House Approves Medicare SGR

On March 26th the U.S. House of Representatives passed legislation (with a 392-37 vote) to permanently replace the Medicare sustainable growth rate formula and reimbursement mechanism.  The senate did not review the bill before its 2 week recess.  Mitch McConnell, R-Ky., said that the Senate will act quickly on the legislation when the session resumes on April 13 stating,

Is ICD-10 Dangerous?

Groups including American Medical Association (AMA) and the American Academy of Family Physicians recently wrote to Centers for Medicare and Medicaid Services (CMS) voicing their concerns stating that “the transition to ICD-10 represents one of the largest technical, operational, and business implementations in the health care industry in the past several decades” and arguing that there needs to be industry wide end-to-end testing as the current testing shows results only for a broad overview of claims.

Interoperability – Committees, Issues, and Insights

A draft bill is being circulated among Congress that outlines a plan for achieving interoperability (the ability of any authorized user to read a medical record from any source) by year 2018.  This bill is Rep. Mike Burgess’ (R-Texas) plan to appoint a 12 member committee to help develop standards and stop Electronic Health Record (EHR) software from blocking other interfaces.

CMS ICD-10 Test Gets a Passing Grade

Centers for Medicare and Medicaid Services (CMS) recently conducted a week long test wherein 660 volunteer Medicare fee-for-service providers, clearing houses and billing companies submitted about 15,000 test claims, and Administrator Marilyn Tavenner says CMS is ready.  Of the claims submit 56% were from professionals, 38% were from institutions and 6% were supplier claims.

The goal of the test is to have providers successfully submit claims using ICD-10 codes to the Medicare Fee-For Service (FFS) claims systems,

Meaningful Use Attestation Date Extended

March 20th is now the deadline date set for 2014 Meaningful Use Attestation.  The date was originally set at February 28th, but Centers for Medicare and Medicaid Services (CMS) extended the deadline to allow providers more time to gather and submit their data.  During this extension period, providers an also utilize their one “switch” from Medicare to Medicaid or Vice Versa. 

Eliminating the Gap in Medicare Payments to Independent Doctors vs. Health System Doctors

Last week in the Annual Budget presented by President Obama, the White House asked Congress to “encourage efficient care by improving incentives to provide care in the most appropriate ambulatory setting.” What this means in plain English is that the White House is looking to close the existing gap in payments that Medicare (the government health insurance program for those over 65 or disabled) makes to independent doctors vs.

ICD-10 Is a Go

After several delays, much debate and worry from providers across the nation, ICD-10 finally seems to have the green light, at least based on the interpretation from 2 senators of the recently released report from the Government Accountability Office (GAO). Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore.) feel that the conversion will meet the October 1,

ICD-10 Preparedness News

2015 is here and with the ICD-10 coding standard deadline set for October 2015, organizations and providers continue to ready themselves for the new coding.  Here’s what’s happening …

The Centers for Medicare & Medicaid Services (CMS) will be conducting a weeklong ICD-10 end-to end test using approximately 850 volunteer providers.

Over 200,000 Professionals to Receive Meaningful Use Penalties

A Center for Medicare & Medicaid Services (CMS) official reported that there will be 257,000 penalties levied for failing to meet Medicare Meaningful Use and notices will begin going out January 1, 2015.  The penalty letters will state that there will be a 1% reduction in Medicare payment for not meeting Meaningful Use criteria. 

Meaningful Use Audit Information

Any provider who received electronic health record (EHR) incentive payments for the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program may be subject to an audit.  According to The Centers for Medicare and Medicaid Services (CMS) website ( Figliozzi and Company will be performing the meaningful use audits and if you are selected for an audit,