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Independence at Home Demonstration Project Announced

On , in Industry News, by AQ-IQ LLC

  From the HHS News Release: CMS will join with medical practices to test the effectiveness of delivering primary care services in a home setting on improving care for Medicare beneficiaries with multiple chronic conditions. Medical practices led by physicians or nurse practitioners will provide primary care home visits tailored to the needs of beneficiaries […]

Pioneer Accountable Care Organizations (ACOs) Initiative

On , in Industry News, by AQ-IQ LLC

  From the HHS News Release: Selected Pioneer ACOs include physician-led organizations and health systems, urban and rural organizations, and organizations in various geographic regions of the country, representing 18 States and the opportunity to improve care for about 860,000 Medicare beneficiaries. The 32 Pioneer ACOs underwent a rigorous competitive selection process by the Innovation […]

No Payment Reduction for Many Dialysis Facilities

On , in Industry News, by AQ-IQ LLC

  From the HHS News Release: CMS released the first results for a new Federal pay-for-performance or “value-based purchasing” program for dialysis facilities that is designed to give facilities payment incentives to improve the quality of care furnished to patients diagnosed with End-stage Renal Disease (ESRD). Nearly 70 percent of dialysis facilities that were evaluated […]

Partnership for Patients Funding Announced

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  From the HHS News Release: Hospitals across the country will have new resources and support to make health care safer and less costly by targeting and reducing the millions of preventable injuries and complications from healthcare acquired conditions, the U.S. Department of Health and Human Services (HHS) announced. As a part of the Partnership […]

Sunshine Rule Proposed

On , in Industry News, by AQ-IQ LLC

  From the HHS News Release: The proposed rule would require manufacturers of drugs, devices, biologicals, and medical supplies covered by Medicare, Medicaid, or the Children’s Health Insurance Program to report to CMS payments or other transfers of value they make to physicians and teaching hospitals. The proposed rule would also require manufacturers and group […]

OIG discusses the Physician Self-Referral Law

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  From the OIG HEAT Compliance Videos: OIG’s Provider Compliance Training initiative provides free videos and audio podcasts – averaging about four minutes each – which cover major health care fraud and abuse laws, the basics of health care compliance programs, and what to do when a compliance issue arises. These are in the audio […]

Medical Loss Ratio (MLR) Rule Updated

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  From the HHS News Release: CMS issued a final regulation that will ensure health insurance companies spend at least 80 percent of consumers’ health insurance premiums on medical care, not income, overhead and marketing. Insurance companies that fail to meet the new standard are required to provide a rebate to consumers. Known as the […]

Medicare Expands Competitive Bidding Program (DMEPOS)

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  From the HHS News Release: The Medicare Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) was expanded by the Affordable Care Act and is estimated to save Medicare, seniors, and taxpayers more than $28 billion over 10 years. Already in 2011, the first phase of the program has saved Medicare […]

Medicare Covers Screening And Counseling For Obesity

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  From the HHS News Release: Medicare is adding coverage for preventive services to reduce obesity.   This adds to Medicare’s existing portfolio of preventive services that are now available without cost sharing under the Affordable Care Act.  It complements the Million Hearts initiative led jointly by CMS and the Centers for Disease Control and Prevention […]