Medical Office Manager

Health care reform

Doctors pay $1.1 million to settle genetic test kickback claims

Kickbacks for genetic test referrals has become a focus of recent federal enforcement action. The most recent case involves three doctors and a cardiology practice that allegedly accepted bribes from a now-bankrupt genetic testing company in the Seattle area. The DOJ claims that Natural Molecular Testing Corporation (NMT) paid doctors as much as $10,000 per month in consulting … [Read more...] about Doctors pay $1.1 million to settle genetic test kickback claims

Tell your patients about the new eMedicare app launched this year

The Centers for Medicare & Medicaid Services (CMS) has launched an app that gives consumers a modernized Medicare experience with direct access on a mobile device to some of the most-used content on Medicare.gov. The "What's Covered" app lets people with Original Medicare, caregivers and others quickly see whether Medicare covers a specific medical item or service. … [Read more...] about Tell your patients about the new eMedicare app launched this year

2017 QPP performance information is now available on Physician Compare

CMS has added new performance information to the Physician Compare website.  Medicare patients and caregivers are able to use the Physician Compare website to search for and compare clinicians and groups who are enrolled in Medicare, as shown in this patient story video. The overarching goals of Physician Compare are, 1) to help people with Medicare make informed health care … [Read more...] about 2017 QPP performance information is now available on Physician Compare

CMS releases preliminary data on 2018 Quality Payment Program participation

The Centers for Medicare & Medicaid Services (CMS) has published a blog post and released an infographic to share preliminary participation data for the Quality Payment Program during 2018. Key findings include: Overall, MIPS participation rates increased between 2017 and 2018 from 95 percent to 98 percent, respectively. Small practices participation increased … [Read more...] about CMS releases preliminary data on 2018 Quality Payment Program participation

Putting the patient first

By Nick Hernandez  bio Medical practices should take a measured approach to the future of their practice, keeping in mind that patients define value as appointment access and availability. With the changes and incentives (often misaligned incentives) in play as a result of healthcare reform, many hospitals and provider groups are hedging their bets that bigger is … [Read more...] about Putting the patient first

New CMS competition seeks innovative AI solutions to better predict healthcare outcomes

The Centers for Medicare & Medicaid Services (CMS) has announced a new competition that aims to accelerate innovative solutions to better predict health outcomes and improve the quality of care for patients. "The Artificial Intelligence Health Outcomes Challenge is an opportunity for innovators to demonstrate how artificial intelligence tools—such as deep learning and … [Read more...] about New CMS competition seeks innovative AI solutions to better predict healthcare outcomes

You have less than one month to submit MIPS Year 2 (2018) Data for the Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) has officially opened the data submission period for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in Year 2 (2018) of the Quality Payment Program. Data can be submitted and updated any time until 8:00 p.m. ET on Tuesday, April 2, 2019. CMS Web Interface users need to report their … [Read more...] about You have less than one month to submit MIPS Year 2 (2018) Data for the Quality Payment Program

Compliance officers must establish credibility with consistent, well-documented decision-making

One of the tougher issues a non-lawyer compliance officer faces is a challenge to their decisions and recommendations by other members of the management team. This happens more often when the person is new to the company or the position. In a large proportion of these challenges, the challenger cites a lawyer's comments or an interpretation they saw in a newsletter or on the … [Read more...] about Compliance officers must establish credibility with consistent, well-documented decision-making

What every medical office manager needs to know about the Sunshine Law

Another product of the Affordable Care Act, the Sunshine Law (also called Open Payments) begins implementation this year. The law requires manufacturers and group purchasing organizations publicly report certain transfers to or transactions with physicians. The goal is transparency and avoiding improper influence of physician's prescribing practices. Physicians should make sure … [Read more...] about What every medical office manager needs to know about the Sunshine Law