CMS’s Annual Report Shows Increase In Savings

The Centre for Medicare and Medicaid Services recently released their annual report on Medicare and Medicaid integrity programs. According to the report, Medicare has saved $12.40 during the financial year 2013-14, for every dollar they invested for program integrity. During the fiscal year 2013, the program integrity has saved around $21.1 billion, where the savings…

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CMS Proposes Updates For 2017 Medicare PFS And HOPPS

CMS published the Medicare Physician Fee Schedule Proposed Rule (NPRM) for reviews and comments in July. With that, CMS is looking to propose changes to the reimbursement rates for the services that come under the Physician Fee Schedule (PFS) and other similar payment policy. CMS said that over a million medical suppliers, physicians, and practitioners,…

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New Policy By AMA Promotes The Use Of Telemedicine

Physicians-in-training are not extensively offered a proper, formal training in telemedicine. To deal with that, the American Medical Association recently announced a policy that aims to ensure that medical students and residents are trained to use telemedicine in medical practice. AMA recommends that graduate and undergraduate medical education should include core competencies for telemedicine in…

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SMP Program Shows Great Improvement In Medicare Recoveries

The Office of the Inspector General (OIG) recently released a report on the effectiveness of the Senior Medicare Patrol (SMP) program in 2015. The SMP program was established back in 1997 to detect, prevent, and report health care fraud and abuse through outreach, education, and counseling. It acts as an official organization of Medicare recipients…

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HHS Releases ACA Enrollment Details

The revised enrollment figures for health insurance exchanges have now been released by the Department of Health and Human Services (HHS). The report shows that the number of consumers, who have maintained insurance coverage through March 2016, is about 11.1 million. This number is one million more than the number of users with active policy…

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HBMA Comments On The MIPS And APM Initiatives

Members of the Healthcare Billing and Management Association (HBMA) recently visited senior CMS staff and chief health policy makers in Congress. The meeting gave HBMA members a chance to discuss about the improvements needed in the daily functioning of the Medicare program as well as long-term policies affecting it. The meeting also helped HBMA to…

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House Committee Analyzes Federal Health Programs Abuse and Frauds

The Subcommittee on Oversight and Investigations conducted a hearing last month to analyze frauds and abuse within the federal healthcare programs. The hearing was chaired by Tim Murphy (R-PA- 18), and included three witnesses; Dr. Shantanu Agrawal (Deputy Administrator and Director of Center for Program Integrity, CMS, HHS), Mr. Seto J. Bagdoyan (Director, Audit Services,…

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Medical Immigration Bill Stalls In Senate Over Dispute On Funding

On April 6, the Senate Committee on Health, Education, Labor and Pensions moved for the approval of five bills on biomedical research, Precision Medicine Initiative, and drug development. Collectively, these represent the last part of the Senate’s Innovation for Healthy Americans initiative, which was originally brought out as a single bill, but now contains 19…

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Insurers Starting To Quit HIEs

Last year, UnitedHealth reported a projected loss of $650 million in 2016 on the health insurance exchanges formed under the ACA. Now, the company announced that it would exit a few state marketplaces next year, setting off a disturbing trend of insurers pulling out of HIEs. UnitedHealth’s loss in 2015 was $500 million. The largest health…

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CMS brings out Successor for Meaningful Use Program

  The proposed rule on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) has given way to a major new development. From now on, EHR programs will be folded the Merit-Based Incentive Payment System (MIPS), starting January 1, 2017, according to a news conference announcement by CMS’s acting administrator, Andy Slavitt. Slavitt…

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