HHS Reports Improper Medicare Claims From Chiropractors
A recent report issued by the Department of Health and Human Services (HHS) claims that the amount paid by the Medicare to chiropractors in 2013 for spinal manipulation was medically unnecessary. Reports indicate that approximately 82% (around $359 million) of the total $439 million Medicare reimbursement was for spinal manipulation. According to the HHS Office…
ONC National Coordinator Analyzes Carequality Data Exchange
Health officials from Carequality, which is an initiative under the Sequoia Project, revealed that more than 150,000 clinicians, spread across 11,000 clinics, and five hundred hospitals, are live on their network. They said that the participants of the program are able to share health records and this can be done regardless of the vendor of…
Substantial Increase In Civil Monetary Penalties Put Health Care Providers At Huge Risk
The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) recently announced some “adjustments” in Civil Monetary Penalties (CMPs) and False Claims Act (FCA) penalties. However, reports indicate that the substantial increase might put government contractors, health care providers, and life science companies at high risk. The penalties cover several health…
ACA Plans Will Remain Affordable To The US Citizens
The ruling party has reacted to the bad news that is circulating against Affordable Care Act marketplaces for quite some time now. The news indicates that ACA marketplaces have been facing serious challenges as a few of the insurers have quit the program, and the premium rates are on the rise as well. However, the…
OIG Conducts Study On Provider-Based Requirements
The Office of the Inspector General, HHS recently published a report on off-campus units that were covered under Medicare as provider-based facilities. OIG conducted a study to make sure that only those facilities that meet the CMS requirements receive the provider-based reimbursements. For a facility to be eligible as a provider-based unit, it should be…
House Passes New Bill To Revamp Healthcare Payment Policies
The House Ways and Means Committee proposed a bill last month, aimed at improving the current hospital payment policies. The bill, named Helping Hospitals Improve Patient Care Act (H.R. 5273), would also clarify the site neutral policy and address issues with the hospital readmission penalties. The House of Representatives passed the bill earlier this month.…
The Significance Of Prior Authorization In Healthcare Industry
Prior Authorization (PA) has got much higher relevance in the profession of physicians and the staffs working under them. As per PA, healthcare providers are required to collect approvals in advance from the concerned people and services before administering any treatment. Only once the approval is granted, the healthcare provider gets qualified for any sort…
New APM Criteria For MIPS Participation Discussed
The HCPLAN is no longer the sole group working to develop APMs. There is also the Medicare advisory committee, which allotted a share of its meeting time last month for the discussion of Alternative Payment Models (APMs), which serve as alternatives to traditional fee-for-service Medicare. As the previous article mentioned, MACRA supports the development of…
CMS Seeks Public Opinion On Improving MAC Contracts
In a latest move, the Centers for Medicare and Medicaid Services (CMS) have decided to seek opinions from public on improving Medicare Administrative Contractor (MAC) contracts. As part of the process, it issued an official Request For Information (RFI) in the Federal Register. The decision is said to help CMS in monitoring the MAC contracts.…
