Author Archives: Mark Sanna
Senate Clears Legislation to Prevent Medicare Payment Cuts
Chiropractic documentation education, new quality-reporting incentives included in measure Arlington, Va. – The U.S. Senate, following the earlier lead of the House, late last night passed a long-awaited “permanent fix” to the flawed Sustainable Growth Rate (SGR) formula used to determine provider reimbursement levels under the federal Medicare program. The plan would give physicians treating Medicare patients, […]
Next Generation Accountable Care Organization (ACO) Model
The CMS Innovation Center has announced a new ACO model: the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, which they state “offers a new opportunity in accountable care—one that sets predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care, and aims to attain the highest quality standards […]
BREAKING: Providers can’t sue state Medicaid agencies over rates, Supreme Court rules
Private healthcare providers cannot sue state Medicaid agencies over low reimbursement rates, the U.S. Supreme Court decided Tuesday in a 5-4 decision (PDF), reversing a lower court’s ruling. Providers had argued in a case, Armstrong v. Exceptional Child Center Inc., that suing over low rates is sometimes the only way to enforce federal payment requirements. Otherwise, low rates could lead to fewer providers […]
‘Doc fix’ bill would overhaul health IT policy, too
The bill introduced Thursday to replace Medicare’s sustainable growth-rate formula for physician pay would also significantly alter federal policy on health information technology. Lawmakers avoided making any changes to the timeline for requiring the industry to switch to ICD-10 diagnostic and procedure codes. Last year’s temporary “doc fix” included a stealthily added delay of the conversion.But the legislation’s merit-based incentive payment […]
Special Action Bulletin
Congress needs to enact legislation that will permanently repeal the flawed Sustainable Growth Rate (SGR) formula before the March 31, 2015 deadline. Medicare Part B providers of all types, including doctors of chiropractic, will face devastating cuts to the payment rates if action is not taken. These payment cuts will also impact patients by threatening their ability […]
CCGPP Low Back Pain Consensus Guideline Comment Period Open
The Council on Chiropractic Guidelines and Practice Parameters has updated their guideline so it can be placed on the National Guidelines Clearinghouse site. This is very important for our profession to ensure that stakeholders that don’t have our best interest at heart are not using bogus guidelines to restrict care/access, and to ultimately help providers […]
New EHR Attestation Deadline for Medicare Eligible Professionals: March 20, 2015
New EHR Attestation Deadline for Medicare Eligible Professionals: March 20, 2015. Eligible professionals now have until 11:59 pm ET on March 20, 2015, to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year. CMS extended the deadline to allow providers extra time to submit their meaningful use data. CMS continues […]
100 medical societies warn about possible ICD-10 problems
By Joseph Conn | March 4, 2015 Modern Healthcare The American Medical Association and 99 other state medical, medical specialty and professional associations are asking CMS acting Administrator Andrew Slavitt to have the agency improve transition plans for the Oct. 1 conversion to ICD-10 diagnostic and procedural codes.“By itself, the implementation of ICD-10 is a massive undertaking,” the AMA and […]
CMS Updates Additional Documentation Request Time Frame as of April 1, 2015
CMS recently published an update regarding the time frame for responding to pre-payment review Additional Documentation Requests (ADRs). Effective April 1, 2015, when a provider receives a pre-payment review ADR from a Medicare Administrative Contractor (MAC) or Zone Program Integrity Contractor (ZPIC), the provider will now have 45 calendar days to respond and supply the requested […]
Lawmakers Oppose Delaying October 2015 Rollout for ICD-10
No further delays should occur in implementing the ICD-10 coding system for Medicare payments, said legislators from both sides of the aisle during a congressional hearing Wednesday. Six of seven healthcare officials who testified agreed. The lone dissenter was a doctor concerned that most private practice physicians are simply not prepared. The switch to new diagnostic and procedural […]
2015 PQRS Remittance Advice/EOB Code Clarifications
N620 If you billed the PQRS codes with $0.00. It has also replaced the N365 code. CO 246 N572 code: If you billed the PQRS codes with $0.01 correctly. N365 has been deactivated. Each QDC line-item will be listed with the N365 denial remark code. Claim Adjustment Reason Code CARC 246 with Group Code CO […]
Future Health Meaningful Use Update
***There is important information included in the message below. Please take the time to review it thoroughly.*** Future Health is happy to announce two updates regarding Meaningful Use reporting. The CQM scorecard has been released to several clinics as part of the final testing process and should be available to all clinics next week. We […]
Texas Chiropractic College Alumni
CAREER/VENDOR FAIR MARCH 5 – We’re excited to kick off the Spring 2015 Career & Networking Fair hosted by the Alumni Relations office. If you are currently looking for a chiropractor to join your team or would just like to meet our students and network with your future colleagues, please consider joining us. We also invite vendors […]
What to do if a Business Associate Won’t Sign a HIPAA BAA?
Q: Who is a Business Associate and what do we do if they refuse to sign the BAA (Business Associate Agreement)? A: See the link below, as that will define for you exactly who your business associates would be. When uncertain or in doubt, it is always good to double check the HHS guideline to be […]
2015 PQRS Changes and the New Fee Schedule Format
Beginning January 1, 2015 and beyond the Centers for Medicare and Medicaid Services (CMS) is required to apply negative payment adjustments to the fee schedule amounts for those providers that have not successfully/satisfactorily participated in Medicare’s Physician Quality Reporting System (PQRS). Doctors of chiropractic can avoid the 2 percent payment deduction to their 2017 Medicare […]
National Chiropractic Leadership Conference
Dear Breakthrough Coaching Members: As you know, we have the National Chiropractic Leadership Conference February 25-28, 2015 in Washington DC. This is one of the most important years for us for two reasons: (1) There are 70 new members in Congress, and it’s critical that we arrive in force to help them understand the importance of chiropractic […]
New CMS rules enhance Medicare provider oversight; strengthens beneficiary protections
CMS Administrator Marilyn Tavenner today announced new rules that strengthen oversight of Medicare providers and protect taxpayer dollars from bad actors. These new safeguards are designed to prevent physicians and other providers with unpaid debt from re-entering Medicare, remove providers with patterns or practices of abusive billing, and implement other provisions to help save more […]
Chiropractic PQRS Update for 2015
Blood Pressure is no longer required by chiropractors for PQRS 2015. Chiropractors are still required to take BP on 80% of patients age 3 and older for Meaningful Use criteria. PQRS 2015 FOR CHIROPRACTORS: Measure #131: Pain Assessment and Follow-Up Updated Denominator Criteria, Rationale, and Clinical Recommendation Statements Added to Denominator Coding, CPT Code 96151 […]
Joint Commission Issues New Pain Standards in Response to Integrative Medicine Team
A Nov. 12, 2014 announcement from the principal accrediting agency for health care organizations could significantly impact access to integrative pain care throughout the United States. The agency is the Joint Commission. The revised accreditation standard will apply to all the institutions under the agency’s guidance and review: hospitals, ambulatory care facilities, home health and senior homes. […]
Nationwide D.C. Directory Supports Collective Goal Established in 2003
View YOUR Listing Online… While the F4CP had its big debut in 2003, it didn’t get much attention until 2006 after retaining the services of CPR Communications. The public relations agency initiated a monthly campaign that included the distribution of press releases, print advertorials, public service announcements, social syndications and advertisements. As a result, for the […]