Spending for federal health programs is expected to remain 'modest' over the next 10 years Total health care spending growth for federal health programs such as Medicare and Medicaid is expected to average 5.8 percent in aggregate over 2014-2024, according to a report published by the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. The authors noted that this rate of growth is still substantially lower than the 9 percent average rate seen in the three decades before 2008. “Growth in overall health spending remains modest even as more Americans are covered, many for the first time. Per-capita spending and medical ... July 30, 2015 Medi-Cal, Medicare Centers for Medicare and Medicaid Services, Medicaid, Medicare, Affordable Care Act 0 0 Comment Read More »
CMS releases proposed 2016 Medicare physician fee schedule The Centers for Medicare and Medicaid Services (CMS) recently released the 2016 proposed Medicare physician payment rule. The rule reflects the 0.5 percent increase in payment as of July 1, 2015, and the additional 0.5 percent increase in payment on January 1, 2016, recently adopted by Congress. Overall, Medicare will pay physicians nearly $700 million more in 2016 than they will have paid in 2015. Most notable in the payment rule is CMS’ proposal to pay for advance care planning and end-of-life counseling. The fee schedule would establish two new ... July 29, 2015 Medicare CMS, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Senate panel pushes HHS to delay stage 3 meaningful use The Senate Health, Education, Labor and Pensions Committee is asking the U.S. Department of Health and Human Services (HHS) to delay the stage 3 meaningful use rules, its chairman, Lamar Alexander (R-Tenn.) said during a news conference Thursday. The Centers for Medicare and Medicaid Services (CMS) issued proposed rules for stage 3 in March 2015. What's concerning providers is that this stage differs from the others in the degree to which a medical provider, to fulfill its requirements, must depend on other providers to document electronically that they have fulfilled ... July 29, 2015 Medi-Cal, Medicare CMS, Meaningful Use, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS to begin provider reimbursement for end-of-life care On July 8, the Centers for Medicare & Medicaid Services (CMS) released the first proposed update to the Medicare physician payment schedule since the repeal of the sustainable growth rate (SGR) formula through the Medicare Access and Children’s Health Insurance Plan (CHIP) Reauthorization Act of 2015. One of the biggest changes in the CMS proposal is the assignment of codes to pay providers for end-of-life consultations. In addition the department would make advance care planning “an optional element” of a beneficiary's annual wellness visit. The American Medical Association (AMA) lauded ... July 14, 2015 Medicare CMS, End of Life Issures, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS publishes 2014 open payment data On June 30, the Centers for Medicare & Medicaid Services (CMS) published the 2014 Open Payments data of financial transactions between drug and medical device makers and health care providers. The data includes information about 11.4 million financial transactions attributed to over 600,000 physicians and more than 1,100 teaching hospitals nationwide, totaling $6.49 billion. The Sunshine Act requires drug and medical device manufacturers and group purchasing organizations to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts. Last year’s inaugural launch of ... July 14, 2015 Medi-Cal, Medicare CMS, Physician Payments Sunshine Act, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS announces changes to make Medicare ICD-10 transition less disruptive for physicians The Centers for Medicare & Medicaid Services (CMS) announced that it will provide a one-year grace period during which it will allow for flexibility in the claims payment, auditing and quality reporting processes as the medical community gains experience using the new ICD-10 code set. The ICD-10 implementation date of October 1, 2015, has not changed. The changes announced include: Claim denials: Medicare review contractors will not deny claims based solely on the specificity of the ICD-10 diagnosis code as long as a valid code from the right family of codes ... July 13, 2015 Managed Care, Medicare CMS, ICD-10, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Slight increase to Medicare reimbursement rates effective as of July 1 A 0.5 percent physician payment increase will go into effect for dates of service from July 1 through December 31, 2015. This mid-year increase is a result of the Medicare Access and CHIP Reauthorization Act. The Centers for Medicare & Medicaid Services released the updated RVU files reflecting the payment increase and new conversion factor, $35.9335 (previously $35.7547). Noridian, the Medicare Administrative Contractor for California, has posted the new fee schedule that will be in effect from July 1 through December 31, 2015. There will be an additional 0.5 ... July 6, 2015 Medicare Medicare 0 0 Comment Read More »
CMS rule reduces Meaningful Use burdens; CMA advocates for more change On June 15, the California Medical Association (CMA) submitted comments to the Centers for Medicare and Medicaid Services (CMS) on proposed rules modifying Stage 1 and Stage 2 Meaningful Use criteria of the federal electronic health records (EHR) incentive programs. Under the federal EHR incentive programs, qualifying Medicare and Medi-Cal providers are eligible to receive incentive payments for adopting and demonstrating “Meaningful Use” of certified health information technology. The proposed rule aligns Stage 1 and Stage 2 Meaningful Use objectives and measures for 2015 through 2017 with proposed Stage 3 ... June 26, 2015 Managed Care, Medi-Cal, Medicare CMS, EHR, Electronic Health Record, HIT, Meaningful Use 0 0 Comment Read More »
CMA President's Message: A Critical Year for Health Care We haven’t quite hit the halfway mark, but 2015 is already shaping up to be an important year for health care. In just these past few months, legislators have repealed the Medicare sustainable growth rate (SGR), saving physicians from an imminent 21 percent payment cut, and have considered an abundance of new bills aimed at solving several major health issues across the state. The topic of health has been filling front-page headlines at every leading newspaper in California recently, reaffirming my belief that this is truly an exciting time to be ... June 15, 2015 General, Medi-Cal, Medicare President's Message, Physician Leadership 0 0 Comment Read More »
CMA supports bill to eliminate RAC incentives that cause punitive and burdensome auditing The California Medical Association (CMA) has announced its support of a bill introduced in Congress on May 22 that would reform the Medicare Recovery Audit Contractors (RAC) system. It is titled the Fair Medical Audits Act of 2015 and was introduced by North Carolina Congressman George Holding. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 established the Medicare RAC program to combat fraud and waste in the Medicare system. Initially launched in 2005 as a demonstration project in three states (California, Florida and New York), the Centers for ... June 2, 2015 Medicare Advocacy, Federal Legislation, Medicare, Recovery Audit Program 0 0 Comment Read More »
