CMS issed new regulation that adopts operating rules for making health care claim payments electronically and describing adjustments to claim payments. The operating rules build upon industry-wide health care electronic fund transfer (EFT) standards that HHS adopted in January of this year. Operating rules include best business practices on how electronic transactions are transmitted and often target […]
CMS issued a final rule that will update Medicare payment policies and rates for inpatient stays in acute-care hospitals under the Inpatient Prospective Payment System (IPPS) and hospitals paid under the Long-Term Care Hospitals (LTCH) Prospective Payment System (PPS), in fiscal year (FY) 2013. The rule also finalizes the payment update that will be used […]
On July 19, 2012, CMS announced a competitive funding opportunity for up to 30 States to design or implement multi-payer payment and service delivery models. The State Innovation Models initiative, authorized by the Affordable Care Act as part of the Center for Medicare and Medicaid Innovation (Innovation Center), will provide financial, technical and other related […]
OVERVIEW CMS issued a proposed rule July 6, that would update payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (MPFS) on or after Jan. 1, 2013. The proposed rule also proposes changes to several of the quality reporting initiatives that are associated with MPFS payments – the Physician Quality […]
Global health care giant GlaxoSmithKline LLC (GSK) agreed to plead guilty and to pay $3 billion to resolve its criminal and civil liability arising from the company’s unlawful promotion of certain prescription drugs, its failure to report certain safety data, and its civil liability for alleged false price reporting practices, the Justice Department announced today. The […]
CMS has issued a proposed rule that would update Medicare policies and payment rates for End-Stage Renal Disease (ESRD) facilities paid under the ESRD Prospective Payment System (PPS) for calendar year (CY) 2013. The proposed rule would also strengthen incentives for improved quality of care and better outcomes for patients through improvements to the ESRD […]
Summary While discussing a separate, ongoing study on the extent of documentation vulnerabilities of evaluation and management (E/M) services using electronic health record (EHR) systems, officials from the Office of the National Coordinator (ONC) for Health Information Technology expressed interest in getting additional information about physicians’ reported use of EHR systems. ONC officials also wanted […]
In an effort to provide more effective, more affordable, higher quality health care, 45 commercial, federal and State insurers in seven markets pledged to work with the CMS to give more Americans access to quality health care at lower cost. Under the Comprehensive Primary Care initiative, CMS will pay primary care practices a care management […]
OCR developed HIPAA Enforcement Training to help State Attorneys General and their staff use their new authority to enforce the HIPAA Privacy and Security Rules. The training course will aid State Attorneys General in investigating and seeking damages for HIPAA violations that affect residents of their states. Videos and slides from live training sessions conducted […]