Care Organizations on Track to Take Over Medicaid
In January, Alabama Medicaid named eleven organizations as probationary Regional Care Organizations (RCOs). By October of next year, the plan is for these nonprofit RCOs to manage the care of just over 600,000 qualifying Medicaid patients in the state.
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Medicaid Begins Setting Rules for RCOs
Medicaid Begins Setting Rules for RCOs

On April 4, another legal layer to introducing Regional Care Organizations (RCO) into Alabama officially hit the books. Senate Bill 459 set the stage for publication of rules and other actions that will transform the state’s Medicaid Agency from a fee-for-service system into a capitated, coordinated care model.

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