HIPAA Privacy & Security Audit Program

On , in Industry News, by AQ-IQ LLC

Phase 2 (2016): As a part of its continued efforts to assess compliance with the HIPAA Privacy, Security and Breach Notification Rules, the HHS Office for Civil Rights (OCR) has begun its next phase of audits of covered entities and their business associates.  Audits are an important compliance tool for OCR that supplements OCR’s other […]

Interactive Mapping Medicare Disparities Tool

On , in Industry News, by AQ-IQ LLC

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) released a new interactive map to increase understanding of geographic disparities in chronic disease among Medicare beneficiaries. The Mapping Medicare Disparities (MMD) Tool identifies disparities in health outcomes, utilization, and spending by race and ethnicity and geographic location.  Understanding geographic differences in […]

Skilled Nursing Facility utilization and payment data

On , in Industry News, by AQ-IQ LLC

The Skilled Nursing Facility Utilization and Payment Public Use File (SNF PUF) contains information on utilization, payments, and submitted charges organized by provider, state, and resource utilization group (RUG).  The data include information on 15,055 skilled nursing facilities, over 2.5 million stays, and almost $27 billion in Medicare payments for 2013. The data set does […]

CMS proposes to test new Medicare Part B prescription drug models

On , in Industry News, by AQ-IQ LLC

The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule to test new models to improve how Medicare Part B pays for prescription drugs and supports physicians and other clinicians in delivering higher quality care. CMS values public input and comments as part of the rulemaking process, and looks forward to continuing to […]

CMS Finalizes Improvements for the 2017 Health Insurance Marketplace

On , in Industry News, by AQ-IQ LLC

The Centers for Medicare & Medicaid Services (CMS) issued the final annual Notice of Benefit and Payment Parameters for the 2017 coverage year, along with related guidance documents, as part of our ongoing efforts to promote healthy and stable markets that works for consumers and for insurers. The rule finalizes provisions to: help consumers with […]

Medicare Fee-for-Service Provider & Supplier Lists

On , in Industry News, by AQ-IQ LLC

Posting of ambulance, home health utilization data follows recent provider and supplier moratoria extension The Centers for Medicare & Medicaid Services (CMS) released two public data sets regarding the availability and use of services provided to Medicare beneficiaries by ground ambulance suppliers and home health agencies, as well as a list of Medicare fee-for-service (FFS) […]

CPT© Coding Update for CY16

CMS Inpatient Only List CY2016

On , in Archives, by AQ-IQ LLC

This is a zip file for download. CPT® license agreement required. 2016 OPPS Final Rule Addenda – Opens in a new window (The 2016 Inpatient Only List is here as Addendum E.) It is available as an Excel file or as a Text file. For additional information on the OPPS Final Rule see this document. […]

OIG Work Plan 2016

On , in Archives, by AQ-IQ LLC

The Work Plan describes the primary objectives and provides for each review its internal identification code and the year in which OIG expects one or more reports to be issued as a result of the review. Get the PDF (80 pages)