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CMS offering webcasts on ICD-10 clinical documentation requirements

The Centers for Medicare and Medicaid Services (CMS) is offering a series of webcasts for small physician practices regarding clinical documentation requirements instituted for the transition to ICD-10. Available webcasts in the ICD-10 Documentation and Coding Concepts series include orthopedics, cardiology, pediatrics, obstetric and gynecology, and family practice and internal medicine. For more information, future events and to access the webcasts, please visit www.roadto10.org (click “webcasts” in the left margin).

Cal MediConnect lawsuit unsuccessful

Last week, the Sacramento Superior Court denied a request to delay implementation of the Cal MediConnect project. In a last minute challenge to the program, the Los Angeles County Medical Association (LACMA) joined a coalition of plaintiffs, including three Los Angeles independent living centers, to file a lawsuit in Sacramento Superior Court to stop the implementation of the project. The Cal MediConnect project was authorized by the state in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. ...

Fall 2015 is new implementation date for ICD-10

The Centers for Medicare and Medicaid Services (CMS) last week published a final rule, officially setting Oct. 1, 2015, as the new ICD-10 implementation deadline. The bill including a temporary patch of the sustainable growth rate (SGR), passed by Congress in April also included a delay in ICD-10 implementation, which was previously to begin on Oct. 1, 2014. The new deadline allows providers, payors and others in the health care industry time to ensure their systems and business processes are ready to go on Oct. 1, 2015. ICD-10 (The International ...

Noridian offering webinars for practices

Noridian, the Medicare Administrative Contractor for California, has scheduled a series of one-hour webinars during the month of August. Topics include common errors, global surgery and a series of three webinars titled “Climbing The Ladder To Success.” (For details on each workshop, click on the title.) Continuing education units are offered for most workshops.  

CMS issues proposed 2015 Medicare payment rule

The Centers for Medicare and Medicaid Services (CMS) recently published the 2015 proposed Medicare physician payment rule in the Federal Register. The proposal contains several notable changes. The rule expands the services eligible for telemedicine reimbursement (psychotherapy services and the annual wellness visit). It also extends the new payment policies for non-face-to-face care coordination. It allows primary care physicians to be paid for care management of Medicare beneficiaries with two or more chronic conditions. These are tasks (including managing lab and imaging reports, medications and care plans in addition ...

Medicare's financial outlook improves

Trustees overseeing Medicare’s Hospital Insurance Trust Fund, which finances about half the health program for seniors, said Monday in a report that the program won’t run out of money until 2030 – that’s four years later than projected last year and 13 years later than projected at the passage of the Affordable Care Act (ACA). The outlook for Medicare improved largely because of lower-than-expected hospital spending and savings resulting from the ACA. The effect of the new law encouraged providers and Medicare Advantage insurers to deliver care more cost-effectively and ...

Deadline to submit meaningful use hardship exception is July 1

Beginning January 1, 2015, Medicare physicians who have not successfully attested to meaningful use of a certified electronic health record (EHR) system may incur payment penalties, as mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act. These payment adjustments will be 1-2 percent of total Medicare charges in 2015, to 2 percent in 2016 and 3-5 percent in 2017 and beyond. The 2015 penalties are based on 2013 reporting data. Physicians who failed to successfully demonstrate meaningful use in 2013 can apply for a hardship exception ...

Medicare Advantage plans to see a modest increase in payments

The Centers for Medicare and Medicaid Services (CMS) announced this week that Medicare Advantage plans would see a 0.4 percent boost in payment rates for 2015.   This small payment boost is a change from CMS's February proposal that would have reduced Medicare Advantage plans payment rates by 1.9 percent.   This announcement comes on the heels of new data that predicts falling Medicare costs due to healthier baby boomers aging into the system. Healthier beneficiaries in Medicare have led to a downward drop in risk adjustment for the program. CMS has also ...

CMS to publicly release Medicare physician payment data

The Centers for Medicare and Medicaid Services (CMS) announced yesterday that it would soon begin publishing individual Medicare physician billing data, despite objections from the American Medical Association (AMA) and other provider groups. CMS intends to publicly post the data as early as April 9.   The release will cover some $77 billion worth of Medicare Part B payments made to physicians in 2012 and will include physicians’ provider IDs, their charges, their patient volumes and what they received in reimbursements from Medicare. Individual patient level data will not be released. ...

Congress passes California Medicare GPCI fix

After 10 long years of lobbying efforts by the California Medical Association (CMA), Congress has finally passed a bill to update California's outdated Medicare localities. The long overdue fix will update California’s Medicare physician payment regions to the same Metropolitan Statistical Areas (MSA) used to pay hospitals and raise payment levels for urban counties misclassified as rural, while holding remaining rural counties harmless from cuts.   The MSAs used to determine payment rates for hospitals are continuously updated, so that reimbursement accurately reflects local costs to deliver care. The physician payment ...