Highmark Blue Cross Blue Shield plans to follow the Medicare reductions for the technical component of multiple diagnostic imaging services beginning in the spring of 2007. Following is a quote from the announcement in the December 2006 PRN:
“Highmark Blue Cross Blue Shield plans to reduce payment for certain diagnostic imaging services when more than one…
Assuming siganture by the President of the "Medicare Improvments and Extension Act of 2006" , the following will be the major Medicare changes for the coming year. The complete text of the changes and Committee reports are avaialble on the link in the article posted here yesterday.
1. 2007 PHYSICIAN FEE SCHEDULE: The conversion…
Both Houses of Congress have approved the Tax Relief and Health Care Act of 2006, which eliminates the planned 5% Medicare Physician Fee Schedule cut for 2007. The bill now goes to the White House and President Bush is expected to sign it. The bill contained other key health care provisions which we intend to explain in…
BNA Health Care Daily has reported that House & Senate leaders have agreed upon a compromise that will eliminate the physician fee schedule pay cut which would have been implemented by the SGR fee schedule mechanism. The House and Senate are expected to vote on the measure today.
All health care providers covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) must begin using the standard unique identifiers for healthcare providers and health plans mandated by HIPAA no later than May 23, 2007. According to the Centers for Medicare and Medicaid Services release on November 17, 2006, “every covered health care…
The Office of Inspector General (OIG) issued Advisory Opinion 06-22, which is another in a series of similar approving gainsharing arrangements, i.e., 01-01 and 05-01 through 05-06. Under the current proposed arrangement, a hospital would pay a cardiac surgery group 50 percent of the hospital’s first year cost savings directly attributable to specific changes in the…
In accordance with § 626 of the Medicare Modernization Act of 2003, which commissioned a study by the GAO to evaluate a payment system using groups of covered services under the outpatient prospective payment system, the Centers for Medicare and Medicaid Services (CMS) proposed a new reimbursement system for Ambulatory Surgery Centers (ASC) on August 23…
The Centers for Medicare and Medicaid Services (CMS) issued the final rule for the 2007 Physician Schedule on November 1, 2006, which will soon be published in the Federal Register.
§ The final rule provides a 5% reduction in the 2007 Fee Schedule, which is just a slight change from the proposed 5.1% reduction…
CMS Gainsharing Demonstration
The Centers for Medicare and Medicaid Services (CMS) announced its Physician-Hospital Collaboration Demonstration (PHCD) Project. This is a three year demonstration program designed to examine whether allowing hospitals to provide financial incentives for physicians to support better care can improve patient outcomes without increasing costs. The CMS Press Release is available in the…
