Category: CMS - CLAIMSMED

Anticipated Medicare fee schedule to release administrative burden – Let the Doctors remain Doctors

8/8/2019

There are proposed policy revisions in Medicare payment schedule by American Medical Association (AMA) in collaboration with Centers for Medicare and Medicaid Services (CMS). The aim is to streamline reporting requirements, reduce paperwork, improve workflow and contribute to a better environment for healthcare professionals as well as their Medicare patients.

The provision to alter how documenting & coding (E/M Services) stands out and will be implemented in 2021, worked on by both AMA & CMS with the help of the medical community. This showcases the complexity of the rendered services and the resources required. This is a big step in curbing the documentation burdens in medicine.

This proposal reveals the raised complexity of these services and the means needed to provide them, the significance of this represents an initiative towards reducing administrative burdens in medicine and make it easy for doctors to concentrate on providing quality services to patients. The AMA is fully prepared to help the entire healthcare community system through implementing the simplified method to E/M coding and documentation with an aim to encourage key principles of accessibility, quality, affordability and innovation.

CMS show its pledge in lining up patients over paperwork, collaboration with the medical community is a rigorous effort to further improve former policies and proposals. CMS and AMA is looking forward for further collaboration together with joint aim of providing high-value care to the patients.

HHSC Update: New Provider Management and Enrollment System (PMES)

5/20/2019

The Texas Health and Human Services Commission (HHSC) is preparing to roll out its new provider and enrollment system. With the help of associating and switching some processes and systems, the new Provider Management and Enrollment System (PMES) will reduce administrative burden for providers.

The following processes and systems will be consolidated into the PMES system:

Manual enrollment processes
Texas Medicaid Healthcare Partnership (TMHP) systems
Long Term Care
Vendor drug program
HHSC long term services and supports
Medical transportation program

PMES Rollout Timetable and Feedback Opportunity:
Throughout 2019, the HHSC will be preparing for a March 2020 implementation of the new system:

May: Provider collaboration and feedback opportunities
October: User testing
November: User training
By March 2020: Fully operational

Providers are encouraged to submit feedback about their needs through the implementation period at this link: “CLICK HERE”

Benefits of New PMES System for Providers

Single system to manage information even for providers with different lines of business. Easier to update information and renew enrollment.
Online “smart” application – providers apply for multiple programs once. Only relevant fields that must be completed will be shown.
Timeline reduced for enrollment and re-validation. Real-time workflows and electronic validations will reduce submission processing cycles. PMES will issue status alerts and automatic reminders.

Read more about the PMES system in this HHSC fact sheet

CMS delays new rule to improve quality and Patient Care of Home Health Agencies

7/11/2017

An additional six months are being provided to the home health agencies in order to prepare for a new CMS rule targeted at improving quality and patient care

CMS pulls the release of Medicare Advantage data

7/6/2017

Highlights:

The release of Medicare Advantage data has been delayed by the CMS from the year of 2014 that it planned to make public at the AcademyHealth’s annual research meeting last week, ProPublica reported.

CMS not to punish eClinicalWorks clients for MU EHR attestations

7/3/2017

As the word got out that the U.S. Department of Justice has settled a False Claims Act case with eClinicalWorks, the customers of company started inquiring whether they might have to pay back incentives for which they utilized the EHR vendor’s software to attest to meaningful use (MU) criteria.

ACR appreciates CMS efforts to enhance flexibility, decrease regulatory burdens

6/21/2017

Today, the ACR (American College of Rheumatology) welcomed components of a new proposed rule from the CMS (Centers for Medicare & Medicaid Services) regarding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program (QPP) as consisting of various positive developments for rheumatology providers. Particularly, support has been expressed by the rheumatologists for CMS's proposals to enhance the threshold for Merit-Based Incentive Payments System (MIPS) exemptions, to extend "Pick Your Pace" flexibility for another year and to delay electronic health records (EHRs) requirements. Furthermore, the ACR supports keeping the cost performance category weighted at zero for another year beyond the year of 2018.

OIG Report Claims More Than $731M in Incorrect Medicare Meaningful Use Payments

6/20/2017

The EHRs (Electronic Health Records) Incentive Program run by the CMS (Centers for Medicare and Medicaid Services) garnered attention again previous week following the issue of a report by the Office of Inspector General of the US Department of Health and Human Services (OIG) explaining incorrect payments to physicians under the program. On the heels of a high-profile settlement, the report follows under the False Claims Act between the US Department of Justice and an EHR vendor regarded to certified electronic health record technology (CEHRT) used in the EHR Incentive Program.

American Hospital Association inquires CMS to suspend hospital star ratings

6/14/2017

According to a letter released to CMS (Centers for Medicare and Medicaid Services) Administrator Seema Verma Tuesday, the American Hospital Association (AHA) emphasized the agency to suspend its "deeply flawed" overall star ratings program, which is less than one year old.

CMS: 47 counties projects to have NO Obamacare coverage in the year of 2018

6/13/2017

Next year, 47 counties are projected to have no Obamacare insurers and 1,200 could have just one, in accordance with a new federal report

CMS pays $729.4 Million in improper EHR incentive payments

6/12/2017

$729.4 million has been paid by the Centers for Medicare and Medicaid Services (CMS) in improper incentive payments to eligible professionals (EPs) who didn’t meet Meaningful Use requirements, in accordance with a new audit by the Office of Inspector General (OIG) of the Department of Health and Human Services.