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Here’s What’s in Store for Medicare Advantage and Part D in 2018

23. May 2017

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Check out these bullet points for highlights from the 2018 Medicare Advantage and Part D payment and policy updates posted by CMS. Medicare Advantage Medicare Advantage (MA) plans, sometimes called Medicare Part C, are private plans approved by Medicare for people enrolled in Medicare. Medicare pays a fixed amount to the MA plan company, and […]

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60 Days & 6 Years: The Numbers to Know to Comply With Medicare’s Overpayment Rule

4. April 2017

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You get a fairly clear picture of what this rule is about from its name: Medicare Reporting and Returning of Self-Identified Overpayments. If you discover Medicare gave you too much money, you have to give it back. But there are some layers here, so let’s dig in for a refresher on some of the more […]

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How Do AHCA Amendments Affect Medicaid?

23. March 2017

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The US House of Representatives is scheduled to vote on the American Health Care Act (AHCA) today, Thursday, March 23, 2017. To put it mildly, there are more than a few opinions out there about AHCA. The GOP bill repeals and replaces the Affordable Care Act, often called the ACA or Obamacare. If the bill […]

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Get a Glimpse at Potential 2018 MACRA Coding Requirement for Patient Relationship Category

3. March 2017

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There could be new HCPCS modifiers coming your way as part of MACRA to identify patient relationship categories. If the term “patient relationship categories” is new to you, then here’s a brief overview. MACRA requires patient relationship categories and codes as part of an effort to improve resource attribution to clinicians. So there’s a look […]

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Translate HIMSS17 Tips Into Career Advice for 2017

24. February 2017

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This past week, two of our newsletter editors from The Coding Institute attended health IT conference HIMSS17 and Tweeted highlights from sessions. One point that came through loud and clear is that no matter what job you have in healthcare, data connections are so intertwined you have to expand your thinking beyond your own department. […]

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Haven’t Started MACRA QPP Prep? There’s Still Time!

3. February 2017

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Groundhog Day has come and gone, and Punxsutawney Phil has declared six more weeks of winter. That gives you plenty of inside time to focus on getting up to speed on MACRA so you can participate in 2017. Remember: With CMS’s Pick Your Pace approach to the Merit-based Incentive Payment System (MIPS), it’s OK if […]

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What You Need to Know About the 2017 OIG Work Plan

13. January 2017

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The 2017 HHS OIG Work Plan is out, revealing what’s in the crosshairs for special scrutiny. There’s a good chance there’s something in its 101 pages that affects you. Make sure your team’s work is up to scratch on these topics listed in the Medicare Parts A and B/Other Providers & Suppliers section of the […]

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What Do the AMA and ACP Say About ACA Repeal?

10. January 2017

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The president-elect ran on a platform of repealing the Affordable Care Act (ACA). What will actually happen is still up in the air. The American Medical Association (AMA) and American College of Physicians (ACP) have both recently posted letters to congressional leadership about healthcare system reform. Below is a summary of each letter. From the […]

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5 Fast Facts From the 2017 MPFS Final Rule

9. December 2016

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Digesting the hundreds of pages in the MPFS 2017 Final Rule is best done in small bites. Here are five tidbits to get you started. 1. The Conversion Factor Goes Up a Little The 2017 conversion factor is just a bit bigger than the 2016 conversion factor: 2016: 35.8043 2017: 35.8887. Read about it: You’ll […]

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The Quick, CMS-Approved Way to Avoid a MACRA Penalty

29. November 2016

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If you’ve been trying to wrap your head around MACRA for a while, you may be at the point where you’re willing to give up hopes of a bonus if you could just be sure you won’t face penalties. Good news: As long as you submit a little something to the Quality Payment Program, you won’t […]

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