Category
Medicare & MACRA/MIPS
63 articles in this category. Showing the 36 most recent below.
Medicare 2026 Payment Changes: Your Introductory Guide
Medicare 2026 brings major changes to payment policies, coverage, and compliance. Every healthcare organization must prepare now to stay compliant and financially healthy.
Navigating CMS Medical Records Modifications
In healthcare, a single mistake in documentation can cost millions. That’s why CMS medical record modifications are under strict scrutiny from auditors, payers, and federal agencies like the OIG and DOJ .
The Villages Health Bankruptcy: What Went Wrong and What We Can Learn
The Villages Health Bankruptcy filing in July 2025 sent shockwaves through the healthcare industry, especially among Medicare Advantage providers.
Medicare Advantage: Trends, Payment & Challenges
Medicare Advantage trends, payments and challenges are a critical aspect of the modern healthcare landscape, requiring specific activities on behalf of their patients and changing payment patterns where risk is shifted f
MIPS Data Validation and Audits
In the intricate landscape of healthcare reimbursement, adhering to regulatory mandates is essential.
MACRA MIPS, Promoting Interoperability (PI) Guide!
Welcome to our guide on MACRA MIPS and the Promoting Interoperability (PI) category! As healthcare providers navigate the ever-changing landscape of Medicare reimbursement, understanding the intricacies of MIPS is essent
Navigating MIPS SAFER guides Requirements for 2024
As healthcare providers gear up for the new year, it's essential to stay abreast of the latest requirements and updates in the Merit-based Incentive Payment System (MIPS).
Introduction to SAFER Guides and Promoting Interoperability
The Quality Payment Program under the Centers for Medicare & Medicaid Services (CMS) introduced a new measure within the Protect Patient Health Information objective starting from Calendar Year 2022.
Understanding CMS Merit-based Incentive Payment System (MIPS)
In the ever-evolving landscape of healthcare reimbursement, it's crucial for healthcare providers to stay informed about payment models that directly impact their practice.
2020 MIPS Report Exception Application Deadline has been extended to February 1, 2021
Due to COVID 19, the Centers for Medicare & Medicaid Services (CMS) has extended the deadline to apply for exceptions due to Extreme and Uncontrollable Circumstances policy.
CMS 2021 Evaluation & Management Guidance
Effective January 1 st , 2021, the Centers for Medicare & Medicaid Services (CMS) Evaluation and Management (E&M) coding and documentation requirements have been changed.
2020 MIPS Exceptions
Due to COVID-19 CMS will be accepting exceptions that allow MIPS eligible clinicians, groups, and virtual groups, Qualifying Providers (QPs) for the purpose of this article, to submit an application requesting reweightin
CMS Direct Contracting
CMS is moving forward with their attempts to move into a risk payment system. The problem is that some of the players may not have their logistics process in place which could result in those participating losing monies.
CMS Quality Program Reports Extension
Quality Program Reports Extension As expected, the Federal Government is aware of the unexpected impact that COVID 19 is having and how this affect HealthCare Professionals and organizations as it relates to other issues
MACRA 2019
October 3, 2019 marks the last day to start the 90-day Performance Period for Promoting Interoperability and Improvement Activities.
CMS Initiatives
Spring 2019 Conference Cliff Notes from CMS Administrator Seema Verma In a way it was refreshing to read what Ms. Seema Verma, CMS Administrator, had to say regarding CMS initiatives moving forward.
MACRA MIPS 2019
As expected, MACRA, which is the acronym for Medicare's Quality Payment Program, continues to evolve. The latest changes that apply to the third performance year, CY 2019, of this program were released Nov 1, 2018.
Healthcare Business Priorities for 2018
As the month of January comes to an end I’m looking at what is to come and what should be the Healthcare Business Priorities for 2018. MACRA .
Financial Impact of MACRA
Looking at the 2018 calendar and working on a couple of presentations for the EPI Conference I decided to shift gears and calculate the financial impact of MACRA.
MACRA Data Submission System
On January 2, 2018 the Centers for Medicare & Medicaid Services (CMS) released a new data submission system for eligible providers who participate in Medicare's Quality Payment Program also known as MACRA ( Medicare
MACRA - what to report
December 31 st , 2017 was the last day to collect data for Medicare’s new Quality Payment Program. The next key date is March 31, 2018 as this date marks the last day to submit data to Medicare.
MACRA Due Dates
The MACRA due date to finalize capturing measures is December 31 st , 2017. Failure to capture these measures will have a cascading result as it regards to Medicare payment.
MACRA Misunderstood
By now we hope that all healthcare professionals and organizations recognize the term MACRA and what it really means.
Analytical Approach to MACRA
MACRA is upon us and the urgency to act is paramount. However, rather than panicking and throwing away resources without a plan, we recommend more of an analytical approach.
MACRA MIPS Advancing Care Information
MACRA MIPS Advancing Care Information I started this article and previous seminars by referring to MACRA as Medicare’s new payment system. However, that concept is incorrect and an oversimplification of MACRA.
MACRA by the numbers
MACRA (the Medicare Access and CHIP Reauthorization Act) is in a simplistic way Medicare’s new payment system.
MACRA June 2017 Update
To this date we still find Healthcare Professionals who are not aware of MACRA or their responsibilities under the same.
HICN No more
HICN stands for Health Insurance Claim Number which is a number assigned to Medicare recipient as an identifier in their cards.
Medicare New Payment System – First Quarter
The Medicare Access and CHIP Reauthorization Act of 2015, also known as MACRA, is the most immediate challenge faced by healthcare professionals and organizations.
Advancing Care Information
Advancing Care information is one of MACRA’s (Medicare Access and CHIP Reauthorization Act of 2015) categories.
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
http://www.slideshare.net/joseidelgado509/macra-2017
2017 New Physical Therapist Codes
The new PT Codes are here to stay. Starting January 1, 2017, Medicare will require Physical Therapists and Occupational Therapists to use new codes when conducting evaluations and re-evaluations of patients.
MACRA basic information and actions for 2017
MACRA is an acronym that describes how Medicare will be reimbursing physicians as of January 1 st , 2017.
MACRA Nov 2016 Update
MACRA stands for the Medicare Access and CHIP Re-authorization Act and is the new system that the Center for Medicare and Medicaid Services (CMS) will be using as of January 2017.
Notes to ponder
As I was conducting my afternoon research I was reading an article written by Jonathan Krasner about MACRA.
Medicare Access and CHIP Reauthorization Act (MACRA) Merit Based Incentive Payment System (MIPS)
As we move into the year of 2017 Medicare intents to incorporate a new payment system under the Medicare Access and CHIP Reauthorization Act also known as MACRA.