The Affordable Care Act’s temporary increase in Medicaid payments for qualifying primary care services provided by qualifying physicians for 2013 and 2014 dates of service (DOS) is coming to an end. READ MORE
On December 3, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that will improve CMS’ ability to deny or revoke the enrollment of entities and individuals that pose a program integrity risk to Medicare. READ MORE
The Indiana Family and Social Services Administration (FSSA) recently announced the selection of Anthem Blue Cross and Blue Shield, MDwise, Inc., and Managed Health Services of Indiana to provide coordinated healthcare services for the new Hoosier Care Connect program starting next year. READ MORE
Two updates will affect Medicare provider enrollment for 2015. READ MORE
When the Centers for Medicare and Medicaid Services released the Final Rule of the Medicare Physician Fee Schedule recently, it contained two sets of conversion factors for calculating the 2015 fees: one for January through March 2015 and another for April through December. READ MORE
When billing for anesthesia services, using the informational QS modifier alerts commercial and government payers that monitored anesthesia care was provided. Before adding this modifier, though, here are a few guidelines to remember. READ MORE
As 2014 draws to a close, so does the 2014 PQRS reporting year. Here are a few tips to help you wrap up 2014 PQRS. READ MORE
Now is the time to begin considering your options for the 2015 reporting year of the PQRS program. Successfully reporting PQRS for 2015 will allow you and your group to avoid a 2 percent payment adjustment in 2017. READ MORE
The Centers for Medicare and Medicaid Services (CMS) Value-Based Payment Modifier (VBPM) Program was developed to encourage eligible professionals to improve both quality and efficiency in providing medical care. As such, the program provides incentive payments and payment adjustments based on a medical group’s quality-to-cost ratio. In 2015 for the 2017 payment adjustment year, all physicians—whether in groups of 2 or more or solo practitioners—are required to participate. READ MORE
The Centers for Medicare and Medicaid Services (CMS) took the opportunity during the rule making with comment period for the 2015 Physician Fee Schedule to seek comment on two issues they may eventually address in future rule making, namely secondary interpretation of images and substitute physician billing arrangements. READ MORE
