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.
Medicare & Reimbursement
National Provider Identifier (NPI) Usage Mandatory in Six Months
By Michael Cassidy on
Posted in Medicare & Reimbursement
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…
OIG Issues Another Physician Gainsharing Advisory Opinion
By Michael Cassidy on
Posted in Medicare & Reimbursement
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…
CMS Proposes New Ambulatory Surgery Center (ASC) Fee Schedule
By Michael Cassidy on
Posted in Medicare & Reimbursement
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…
Link: 2007 Medicare Physician Fee Schedule
By Michael Cassidy on
Posted in Medicare & Reimbursement
2007 Physician Fee Schedule
By Michael Cassidy on
Posted in Medicare & Reimbursement
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…
Reimbursement News: CMS Announces Gainsharing Demonstration Project and Congressional Advisory Board Analyzes Physician Payment System Options
By Michael Cassidy on
Posted in Medicare & Reimbursement
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…
2007 Medicare Physician Fee Schedule Proposals: Reassignment and Centralized Building Definiton
By Michael Cassidy on
Posted in Medicare & Reimbursement
In the Proposed Rules, the link for which was provided in the August 29, 2006 MedLaw Blog post, CMS announced proposed changes to the reassignment exceptions for purposes of Medicare billing and to the definition of “centralized building” for purposes of the ancillary services exception of Stark II.
REASSIGNMENT
CMS is basically proposing to treat…
Independent Diagnostic Testing Facilities (IDTF): Medicare 2007 Proposed Physician Fee Schedule
By Michael Cassidy on
Posted in Medicare & Reimbursement
CMS and the OIG are concerned with the potential for erroneous payments for either unjustified or medically unnecessary services in the independent diagnostic testing facilities (IDTF), which concern is initially based upon an audit performed for fiscal year 2001 by the OIG (A-03-03-00002). Therefore, in the August 22, 2006 Proposed Regulations, a link to which was…
CMS Issues Proposed 2007 Physician Fee Schedule
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services issued the 2007 Proposed Physician Fee Schedule in the August 22, 2006 Federal Register: http://www.cms.hhs.gov/quarterlyproviderUpdates/downloads/cms1321p.pdf. In addition to the fee schedule reductions arising out of the proposed revisions to the work relative value units (RVUs) as proposed in…