Value-based payment system shortchanges PCPs, says study
Fierce Healthcare
DECEMBER 13, 2022
Value-based payment system shortchanges PCPs, says study. Tue, 12/13/2022 - 14:39.
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The one code Congress must support: G2211
Healthcare Dive
SEPTEMBER 22, 2023
Presidents of the American Academy of Family Physicians and the American College of Physicians argue for reforms in the national physician payment system.
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Bonus Features – January 12, 2025 – 80% of providers prioritizing updates to billing and payment systems, new board chairs at AHIMA and the EHR Association, plus 19 other stories
Healthcare IT Today
JANUARY 12, 2025
Surveys About 80% of providers said updating billing and payment systems and expanding payment options are key focus areas for 2025 , according to a TrustCommerce survey. It’s been a minute. We hope you all had a restful holiday season and are ready for whatever 2025 has to offer.
New Financial Platforms Aim to Fix a Confusing Healthcare Payment System
Electronic Health Reporter
FEBRUARY 7, 2023
By Bob Chin, chief information officer, PayMedix Employers who shift more healthcare insurance payments to employees to keep costs down risk increasingly discontented employees who struggle with growing out-of-pocket (OOP) costs compounded by a flood […] The article New Financial Platforms Aim to Fix a Confusing Healthcare Payment System appeared (..)
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Navigating QPP Reporting in 2025: Finding the Best Path for Your ACO
MRO Compliance
JANUARY 28, 2025
With our ability to support all three reporting optionsElectronic Clinical Quality Measures (eCQMs), Merit-based Incentive Payment System Clinical Quality Measures (MIPS CQMs), and Medicare Clinical Quality Measures (Medicare CQMs)were here to help you submit your highest scores for maximum results.
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Health Payment Systems Taps Madaket Health for Provider Data Management
HIT Consultant
NOVEMBER 7, 2023
What You Should Know: Health Payment Systems (HPS) today announced it has selected Madaket Health to help manage its provider directory and roster requirements for No Surprises Act (NSA) compliance.
2023 Medicare Hospital Outpatient Prospective Payment System
HealthIT Answers
JULY 25, 2022
On July 15, 2022, CMS proposed Medicare payment rates for hospital outpatient and Ambulatory Surgical Center services. The calendar year 2023 Hospital Outpatient Prospective Payment System and ASC Payment System Proposed Rule is published annually and will have a 60-day comment period, which will end on September 13, 2022.
Two 2023 CMS Payment System Final Rules Released
HealthIT Answers
AUGUST 2, 2022
CMS releases Fiscal Year 2023 Inpatient Rehabilitation Facility Prospective Payment System Final Rule (CMS-1767-F) and Fiscal Year (FY) 2023 Skilled Nursing Facility Prospective Payment System Final Rule (CMS 1765-F). The post Two 2023 CMS Payment System Final Rules Released appeared first on Health IT Answers.
2025 MIPS Value Pathway (MVP) Registration Now Open
HealthIT Answers
APRIL 21, 2025
The Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) registration window is open for the 2025 performance year. Individuals, groups, subgroups, and Alternative Payment Model (APM) Entities that wish to report an MVP can register until December 1, 2025, at 8 p.m.
Atrium Health responds to new social engineering attack
Healthcare It News
SEPTEMBER 17, 2024
THE LARGER TREND The most popular style of attack, phishing emails can open up access to employees' email accounts, and threat actors can then pivot to attack networks, reimbursement payment systems and more.
CMS issues guidance for new telehealth eCQM reporting in 2020 and 2021
Healthcare IT News - Telehealth
JULY 9, 2020
The new telehealth-eligible eCQMs are for any eligible professionals or eligible clinicians participating in CMS quality reporting programs for performance period 2020, including the Merit-based Incentive Payment System and Advanced Alternative Payment Models, Comprehensive Primary Care Plus, Primary Care First, and the Medicaid Promoting Interoperability (..)
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Why Your Final MIPS Score Might Be Different from What You Expected – and What You Can Do About It
MRO Compliance
OCTOBER 31, 2024
If you’re participating in the Merit-based Incentive Payment System ( MIPS ) or MIPS Value Pathways ( MVPs ), you’ve likely encountered a familiar scenario: you review your estimated MIPS score in your dashboard, only to find that months later, when CMS releases the final score, the numbers don’t quite add up.
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Why Your Final MIPS Score Might Be Different from What You Expected
HealthIT Answers
NOVEMBER 14, 2024
By Misty Graham - If you’re participating in the Merit-based Incentive Payment System or MIPS Value Pathways, you’ve likely encountered a familiar scenario: you review your estimated MIPS score in your dashboard, only to find that months later, when CMS releases the final score, the numbers don’t quite add up.
CMS Releases 2023 Hospital OPPS and ASC Payment System Final Rule
Holland & Knight
NOVEMBER 14, 2022
Miranda A. (..)
