In the world of healthcare, the Merit-Based Incentive Payment System (MIPS) plays an instrumental role in incentivizing providers to deliver high-quality, efficient patient care. However, staying up-to-date with MIPS can be a challenge as the program is subject to continuous changes and updates. This article aims to provide a comprehensive understanding of MIPS, discuss its current impact, and delve into upcoming changes announced by the Centers for Medicare & Medicaid Services (CMS).
Dermatology Management Company Pays Millions for Self-Reported FCA Liability
Vasilios (“Bill”) J. Kalogredis has been exclusively practicing Health Law and Health Care consulting for over 45 years, representing physicians, dentists, veterinarians, chiropractors, podiatrists, group practices, other health care professionals and health care-related entities.
OCR Issues Guidance on HIPAA protected Telehealth Platforms once the PHE ends May 11th 2023
Under the PHE (Public Health Emergency), non-HIPAA compliant platforms (like smart phone applications FaceTime and Skype) were allowed as long as they were not public facing (i.e. TikTok, Vimeo etc). But with the PHE winding down in less than a month, the OCR (Office of Civil Rights) originally state that this flexibility would expire with the PHE. Meaning that the platform used for all Telehealth encounters have to be HIPAA protected.
Make Sure You Have A HIPAA Compliant Relationship
Many healthcare providers outsource some or all of their marketing to marketing agencies. We find that few of those healthcare providers set up a HIPAA compliant relationship before sharing PHI. Are you compliant?
White House announces the end date of the (PHE) Public Health Emergency to end on May 11 th 2023
An announcement on Monday, January 30th, by the White House, OMB (Office of Management and Budget), stated that they plan to end the COVID-19 national emergency and public health emergency on May 11th. Read further to determine the impact to your medical and/or dental practices.
HHS PRF Audits – The top 10 things to prepare
PRF (Provider Relief Funding) recipients that expended a total of $750,000 or more in federal funds, including PRF payments and other federal financial assistance, during their fiscal year(s) are subject to Single Audit requirements. Read our article on what the requirements are, and to find out if you are compliant.
CMS Final Rule and Physician Medicare Fee Schedule 2023
While CMS (the Centers for Medicare and Medicaid Services) are patting themselves on the back for their new policies on access to behavioral health services, the Medicare Physician Fee Schedule Final Rule, released on Tuesday, November 1st, is anything but exciting news. First, the 2023, Medicare Physician Fee Schedule, will end the temporary 3% increase that the COVID pandemic brought for 2021 and 2022. This will decrease the Medicare physician payment to 4.5% from these “statutorily-mandated” cuts.
The New 2023 AMA CPT E/M update are published. What is changing?
The CPT Editorial Panel announced this week their approval, for 2023, of additional revisions to the rest of the Evaluation and Management code section. These revisions seek to provide continuity across all the E/M sections allowing for the revisions implemented in the E/M office visit section in 2021 to extend to all other E/M sections, including hospital, SNF and LTNF encounters. Read our Breaking News! article for details on this important update for 2023.
The PHE renewed for the 10th time on 7/15/22, and is good for another 90-days (through 10/13/22), but how does that impact your medical practice?
The PHE, Public Health Emergency has been extended a 10th time in 7/15/2022, extending through October 13th, 2022. Please read our update for what has expired, what is still in effect, and how to stay compliant in your Telehealth Services.
Diving in to the SRDP
Health care providers and suppliers face a dilemma when they identify that potentially problematic claims have been submitted to a federal health care program (i.e. Medicare, Medicare Advantage Programs, Tricare and Medicaid Programs, ). Balancing legal disclosure obligations and business interests can be difficult when entities look at short term risks and benefits, to disclose to the OIG or CMS or simply, voluntary refund the overpayment to the provider’s Medicare Administrative Contractor.
Are you a HIPAA entity? The “Privacy Law” is probably not what you think
If you have heard the acronym HIPAA thrown around a lot lately, you are probably thinking, “Do I really know what HIPAA means?”. So many are throwing that term around in the falsehood that their legal or privacy rights are being violated in some way as more and more companies are requiring COVID-19 vaccinations.
Interim Final Rule for Surprise Billing
NSCHBC member Amanda Waesch walks readers through the newly issued interim final rule which safeguard patients against unforeseen medical bills arising from out-of-network care as part of the implementation of the new bipartisan No Surprises Act. Waesch also details what this rule means for patients, providers, specific health plans, and the rule’s requirements related to surprise billing.
