While reviewing the impact and “game plan” for ICD-10 implementation for our various clients, we found this article – published in 2013 – from the American Academy of Orthopaedic Surgeons: “Are You Ready for ICD-10? The deadline is less than 1 year away”. Well, we all now know that October 1, 2014 has come to pass and we are still using ICD-9 codes. HOWEVER, HHS and CMS have issued a ...

On Friday, August 22nd, the Maryland Insurance Administration released the final insurance rates for individuals buying health insurance plans under the health exchange. In early June of this year, CareFirst proposed drastic premium increases of 23 – 30 percent; fortunately for individual consumers, CareFirst will only be allowed an increase of 9.8 – 16.2 percent. Meanwhile, Kaiser Foundation Health Plan, Evergreen Health Cooperative & other carriers rates will decrease between ...

2015 will bring some well-deserved additional reimbursement for primary care physicians and other providers that manage some of the most difficult patients in the healthcare system: those with multiple chronic illnesses. Beginning in 2015, Medicare is going to begin to make separate, monthly payments to physicians for chronic care management (CCM) services. These services include all of the non-face-to-face work that PCP’s put in to help develop and revise plans ...

Check out this infographic, recently published by Medscape, based on a 2014 physician survey. The survey looked at the top and bottom earners based on specialty, geographic location, and workplace settings. The survey also looked at the compensation between male and female providers, with female providers bringing in only 76% of what their male counterparts earn. The physicians subjective evaluation of their compensation, feeling towards payers and their specialty of choice were ...

On Wednesday, April 9, 2014, the Centers for Medicare & Medicaid Services made a historic release of the most detailed data that it ever has on procedures billed and payments received by each individual physician. Historically, the AMA has been opposed to such a release, as it was seen as a potential for privacy violations or misuse/misinterpretation of the data. According to CMS and the DHHS, this new release demonstrates ...

On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014. Below are the main points of the legislation: ICD-10 delayed until October 1, 2015 (a one year extension from the October 1, 2014 deadline that was previously scheduled). The law prevents the 24% SGR payment reduction, which was scheduled to hit April 1, 2014. This is the 12th year in a row for an ...

  The House of Representatives voted “YES” yesterday, March 27, 2014, on a bill that would delay ICD-10 implementation until October 1, 2015. The vote will now go to the Senate, and if passed, will move to the President’s desk for signature or veto. The bill was originally designed to delay the hefty 24% cut in Medicare physicians’ payment, which is otherwise scheduled to go into effect on April 1, 2014 as ...

In a recent MLN Matters article, CMS re-iterated that it will offer ICD-10 acknowledgment testing from March 3-7, 2014. Per the MLN Article, “This testing will allow all providers, billing companies, and clearinghouses the opportunity to determine whether CMS will be able to accept their claims with ICD-10 codes. While test claims will not be adjudicated, the MACs will return an acknowledgment to the submitter (a 277A) that confirms whether ...

At Healthcare Data Management, we are in the process of actively learning as much as we can about the new health exchange insurance products in Maryland, and the impact that they may have on local physician practices. As information becomes available, we will  continue to provide you with pertinent information and updates. For today, we wanted to draw your attention to the importance of checking eligibility and benefits for all patients – especially for ...