CMS floats 2.6% annual outpatient, ASC pay increase, new obstetrics Conditions of Participation
Fierce Healthcare
JULY 10, 2024
A proposed rule outlining the Centers for Medicare & Medicaid Services’ (CMS’) intended Medicare payment rates and policy updates for outpatient and ambulatory surgical centers (ASCs) in the co | The administration's CY 2025 OPPS and ASC Payment Systems proposed rule looks to improve obstetrical services, quality reporting and care access. (..)
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CMS Forwards Its Health Equity Agenda through Its Annual Prospective Payment System Rulemaking Process
Health Law Advisor
MAY 2, 2023
The Centers for Medicare & Medicaid Services (“CMS”) is using its annual rulemaking process to update the CMS payment system rules for fiscal year (“FY”) 2024 as a mechanism to advance health equity systematically across various CMS payment programs.
Increases to Price Transparency Penalties for Hospitals
Healthcare IT Today
NOVEMBER 4, 2021
While I’m not sure exactly why changes to the Hospital Price Transparency requirement happened in the Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS-1753FC), it happened there nonetheless (Here are the details on the Federal register).
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Fast Focus: Clinical Data Registries and the Compilation of Databases
MRO Compliance
SEPTEMBER 3, 2024
Using this data, registries encompass quality initiatives and improved patient outcomes alongside support for Merit-based Incentive Payment System (MIPS) reporting requirements.
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COVID-19 Is Ushering in a Consumer Revolution in Healthcare
Healthcare IT Today
OCTOBER 28, 2020
The following is a guest article by Terry Rowinski, President & CEO of Health Payment Systems, Inc. We’re now several months into navigating our next normal.
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Why Transparency Is No Longer Optional In Medical Billing
Electronic Health Reporter
DECEMBER 1, 2020
By Terry Rowinski, president & CEO, Health Payment Systems, Inc. This article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited. Almost a year into the COVID-19 pandemic, the stress surrounding the rising number of cases and the ensuing economic recession reminds high. Nearly half a […].
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Reforming Medicaid’s Approach to Remote Patient Monitoring Programs
HIT Consultant
APRIL 22, 2025
To address disparities, these states should consider Medicares recent policy updates, which enabled FQHCs and RHCs to receive separate payment for RPM and Remote Therapeutic Monitoring (RTM) services outside of their prospective payment system. This widespread adoption speaks to Medicares methodical and inclusive approach.
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CMS outlines 2.8% pay increase for outpatient facilities, ASCs in 2024 proposed rule
Fierce Healthcare
JULY 13, 2023
The Centers for Medicare & Medicaid Services has released its proposed Medicare payment rates and policy updates under the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory S | The CY 2024 OPPS and ASC Payment System Proposed Rule includes a 2.8%
Uncovering the Hidden Cybersecurity Risk: Implanted Medical Devices
HIT Consultant
DECEMBER 3, 2024
While protecting EHRs , patient data and payment systems is crucial, the hidden risks of connected medical devices need to be uncovered and taken seriously. To protect patient safety and data, it is imperative that healthcare providers, manufacturers, and regulators work together to address these vulnerabilities now.
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Fast Focus: Clinical Registries and the Compilation of Databases
MRO Compliance
SEPTEMBER 3, 2024
Using this data, registries encompass quality initiatives and improved patient outcomes alongside support for Merit-based Incentive Payment System (MIPS) reporting requirements.
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Hospital groups petition CMS to increase FY2024 inpatient pay as labor, inflation keep costs high
Fierce Healthcare
JUNE 12, 2023
pay bump, disproportionate share hospital payment calculations, new quality measures and other proposals included in the fiscal year 2024 Inpatient Prospective Payment Systems rule proposal.
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What Is the Merit-Based Incentive Payment System (MIPS)?
NCG Medical Blog
JANUARY 19, 2022
This program utilizes a “score” system comprised of four categories. If you’re a Medicare provider , then you might want to know about MIPS—a healthcare incentive program that helps gather data of quality and performance outcomes over time while rewarding medical practices that demonstrate improvements.
Beyond the Bill: Enhancing the Patient Payments Experience
Electronic Health Reporter
JUNE 27, 2023
By Bill Smither, executive director, CSG Forte Payment Systems. Patients and healthcare organizations […] The article Beyond the Bill: Enhancing the Patient Payments Experience appeared first on electronichealthreporter.com. This article is copyrighted strictly for Electronic Health Reporter.
Bonus Features – October 20, 2024 – Clinicians spend 28 hours per week on admin tasks, 80% of adults 18-24 willing to use generative AI in healthcare, plus 22 more stories
Healthcare IT Today
OCTOBER 20, 2024
In addition, Oracle announced Oracle Health Payments , an end-to-end payment system for providers. Products Oracle announced Oracle Health Clinical Data Exchange , which streamlines claims processing between providers and payers.
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3 Ways to Improve Patient Payments Data Security and Compliance
Healthcare IT Today
JULY 15, 2024
PCI compliance refers to the technical and operational standards that businesses must follow to secure and protect payment card data provided by cardholders and transmitted through transactions. PCI DSS can be complex, with 12 key requirements, 78 base requirements, and 400 test procedures to ensure that organizations are PCI compliant.
