If your organization is a Provider-Led Entity that orders advanced diagnostic imaging services for Medicare patients, preparing to meet requirements for imaging appropriate use criteria (IAUC) is likely to be high on your priority list. CMS expects a variety of outpatient settings, including physician offices and emergency departments, to begin educating staff and testing operations for AUC authorization as of January 1, 2020, with the goal of fully implementing the process by January 1, 2021.
Last month on the MEDITECH News page, we covered Low Utilization Payment Adjustment (LUPA) and the Home Health Resource Group (HHRG) vs. Health Insurance Prospective Payment System (HIPPS).
January is traditionally an opportunity to set goals for the year ahead, and while there’s no shortage of advice on how to maintain New Year’s resolutions, 80 percent of people break their resolutions after an average of six weeks.
If you’re like me and starting to feel the waning motivation that February brings, there is hope — we can look to the healthcare industry to be re-inspired by the discipline required to stay successful.
Developing standards for healthcare is nothing new — in fact, you could say the concept of identifying quality measures started in the early 17th century, when a Hungarian Doctor, Ignaz Semmelweis, championed handwashing in his clinic.
The latest Home Health Conditions of Participation (CoPs) that went into effect on Jan. 13 have been making waves across our industry. These updated CoPs — standards that agencies must meet in order to participate in Medicare — included several completely new regulations, as well as revisions to many others. And despite the fact that CMS (Centers for Medicare & Medicaid Services) delayed the phase-in date of the new standards, many agencies had to scramble to prepare in time.
On Halloween, as I was waiting for MACRA's Quality Payment Program (QPP) Year 2 ruling to be finalized, I was pondering tricks and treats. Would practices find a full sized candy bar when the door opened or a toothbrush? As trick-or-treaters often find, the ruling was a little of both. For me, the trick is a ruling that came in at a hefty 1,653 pages: the treat, the 20+ page fact sheet and executive summary.
There is so much change in current regulations that it’s easy to see how the home care industry’s strategic direction gets lost to the “tyranny of the urgent.” The new Home Health Conditions of Participation will place increased emphasis on Quality Improvement, yet agencies’ long-term success are not just dependent on their ability to improve quality. What will win in the end are care delivery systems that provide better outcomes for less money.
If there’s one message that healthcare providers, executives, and IT staff have learned through the evolution of Meaningful Use, it’s that the data we collect and report has significant impact on our sustainability.
Not only do the numbers we transmit to CMS matter, but the numbers they send back — in the form of financial reimbursements — also matter.
For most people, summertime means backyard barbecues, ball games, and vacations. But for those of us in health IT, it also means reviewing the proposed 2018 Quality Payment Program Year 2 changes under MACRA. The proposed ruling was released on June 20th, and coming in at 1,058 pages it makes for a seriously long beach read.
Everyone in healthcare knows the importance of getting paid for services, and outpatient diagnostic imaging procedures are no exception. Beginning January 1, 2019, providers must comply with imaging appropriate use criteria (IAUC) — as outlined by the Centers for Medicare and Medicaid Services (CMS) in accordance with the Protecting Access to Medicare Act (PAMA) of 2014 — when ordering Medicare Part B outpatient advanced diagnostic imaging services, such as CT, MRI, and nuclear medicine including PET scans.