CMS proposes Medicare Advantage changes for 2017
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 19 announced proposed changes to the Medicare Advantage program for CY 2017, which would increase payment rates by a net 1.35%, the February 19 Modern Healthcare reports. When factoring in the risk coding tendencies, Medicare Advantage insurers’ revenue…
Study: Hospitals receive readmission penalties for factors beyond their control
Editor's Note This study of patient readmissions finds that hospitals are receiving financial penalties because of patient social determinants of health (SDH) factors (ie, race, ethnicity, payer, and household income) and not because they provide poor quality of care. Analyzing hospital readmissions at 43 children’s hospitals, researchers found that adjusting…
CMS, health insurers standardize quality measures
Editor's Note The Centers for Medicare & Medicaid Services (CMS) and major health insurance plans, in concert with physician groups and other stakeholders, on February 16 announced a new agreement to standardize measures of quality for physicians. The agreement outlines seven core measure sets to be used as a basis…
CMS extends ‘Meaningful Use’ deadline
Editor's Note The Centers for Medicare and Medicaid Services (CMS) has extended the deadline to attest to achieving “Meaningful Use” in 2015 to March 11, the February 12 MedCity News reports. The original deadline had been February 29. CMS announced the extension in an e-mail to providers and health IT…
CMS issues final rule on Medicare overpayments
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 11 released its final rule for reporting and repaying Medicare overpayments, as required by the Affordable Care Act. The rule requires providers and suppliers to report and return any overpayments they identify within 6 years of receipt, down…
CMS extends comment period for EHR certification, quality reporting
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on February 2 extended the deadline for sending feedback on electronic health record (EHR) certification and quality reporting to February 16, 2016. The request for information is part of an effort by CMS to streamline and reduce the burden of…
Proposed rule would allow sharing, selling of Medicare data
Editor's Note The Centers for Medicare & Medicaid Services on January 29 issued a proposed rule that will allow organizations approved as qualified entities to confidentially share or sell analyses of Medicare and private claims data to health care providers, employers, and others. The Qualified Entity Program, authorized by the…
CMS: Transitioning away from ‘meaningful use’
Editor's Note The Medicare Access and CHIP Reauthorization Act of 2015 requires that physicians be measured on their meaningful use of electronic health record (EHR) technology for purposes of determining their Medicare payments. EHR incentive programs were designed to encourage the adoption of new technology and measure the benefits for…
Recovery centers extend stays beyond 24 hours
One of the last things ambulatory surgery center (ASC) staff want to do is transfer a patient to a hospital because it increases the risk of infection and patient discomfort, and it’s a Centers for Medicare & Medicaid Services (CMS) quality measure (ASC-4). CMS and most states traditionally have not…
Nearly 209,000 healthcare providers receive 'meaningful use' penalties
Editor's Note Nearly 209,000 physicians and other healthcare providers will receive 2% cuts in their Medicare payments in 2016 for failing to meet meaningful use standards in 2014. The penalties total an estimated $600 million. Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, said on January…
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