Fees

Continuing the commitment to greater data transparency, the Centers for Medicare & Medicare Services (CMS) today released privacy-protected data on the prescription drugs that were paid for under the Medicare Part D Prescription Drug Program in 2014. This is the second release of the data on an annual basis, which shows which prescription drugs were prescribed to Medicare Part D enrollees by physicians and other healthcare professionals.

On Feb, 12, 2016, CMS issued its final rule implementing the Affordable Care Act (ACA) requirement that providers and suppliers report and repay overpayments from Medicare, known as the "60-Day Rule."  The ACA requires a person who has received an overpayment to report and return the overpayment by the later of  (a) 60 days after the date the overpayment was identified; or (b) the date any corresponding cost report is due, if applicable.  Notably, the final rule imposes a look-back period of six years, a shorter time period than the ten year period set forth in a proposed version of the rul

July 2016

Eyes Wide Open to the Financial Opportunities

 

Maximizing Revenue, Avoiding Losses 

 

By: Victoria (Tue, Mar/15/2016) 

Healthcare professionals are being forced to move out of their comfort zones. Sweeping changes are being made to change the way healthcare is provided and paid for.

40% of in-network payments are tied to value. And the traditional fee for service model is expected to disappear over the horizon in the years to come. Payments based on quality of care are increasing and it is imperative for healthcare organizations to address the current, on the ground, challenges, posed by the VBP model.

 

Combined Deskbook Resources

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Medicare oupatient hospital services are paid under the Outpatient Prospectivie Payment System (OPPS), under the Ambulatory Patient Classification system. Historically, these had been called Ambulatory Patient Groups (APGs), but before implementation of the OPPS on August 1, 2000, the name changed to APCs.

Proposed FY 2016 Medicare Payment And Policy Changes For Inpatient Psychiatric Facilities

OVERVIEW: On April 24, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule outlining proposed fiscal year (FY) 2016 Medicare payment policies and rates for the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS).

On April 14, 2015, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed the Senate by an overwhelming vote of 92-8. Although President Obama has not officially signed the bill into law, weeks ago he indicated his full support when H.R. 2 passed the House of Representatives.

Offering Discounts For Cash -- Safely

No titleJune 2011

One Fee Is Best Practice

You may be of the opinion that as a doctor you can charge what you want to charge. Of course, you should never overcharge, and no one should object to your charging a fair price for rendering your services. And if you want to give someone a break by taking a little less cash from someone who needs your

Discounting Fees Resources (Resource 110)

All healthcare providers need to be aware that there are both appropriate and inappropriate ways to discount your fees. Both state and federal laws can impact your practice financial policy regarding fee discounts. Additionally, we recommend carefully reviewing Chapter 1.5-Fees of the Behavioral Health DeskBook for important information on fee schedules and discounts.

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