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HHS announced a final rule that establishes a unique health plan identifier (HPID). Currently, when a health care provider bills a health plan, that plan may use a wide range of different identifiers that do not have a standard format. As a result, health care providers run into a number of time-consuming problems, such as […]
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 […]
Click here for the complete document from the Federal Register Hospital IPPS for Acute Care Hospitals and the LTCH Prospective Payment System and Fiscal Year 2013 Rates; Hospitals’ Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers This document contains technical errors which are corrected […]
This course is now in our library for replay. Click for its preview page. We’ve learned about the process of implementing ICD-10 in our organizations and now we’ll look closely at the coding of services using ICD-10 codes and we’ll begin to focus on documentation improvement. For those of you with a clinical perspective, you’ll […]
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 […]
Now that your organizations have begun the implementation process, it’s time to look at the W’s: Who, What, and Why. Who should attend all the ICD-10 trainings and what must those trainings encompass? It looks like there are very few positions that will not require some change, so how does one determine exactly what those […]
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 […]
