Overview: This webinar will cover the changes to the PQRS program in 2016 and will provide tips and strategies to help you select the best measures and reporting approach for your practice.
Why should you Attend: Your future Medicare payments are at risk. Failing to report quality measures to CMS for Calendar Year 2016 will result in a reduction of up to 6% in your 2018 Medicare payments. The PQRS program carries a potential 2% penalty for each provider who does not report quality measures to CMS - physicians, mid-level providers, therapists, psychologists, social workers, even dieticians.
In addition, if your practice has physicians and mid-levels, at least half the physicians must meet the PQRS requirements or the group will face an additional 2-4% penalty from the Value Based Modifier program.
Areas Covered in the Session:
Understand the difference between a reporting rate and a performance rate?
Get access to useful tools to help you identify measures applicable to your specialty.
Learn how to choose among the various reporting approaches - what are the pros and cons of each.
Understand how CMS will evaluate your submission if you report less than 9 measures.
Who Will Benefit:
Practice Administrators
All providers who bill to Medicare including Physicians (All specialties), Podiatrists, Physician Assistants, Nurse Practitioners, Psychologists, LCSW, Physical and Occupational Therapists, Speech/Language Pathologists, etc.
Quality Officers
Nurse leaders
Finance Directors
Speaker Profile
Jeanne J. Chamberlin Jeanne Chamberlin is currently a Practice Management Consultant with MSOC Health. During her 30 years in the healthcare industry, Jeanne has worked in independent medical practices, health systems, state government, and software development. She holds a Masters Degree in Public Policy from Duke University and is a fellow in the American College of Medical Practice Executives. She has been a leader in both state and local MGMA chapters.
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Overview:
This webinar provides an overview of the MACRA legislation and developing regulations and guidelines. We'll help you understand how medical practices will be paid in the future for services to Medicare patients. You'll be asked to choose between two paths. If you choose to participate with other providers in an Advanced Payment Model, the larger organization will be paid for services provided and determine how to share those payments as well as any cost savings among the participants.
If you choose the Merit-Based Incentive Payment System (MIPS), your payment rate will vary based on how you perform on a variety of Medicare Quality Programs - PQRS, VBM, Meaningful Use and a 4th new component focused on Quality Improvement. You'll want to know as much as possible about the pros and cons of each option and how to make the right choice for your practice.
Why should you Attend: Under the MACRA legislation, your providers will need to choose between participating in an Advanced Payment Model (APM) or participating in the new Merit-Based Incentive Payment System. Making the wrong choice can result in significant reductions in your future Medicare payments. You'll want to understand the options and have a plan in place by January 1, 2017 - that's only 6 months away.
Areas Covered in the Session:
Learn the requirements of the new MACRA legislation and how it will impact your Medicare payments in 2019 and beyond
Find out what you need to be doing now to ensure you don't lose Medicare revenue in future years
Understand the options - APM vs MIPS - and how your Medicare payments can increase or decrease under each model
Identify what aspects of the new payment methodology are written into the legislation, what has been released through proposed regulations and when final rules are expected.
Who Will Benefit:
Practice Administrators, CEOs, COOs
Physicians and all providers who bill to Medicare
Quality Officers
Nurse leaders
Finance Directors
Speaker Pro
Dealing with Medicare and Medicaid Overpayments :
Medicare and Medicaid overpayments are pretty common. If they are not dealt with properly, they invite penalties.
Medicare and Medicaid Overpayments happen when a person, provider or supplier receives a payment that is in excess of the amount due to him or her under Medicare statutes and regulations. This overpayment becomes a federal debt that is owed by the individual to the State. So, Centers for Medicare and Medicaid Services (CMS) is required by federal law to recover this amount.
Overpayments routinely occur in Medicare and Medicaid. Many a time, these are unintended and are usually a result of oversight, but could also happen due to intent. Some of the most common reasons for which Medicare and Medicaid overpayments occur can be when:
Duplicate submissions of the same service or claim are made
Excessive or non-covered services are billed or furnished for billing
Services that are not necessary medically or are excluded are paid for
The wrong payee gets paid.
How are Medicare and Medicaid overpayments processed?
Obamacare has amended the federal False Claims Act (FCA), which is part of the Fraud Enforcement Recovery Act of 2009 (FERA), to add provisions relating to recovery of Medicare and Medicaid overpayments. This is how the process of Medicare and Medicaid overpayments works:
Whenever Medicare comes to know that any overpayment of $10 (raised to $25 from July 2014) or more is made, it directs the Medicare Administrative Contractor (MAC) to initiate the process of recovery of this overpayment. The MAC starts the process by initially mailing a demand letter in which repayment is requested
If no action is taken, a second and third demand letters are mailed in a month following the first one.
