CMA responds to CMS 2015 Medicare fee schedule proposals The California Medical Association (CMA) sent a letter to the Centers for Medicare & Medicaid Services (CMS) commenting on the proposed rules that would impact many aspects of physician payment and federal regulatory programs for 2015. The 39-page letter strongly opposes the agency's plan to accelerate the implementation of the value-based modifier (VBM) payment methodology. CMS has said it will expand the VBM to all physicians in 2017 and increase the potential penalty from 2 percent to 4 percent. CMA also argued that because the agency is ignoring the law that ... September 18, 2014 Medicare Medicare, PQRS, CMS, Physicians Quality Reporting System 0 0 Comment Read More »
New CMS rule changes meaningful use timeline The Centers for Medicare and Medicaid Services (CMS) published a new final rule on September 4, 2014, that would provide eligible professionals participating in the Medicare and Medi-Cal electronic health record (EHR) incentive program an additional year to upgrade their certified electronic health record technology (CEHRT). The rule also revises the meaningful use timeline. Under the new rule, eligible professionals can use 2011 Edition CEHRT or a combination of 2011 and 2014 Edition CEHRT for the 2014 EHR reporting period to demonstrate meaningful use. Eligible professionals who were scheduled to ... September 5, 2014 General Certified EHRs, Electronic Health Record, Meaningful Use, CMS 0 0 Comment Read More »
Huge chunk of data excluded from Open Payments website because of inaccuracies According to several news sources, the Centers for Medicare & Medicaid Services (CMS) has rejected about one-third of the "Open Payment" records submitted by manufacturers and group purchasing organizations (GPOs) because of "intermingled data." When the data goes public next month, those records will not be included. CMS says it will not publish the withheld data until June 2015, when it expects that manufacturers will have had time to correct the inaccuracies. Physician Payments Sunshine Act is a provision of the Patient Protection and Affordable Care Act. Drug and medical ... August 21, 2014 Medi-Cal, Medicare CMS, Physician Payment Sunshine Act, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS must provide better oversight to prevent duplicate audits says GAO study A newly released study by the federal General Accounting Office (GAO) found that the Centers for Medicare and Medicaid Services (CMS) needs to provide better oversight and guidance for provider payment auditors to prevent duplicative post-payment claims review audits. Several types of Medicare contractors conduct postpayment claims reviews to help reduce improper payments: Medicare Administrative Contractors, which process and pay claims; Zone Program Integrity Contractors, which investigate potential fraud; Recovery Auditor Contractors, tasked with identifying on a postpayment basis improper payments not previously reviewed by other contractors; and the Comprehensive ... August 21, 2014 General CMS, Insurance/Reimbursement, Medicare, Audits 0 0 Comment Read More »
CMS temporarily takes Sunshine Act system offline The Centers for Medicare and Medicaid (CMS) announced yesterday that the verification system for financial interactions tracked under the Physician Payments Sunshine Act system has been taken offline temporarily because of physician complaints of inaccuracies. Under the Sunshine Act, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts. Any payments, ownership interests and other “transfers of value” will be reported to CMS for publication in an online database. CMS had opened the system for ... August 8, 2014 Medi-Cal, Medicare CMS, Physician Payment Sunshine Act, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS offering webcasts on ICD-10 clinical documentation requirements The Centers for Medicare and Medicaid Services (CMS) is offering a series of webcasts for small physician practices regarding clinical documentation requirements instituted for the transition to ICD-10. Available webcasts in the ICD-10 Documentation and Coding Concepts series include orthopedics, cardiology, pediatrics, obstetric and gynecology, and family practice and internal medicine. For more information, future events and to access the webcasts, please visit www.roadto10.org (click “webcasts” in the left margin). August 8, 2014 Medi-Cal, Medicare Centers for Medicare and Medicaid Services, ICD-10, Webinars, CMS 0 0 Comment Read More »
Fall 2015 is new implementation date for ICD-10 The Centers for Medicare and Medicaid Services (CMS) last week published a final rule, officially setting Oct. 1, 2015, as the new ICD-10 implementation deadline. The bill including a temporary patch of the sustainable growth rate (SGR), passed by Congress in April also included a delay in ICD-10 implementation, which was previously to begin on Oct. 1, 2014. The new deadline allows providers, payors and others in the health care industry time to ensure their systems and business processes are ready to go on Oct. 1, 2015. ICD-10 (The International ... August 8, 2014 Medi-Cal, Medicare CMS, ICD-10, SGR, Sustainable Growth Rate, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Physicians can review Sunshine Act data starting today The Centers for Medicare and Medicaid Services (CMS) announced that starting today physicians can complete part 2 of the registration process to review and dispute disclosures under the Physician Payments Sunshine Act. Physicians have 45 days to review and dispute their data (plus an additional 15 days to resolve disputes). The review and dispute process ends August 27, 2014. The information will be published publicly on September 30, 2014. Under the Sunshine Act, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including ... July 15, 2014 General Advocacy, Physician Payment Sunshine Act, Regulatory Advocacy, CMS 0 0 Comment Read More »
CMA, AMA and others urge CMS to delay new rules authorizing multi-hospital systems to establish system-wide medical staffs The California Medical Association (CMA), the American Medical Association and dozens of other state and specialty medical associations have asked the Centers for Medicare & Medicaid Services (CMS) to delay for one year new Medicare rules that would allow multi-hospital systems to establish system-wide medical staffs. CMA commented extensively on this and prior iterations of this rulemaking expressing serious concerns about the proposed amendments to the CoPs and their impact on medical staff self-governance. CMA believes that medical staff self-governance is a vital part of a carefully crafted system designed ... July 15, 2014 General Medicare, Organized Medical Staff, CMS, Hospital Medical Staff 0 0 Comment Read More »
Sunshine Act dispute proposal threatens physicians' due process A newly proposed dispute resolution process for inaccurate Physician Payments Sunshine Act data would deny physicians their due process rights, the American Medical Association (AMA) and California Medical Association (CMA) told the Centers for Medicare and Medicaid Services (CMS) in comment letters this week. Under the Sunshine Act, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts. Any payments, ownership interests and other “transfers of value” will be reported to CMS for publication ... June 18, 2014 General CMS, Physician Payment Sunshine Act, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
