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Compliance Risks Associated with Outlier Payments 

YouCompli

Raising prices on your hospital’s chargemaster can also raise your level of compliance grief. Price increases can sometimes result in inappropriate outlier payments. Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. If they were not, the hospital must return the funds.

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MIPS and MACRA 2022: What’s New?

Compliancy Group

In 2015, legislation known as the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted. healthcare system since 2010’s Affordable Care Act. Under MACRA, the Centers for Medicare and Medicaid Services created regulations for healthcare providers’ use of health information technology.

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Billing Guidelines for Medicare Home Infusion Therapy (HIT)

Medisys Compliance

Under Fee-for-service (FFS) Medicare, home infusion therapy (HIT) involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home. Medicare Coverage. CPT codes, descriptions and other data only are copyright 2022. Basics of Home Infusion Therapy (HIT). American Medical Association.

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MIPS Rules for 2023: Onward and Upward

Compliancy Group

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law to improve patient healthcare outcomes. Under MACRA, the Centers for Medicare and Medicaid Services (CMS) created regulations to encourage healthcare providers to use secure health information technology. The MIPS rules for 2023 are discussed below.

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Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

A 2022 report from the Commonwealth Fund U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. healthcare system were exorbitant. These different Acts initiated the testing of alternate forms of delivering care and payment methodologies.

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Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

A 2022 report from the Commonwealth Fund U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. healthcare system were exorbitant. These different Acts initiated the testing of alternate forms of delivering care and payment methodologies.

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2023 Deadline for Physicians, Advanced Practice Providers and Teaching Hospitals to Review Sunshine Act Data Approaching

Hall Render

Following this reporting, impacted providers and teaching hospitals will have until May 15, 2023, to review reported payments and investments and to dispute any incorrect reports. For more details regarding the 2022 updates to the Sunshine Act reporting requirements, please access our prior alert here.