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Hospital outpatient providers to see $6.5 billion Medicare pay bump
Modern Healthcare
NOVEMBER 1, 2022
Ambulatory surgery centers will receive a $230 million Medicare reimbursement boost next year under the Outpatient Prospective Payment System final rule.
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CMS proposes 2.8% hospital inpatient reimbursement hike
Modern Healthcare
APRIL 10, 2023
The fiscal 2024 Medicare inpatient prospective payment system proposed rule from the Centers for Medicare and Medicaid Services also includes new safety and health equity provisions.
P2PE vs. E2EE in Healthcare Data Security: Is the Juice Worth the Squeeze?
Healthcare IT Today
APRIL 14, 2025
Cost Savings : By narrowing the scope of compliance audits and reducing infrastructure requirements, P2PE helps organizations save on operational Improved Patient Experience : Secure payment systems enabled by P2PE streamline transactions and foster trust among patients who are increasingly concerned about data privacy.
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The Problem With Surprise Medical Billing
Electronic Health Reporter
APRIL 2, 2020
By Terry Rowinski, president & CEO, Health Payment Systems, Inc. This article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited. We’ve seen it time and time again—a patient receives services from an out-of-network provider at an in-network facility and is surprised with a huge medical […].
Veterans Health Administration employs far less administrative staff than private health sector, study finds
Fierce Healthcare
JANUARY 23, 2024
The healthcare system’s private sector could learn a thing or two about efficiency from the government’s Veterans Health Administration, which employs about 30% less administrative staff across cli | The government health program's simplified payment system helps keep its payroll lean, as opposed to a private sector that employs hundreds of thousands (..)
HPS/PayMedix Closes on $25 Million in New Funding
Healthcare IT Today
JANUARY 31, 2023
Credit funds managed by SVB Capital lead new funding round to finance growth of PayMedix Healthcare Payment Solution Health Payment Systems, Inc. HPS)/PayMedix today announced it has raised another $25 million of funding to accelerate the growth of its groundbreaking PayMedix healthcare financing solution.
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Optum Virtual Care said to be closing down
Healthcare IT News - Telehealth
APRIL 26, 2024
WHY IT MATTERS UnitedHealth Group, Optum's parent company, reported more than $1 billion in net losses during the first quarter – which included impacts from the February 21 Change Healthcare ransomware attack and subsequent payment systems outage.
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CMS Issues 2022 OPPS and ASC Payment System Final Rule
Holland & Knight
NOVEMBER 16, 2021
Miranda A. (..)
Breaking Down the OIG’s First Industry-Specific Guidance
YouCompli
FEBRUARY 4, 2025
Even if an entity makes an isolated billing error, that entity still has an obligation to repay the overpayment to avoid False Claims Act liability.
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2025 CAHPS for MIPS Survey Registration is Now Open
HealthIT Answers
APRIL 17, 2025
ET for the Consumer Assessment of Healthcare Providers and Systems for the Merit-based Incentive Payment System Survey for the 2025 performance year. Registration is open through June 30, 2025, at 8 p.m. The post 2025 CAHPS for MIPS Survey Registration is Now Open appeared first on Health IT Answers.
Upcoming MIPS Important Dates and Deadlines
HealthIT Answers
OCTOBER 30, 2023
Deadlines: The Centers for Medicare & Medicaid Services would like to remind clinicians of important upcoming Merit-based Incentive Payment System (MIPS) dates and deadlines: The post Upcoming MIPS Important Dates and Deadlines appeared first on Health IT Answers.
UHG says it's rebuilding Change Healthcare with cloud-based security
Healthcare It News
MAY 2, 2024
"We pledge to do everything in our power to fix their system or underwrite their cashflow, simple as that," he already promised in his opening testimony. While much of the claims and payment system functionality has been restored, according to an April 29 letter from the American Hospitals Association to Senators Ron Wyden, D-Ore.,
ATA weighs in on proposed CMS Physician Fee Schedule rule
Healthcare IT News - Telehealth
SEPTEMBER 25, 2020
"The ATA is working with Congress to add FQHCs and RHCs to statute and to ensure a fair permanent payment system, which is not currently reflected by the temporary payment created for the pandemic," said the ATA in the recommendations. THE LARGER TREND.
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2025 Hospital IPPS and LTCH PPS – CMS-1808-P Fact Sheet
HealthIT Answers
APRIL 23, 2024
On April 10, 2024, CMS issued the fiscal year 2025 Medicare hospital inpatient prospective payment system and long-term care hospital prospective payment system proposed rule. The proposed rule would update Medicare fee-for-service payment rates and policies for inpatient hospitals and LTCHs for FY 2025.
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HHS Finalizes Rules to Penalize Healthcare Providers Engaging in Information Blocking
HIT Consultant
JUNE 24, 2024
Merit-based Incentive Payment System (MIPS): Clinicians who block information will receive a zero score in the Promoting Interoperability performance category, potentially lowering their overall MIPS score and impacting their reimbursement.
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