All MedFocus Articles

Wednesday, July 14, 2010

Last Tuesday, July 13th, CMS and ONC jointly announced their final rules for both electronic health record standards for certification and the Medicare and Medicaid EHR incentive programs, including the definition of meaningful use.

 

Under the Health Information Technology...

Wednesday, June 30, 2010

Scope and Intention of the RAC Program

In October 2008, The Centers for Medicare and Medicaid (CMS) announced that the Recovery Audit Contractor (RAC) program that was created under the Medicare Prescription Drug, Improvement and Modernization Act of 2003, Section 306...

Thursday, June 17, 2010

As of 6/17, the Senate has been unable to muster enough votes to pass an SGR "fix".  Although broad bi-partisan support for fixing the SGR problems remains, finding enough votes around a single solution has been elusive.  For some, support for fixing the SGR problem is predicated on...

Tuesday, June 15, 2010

Excerpt From Today’s CMS Announcement:

"The Centers for Medicare & Medicaid Services (CMS) is hopeful that Congressional action will be taken within the next several days to avert the negative update.

 

Given the possibility of Congressional action in the very near...

Thursday, June 10, 2010

"Based on the remaining announced schedule for the US Senate, no action will be taken on enacting a fix (temporary or otherwise) to the SGR (Sustainable Growth Rate) problem prior to June 14th.  Beginning on June 14th, HBMA members and their physician clients shoudl expect that Medicare...

Thursday, June 10, 2010

Based upon the remaining announced schedule for the U.S. Senate, no action will be taken on enacting a fix (temporary or otherwise) to the SGR problem prior to June 14th .  Beginning on June 14th, HBMA members and their physician clients should expect that Medicare Contractors will begin...

Tuesday, June 8, 2010

Dear Valued Medical Society Leader:
 
I am writing to inform you that UnitedHealthcare is implementing a change to the commercial Radiology Prior Notification Program, whereby for claims with dates of service September 7, 2010 and thereafter, UnitedHealthcare will require...

Wednesday, June 2, 2010

Last Friday CMS released a transmittal regarding the Internet-based Provider Enrollment, Chain and Ownership System (PECOS) requirements for providers who have not re-enrolled or updated their enrollment within the past 6 years.  Please note this letter will be sent from the MACs to...

Tuesday, June 1, 2010

"Beginning June 1, 2010, requests for outpatient imaging will require web-based prior authorization before L&I can approve reimbursement for:

  • Magnetic Resonance Imaging (MRI) of the spine and upper and lower extremities.
  • Computerized Tomography (CT)/MRI of the head....
Friday, May 28, 2010

At the request of several Members of Congress, the Federal Trade Commission is further delaying enforcement of the “Red Flags” Rule through December 31, 2010, while Congress considers legislation that would affect the scope of entities covered by the Rule. Today’s announcement and the release of...

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