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Category: Medical Billing & Collections

Medical Billing & Collections

CMS to Test Two Voluntary Risk-Sharing Options for Direct Contractors

CMS will test two voluntary risk-sharing options in Direct Contracting starting in 2021: (1) Professional, a lower-risk option (50% Shared Savings/Shared Losses (SS/SL)) and Primary Care Capitation (PCC) equal to …

Medical Billing & Collections / Skilled Nursing

Proposed Medicaid Fiscal Accountability Rule Could Dramatically Lower Reimbursement for Providers

Today, CMS released their proposed Medicaid Fiscal Accountability Rule (MFAR), which works to ensure transparency in Medicaid payments and clamp down on impermissible financing arrangements. From CMS’ Press Release: “States …

Medical Billing & Collections

CMS Releases the 2020 Physician Fee Schedule Final Rule

CMS has released the finalized 2020 Physician Fee Schedule. The final rule is mostly unchanged from the proposed rule that was released in July. The most significant new policies are …

Medical Billing & Collections

CMS Delays Primary Care First Until 2021

CMS has delayed the start of Primary Care First Until 2021. The program was originally scheduled to begin next year. Primary Care First is a set of voluntary five-year payment model …

Behavioral Health Today / Home Health Billing / Home Health Today / Medical Billing & Collections / Skilled Nursing

Medicare and Medicaid Payment Cuts Reach a Tipping Point for Hospitals

Reductions in federal payments to hospitals will total $252.6 billion from 2010 through 2029, reflecting the impact of a series of legislative and regulatory actions, according to a new study …

Medical Billing & Collections

Medicare Diabetes Prevention Program (MDPP) Billing and Claims Webinar

CMS is hosting a webinar that will provide an overview on the MDPP Billing and Claims process this Thursday, October 17th at 3pm EST. During this webinar, participants will become familiar …

Medical Billing & Collections

Important MIPS Dates and Deadlines

Clinicians and groups participating in MIPS have several important deadlines coming up. Add these tasks to your calendar and get them done early! December 31 – 2019 Promoting Interoperability Hardship …

Medical Billing & Collections

Physician Self-Referral Regulations Proposed Rule Offers an Easier Path to Value-Based Reimbursement

From CMS: “On October 9, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to modernize and clarify the regulations that interpret the Medicare physician self-referral …

Home Health Billing / Hospice Billing / Medical Billing & Collections

Home Health & Hospice Providers FISS DDE Annual Recertification Must be Completed by September 30th!

Each year, Medicare providers are required to recertify their FISS DDE user access.  September 30, 2019 is the last day to complete the Annual DDE PPTN Recertification form. Failure to recertify will …

Behavioral Health Today / Medical Billing & Collections

MassHealth is Taking Steps to Improve Access to Behavioral Health Services with Telehealth

MassHealth has issued a new All Provider Bulletin explaining the 2019 expansion of telehealth services. Per All Provider Bulletin 281: “Effective January 1, 2019, Community Health Centers, Community Mental Health …

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