Contents of a demand mail from Medicare/Medicaid:
The demand letter sent by the MAC will explain the details of the Medicare and/or overpayment. When repayment is not made in full within 30 days, interest starts get
The program also provides real-time electronic information to support the provision of appropriate care and offers significant financial incentives that reward practices for becoming recognized as a National Committee for Quality Assurance Patient-Centered Medical Home™. The program has improved the provision of appropriate care and services and reduced utilization and growth in health care spending.
Overview: The Sunshine Act, or Open Payments Program, requires manufacturers of drugs, medical devices, and biologics that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. This Act was part of a healthcare reform bill adopted in March 2010. It came about due to requests for increased transparency about the financial relationships between physicians and industry.
The Centers for Medicare and Medicaid (CMS) issued the final rules in 2013 which implemented the Sunshine Act.
Why should you Attend: Anyone required to adhere to the Sunshine Act standards or anyone interested in knowing what must be reported and made public.
Areas Covered in the Session:
Purpose of the Sunshine Act
Who is required to report under the Sunshine Act?
What is reported?
Exclusions
Tracking
Penalties
Useful links
Who Will Benefit:
This webinar will provide valuable assistance to all personnel in:
Human Subjects Research
Healthcare interested in exploring the field of Clinical Research
Clinical Research Coordinators
Principal Investigators/Physicians
Administration in charge of Clinical Research
Regulatory Compliance
Speaker Profile
Sarah Fowler-Dixon is Education Specialist and instructor with Washington University School of Medicine. She has developed a comprehensive education program for human subject research which has served as a model for other institutions. She crafted budgets, policies, procedures, reporting, and training for the new program. She has initiated the planning, development, authorship and implementation of many human subjects research policies, practices, guidelines, submission and reviewer forms often working with state and federal authorities.
She has provided consultation regarding ethical, federal, state, and institutional requirements for faculty and staff both in the design and execution of their projects and teaches research ethics and regulatory affairs and the fu
Medical billing services are more of a conundrum in present times because the process has gotten complicated with time. The government has set value-based criteria for the providers to follow, for ensuring a productive health system while cutting costs.
Its emphasis on the implementation of EHR technology throughout the USA. Moreover, it is also in accordance with the MIPS quality measure Promoting Interoperability (PI) in which physicians use innovative methods to improve the quality of care services.
Here you'll find the official resources to report MIPS 2020; P3Care has a habit of coming up with useful information about the MIPS program. As a CMS MIPS Qualified Registry, in an effort to find the most relevant content for physicians, consider it as another episode.
Physician enrollment and credentialing services are highly specific and difficult to execute. This process helps in hiring new doctors with verified data and credentials, ready to earn your trust as a reliable and trustworthy physician or specialty-specific clinician. Some medical billing companies also provide physician enrollment and credentialing services.
Medical billing services for telehealth services as Medicare and Medicaid reimbursements have always been a difficult topic. Treating remote patients and measuring the quality outcomes is indeed not as easy as it seems for physicians.
Healthcare Solutions meets the challenges posed by Medicaid meaningful use program in a systematic and timely manner. It is noticed that many healthcare professionals are using healthcare IT consultants to collaborate and construct a plan to deal with technology addressing the value-based reimbursement system.
Physicians! It's time to prepare for the MIPS 2019 reporting period. There's only a little time left. This time may be hectic and stressful, even for MIPS qualified registries. But don't worry, P3 Healthcare Solutions has come up with effective tips to target high MIPS scores. Let's be honest, MIPS QPP can be a daunting approach to earn incentives for those who are not careful.
Before we go into the details, the Merit-based Incentive Payment System (MIPS) comes under the direct obligation of the Medicare Access and CHIP Reauthorization Act (MACRA), the law that regulates the incentive program across the US.
Since the healthcare industry has taken serious measures to revamp healthcare services, the emphasis on incentive payment programs has increased. MIPS and MACRA, and more offer facilities to physicians that regular payment method can never provide
Physical therapists are included as one of the groups of healthcare practitioners eligible for MIPS reporting in 2019. It was time their duties were rewarded with an open heart and a clear head. Physical therapy is a serious branch of medicine that, now, comes in the quality circle of the government where physical therapists (PTs) can receive incentives based on their performances.
Healthcare professionals who used to manage medical bills in-house would understand the difference between in-house and outsourcing medical billing services quite explicitly.
Improvement activities (IA) - MIPS 2020 submission is incomplete without it - is easy to submit with the right MIPS consulting firm. Find out more about it.
Improvement activities (IA) - MIPS 2020 submission is incomplete without it - is easy to submit with the right MIPS consulting firm. Find out more about it.
CMS (Centers for Medicare and Medicaid Services) launched an alternative payment model - Primary Car. In this program, eligible clinicians can submit quality measures including for Advance Care Plan at the end of the performance year.
CMS announces a decline of $15 billion in Medicare Fee-For-Service improper payments. The money that is going to come into the system is going to aid programs like MIPS 2020 and APMs and value-based care in general.