CMS Sequestration Cuts
CMS announces details on implementing sequestration cuts to Medicare claims The Centers for Medicare & Medicaid Services (CMS) released the following message regarding Medicare claims and the upcoming sequestration payment cuts: Mandatory Payment Reductions in the...Most Medicare Providers Will Face Performance Penalties
PQRS Payment Penalty Will Become Reality For Most Doctors Most providers participating in the Medicare program are facing reimbursement penalties due to lack of participation in the Physician Quality Reporting System (PQRS). More than 80 percent of participating...Extension of Medicare Overpayment Recoup Period
President Barack Obama signed the American Taxpayer Relief Act of 2012, often called the “fiscal cliff” agreement, on January 2, 2013. Buried in the 59 pages of the act is a seven-line amendment to Section 1870 of the Social Security Act. This section bars recovery of...Aetna to sell Missouri Medicaid
Aetna Inc agreed to sell its Missouri Medicaid business to WellCare Health Plans Inc as part of its purchase of Coventry Health Care Inc because their combined Missouri businesses had exceeded Medicaid membership limits. Aetna agreed to acquire Coventry in a $5.7...Maintenance of Certification (ABMS)
In 2000, the 24 Member Boards of ABMS made significant changes to their recertifiation programs. The ABMS Maintenance of Certification® (MOC) was adopted to require continuous professional development over the career of a physician. The MOC process aims to assure...Medicare physician payments 2013
At the last moment, Congress passed legislation to avert the drastic Medicare physician fee schedule reduction that physicians were facing for 2013. The American Taxpayer Relief Act of 2012 includes the following provisions impacting physician reimbursement: Prevents...CMS PQRS for 2013
Medicare PQRS Guide The 2013 PQRS Measures and Implementation Guide are now available on the CMS website. The PQRS measures guide contains information on reporting PQRS measures for 2013. Providers who don’t meet the 2013 reporting requirements will realize a...States Lean on Feds for Health Insurance Exchanges
With little direction from the federal government, more states are leaning towards the federal insurance exchange to meet coverage requirements of the Affordable Care Act. Open enrollment for insurance exchanges for 2014 begins in October 2013, so a lot needs to...Aetna to join 15 insurance exchanges
Aetna announced that by 2014 it expects to be part of 15 or more insurance exchanges being established under healthcare reforms. The Affordable Care Act is expected to bring 30 million new insured lives over the next decade and millions of those will be...
