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CMS

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Infographic: Making a List and Checking it Twice! Using Medicare Compare Websites

Just like no two snowflakes are identical, no two healthcare facilities are the same. CMS has provided a series of compare websites and checklists to help patients make informed decisions regarding their healthcare needs. Familiarize your organization with these lists in order to help make sure you meet all of the recommended criteria!   Over

By |December 8th, 2016|CMS|

Infographic: MACRA- Understanding the MIPS Impact

On October 14, 2016, the Department of Health and Human Services (HHS) issued its final rule implementing the MACRA Quality Payment Program. Most providers following the traditional Medicare payment model will now be using the Merit-based Incentive Payment System (MIPS). CMS estimates approximately 500,000 clinicians will be eligible to participate in MIPS in the first year of

By |November 10th, 2016|CMS|

Five Star Quality Rating System of Nursing Homes

The Center of Medicare and Medicaid Services’ (CMS) Nursing Home Compare website offers a Five-Star Quality Rating System to help consumers make informed decisions about nursing home choice based on quality.  The top 10% of nursing homes in each state will receive a five-star rating and the lowest 20% will receive a one-star rating.  In

By |October 19th, 2016|CMS|

Updates to the 2016 OIG Work Plan

Fighting fraud, waste and abuse continues to be the focus of the Department of Health and Human Services (HHS) and the Office of the Inspector General (OIG). Almost 80 percent of HHS’ budget is spent on Medicare, Medicaid and CHIP totaling near $985 M for FY 2015.   The ongoing goal for Center for Medicare and

Once Again! CMS is Changing Physician Payments

Have you had the opportunity to read the 962-page proposed rule from Centers for Medicare and Medicaid Services (CMS) regarding changes to physician payments? This lengthy document echoes the same goal throughout, create an “innovative, outcome-focused, patient-centered, resource-effective health system.” For a provider, big changes are ahead. As part of the Medicare Access and CHIP Reauthorization

CMS Enrollment Screening Will Prioritize Fraud Prevention

Protecting the integrity of the Medicare program is a top priority.  Fortunately, the Affordable Care Act has allotted significant funding for task forces to root out fraud, waste and abuse. Up until now, the task forces have focused recovery efforts on funds already paid to the providers and suppliers.  The new focus is on prevention

Overpayments: Reporting and Returning Deadline

The long awaited ruling on reporting and returning overpayments is now in the Federal Register and will become effective on March 14, 2016. As stated in §401.303, an overpayment is any fund that a person has received or retained under Title XVIII of the Social Security Act to which the person, after applicable reconciliation, is

Compliance Program: What is the Value?

The value placed on a compliance program varies greatly with perspective and remains difficult to define. Obviously, the purpose of a compliance program is to prevent and deter wrongdoing. A strong program preempts problems. However, it is difficult to know what might happen in the future or what could have gone wrong in the past.

Meaningful Use Ends In 2016?

Due to the challenges of implementing Meaningful Use, it is unsurprising the Center for Medicare and Medicaid Service (CMS) is finally rethinking the plan.  The goal of Meaningful Use (MU) to achieve nationwide electronic health record (EHR) interoperability and ultimately improve overall healthcare remains intact. Until further details and a formal announcement, certain steps will

Deadline for Breach Reporting Coming Soon

As the end of the year approaches, keep in mind that all breaches of unsecured protected health information involving less than 500 individuals must be reported to the Secretary at the Department of Health and Human Services (HHS) within 60 days of the end of the calendar year. If the organization already reported a breach