Rheumatology Practice Management
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Payment Reform

The Department of Justice filed an antitrust lawsuit to block 2 proposed health insurance plans mergers: Anthem’s acquisition of Cigna Corporation and Aetna’s acquisition of Humana. The suit alleges that the consolidations would reduce the United States’ largest national health insurers from 5 to 3, decrease competition, and raise healthcare costs. Read More ›

CMS Steps Forward with Proposed Changes to PFS in Wake of SGR Repeal
The Centers for Medicare & Medicaid Services (CMS) took the first step toward the Merit-based Incentive Payment System (MIPS) on July 8 with the release of a proposed rule on payment policies and rates, as well as quality provisions, under the Medicare Physician Fee Schedule (PFS). Read More ›

Criteria for stage 3 of Meaningful Use was announced and published recently, detailing benchmarks that eligible providers and hospitals will have to meet to qualify for certain incentive payments and avoid reimbursement penalties. Read More ›

The April 14, 2015, repeal of the sustainable growth rate (SGR) formula for physician payments under Medicare is being welcomed by the healthcare community, including the American Society of Clinical Oncology (ASCO). Read More ›

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law on April 16, making history not just by repealing the sustainable growth rate (SGR) formula for Medicare physician payment, but for the resounding bipartisan support of the legislation after decades of partisan posturing in the US House of Representatives and Senate. Read More ›

Criteria for Stage 3 of Meaningful Use was announced and published at the end of March, detailing benchmarks that eligible providers and hospitals will have to meet to qualify for certain incentive payments and avoid reimbursement penalties. Read More ›

A new payment model announced by the US Department of Health & Human Services offers providers the potential to receive at least $160 per month for patients who are undergoing chemotherapy treatment. Read More ›

The announcement in February of a new Oncology Care Model has brought a lukewarm response by the American Society of Clinical Oncology (ASCO). Developed by the Centers for Medicare & Medicaid Services (CMS) Innovation Center and announced through the US Department of Health & Human Services, the new care delivery model encompasses a multipayer structure as well as incentivized and monthly per beneficiary payments to participating practices. Read More ›

Once again, providers and practice administrators are in limbo about the status of Medicare payments. In late March, Congress moved closer than they ever had before, but stopped just short of repealing and replacing Medicare’s sustainable growth rate (SGR) physician payment formula. Read More ›