HHS Issues Final Rule Establishing New ICD-10 Compliance Deadline

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Yesterday, CMS announced a final rule that establishes Oct. 1, 2015, as the new ICD-10 compliance deadline for payers and providers still making the transition, Modern Healthcare reports (Conn, Modern Healthcare, 7/31). Continue reading

Thrown a Curve

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CMS’ actuaries: Healthcare spending will continue to increase, despite reform law promises

The landmark 2010 healthcare law will not slow the nation’s ballooning healthcare spending in the coming decade, and it will drive spending away from hospitals and toward physicians and pharmaceuticals, according to projections from the government’s healthcare actuaries.

The latest estimates of the impact of the Patient Protection and Affordable Care Act indicate that healthcare spending will continue to increase markedly in almost every respect through 2020. Those increases run contrary to one of the central promises of the law’s advocates, including President Barack Obama: that it would slow the rise of ever-higher healthcare costs.  Continue reading

Changing Reimbursement Models

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It’s probably an unintended consequence—and not a positive one at that—but government programs have helped make dealing with rising operational costs less of a concern for medical practice managers, according to the fourth-annual survey by the Medical Group Management Association on managers’ top daily professional challenges.

Rising operational costs were listed as the top challenge in 2009 and 2010, but in this year’s survey of 1,190 practice managers, they came in third behind “preparing for reimbursement models that place a greater share of financial risk on the practice” and participating in the CMS electronic health-record meaningful-use incentive program. Continue reading

CMS Eases Telemedicine Rules

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The Centers for Medicare & Medicaid Services (CMS) has taken “a giant step” toward removing unnecessary barriers to the use of telemedicine for medically necessary interventions, according to a statement by the Joint Commission.

CMS’ action fits with the Joint Commission’s stance on the need to limit “overly burdensome requirements that may impede patient access to healthcare services,” said Mark R. Chassin, MD, MPH, president of The Joint Commission, in a statement posted on the Joint Commission’s website.

The rule, which applies to all hospitals that participate in Medicare and to inpatients at critical-access hospitals (CAHs), upholds The Joint Commission’s practice of allowing the hospital or CAH to use information from the distant-site hospital or other accredited telemedicine entity when making credentialing or privileging decisions for the distant-site physicians and practitioners.

“The Joint Commission is very pleased that CMS has revised its telemedicine requirements to provide more flexibility to hospitals and lessen their regulatory burden. This is an especially positive step for improving access to care for patients in rural areas,” Chassin stated. “Of particular importance is  Continue reading

CMS Rule Eases Authorization Requirements for Telehealth

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The Centers for Medicare & Medicaid Services today issued a final rule implementing changes to the Medicare Conditions of Participation for the credentialing and privileging of telemedicine physicians and practitioners. The Medicare CoPs previously required the governing body of a hospital to make all privileging decisions based on the recommendation of the hospital’s medical staff after the medical staff had thoroughly reviewed the credentials of practitioners applying for privileges. Similarly, each critical access hospital was required to have its privileging decisions made by its governing body or the individual responsible for the CAH. This requirement was applied regardless of whether the services are to be provided onsite at the hospital or through a telecommunications system. Today’s final rule allows the hospital or CAH receiving the telemedicine services to  Continue reading