As value-based healthcare becomes the norm, strong clinical documentation improvement (CDI) programs are becoming more important than ever. Value-based healthcare is a healthcare delivery model in which providers are paid based on patient outcomes. The Center for Medicare and Medicaid Services (CMS) is implementing a quality payment incentive program as required by law. Value-based reimbursement […]
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On March 5, CMS announced updates coming in April 2019 to Nursing Home Compare and the Five-Star Quality Rating System. Per CMS, these changes will strengthen the tool for consumers to compare quality between nursing homes. These updates are to advance CMS’s goal to improve accuracy and value and promote quality improvement in nursing homes. […]
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Attention 340B covered entities participating with Anthem Blue Cross and Blue Shield: Effective April 1, 2019, Anthem requires that a “JG,” “TB,” or another relevant modifier be added to claims involving 340B eligible outpatient drugs under the Medicare Outpatient Prospective Payment System (OPPS). This decision by Anthem resembles the January 1, 2018 decision by the […]
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On January 31, 2019, the Centers for Medicare and Medicaid Services (CMS) released the revised Federal Fiscal Year (FFY) 2020 Public Use File (PUF). If your hospital requested any changes to the wage index or occupational mix survey data prior to the September 4, 2018 deadline, this file should include revisions your Medicare Administrative Contractor […]
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Effective January 20, 2019, the process for calculating Indiana Medicaid reimbursement rates for home health services has been repealed. In addition, the requirement to file the Indiana Medicaid home health agency cost report is no longer effective. These changes were made to Indiana Administrative code 405 IAC 1-4.2. Therefore, no Indiana Medicaid home health cost reports […]
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The passing of the Tax Cuts and Jobs Act (TCJA) in December 2017 brought about some of the largest changes for exempt organizations since the reformatting of the Form 990 tax return in 2008. This is shown by some organizations now having unrelated business income tax liability that never did in the past. The list […]
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In case you are not aware, the Centers for Medicare and Medicaid Services (CMS)’s new hospital price transparency policy goes into effect January 1, 2019. By that date, hospitals must make available a list of their current standard charges via the internet in a machine-readable format and update this information at least annually, or more […]
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Is your clinic missing out on potential enhanced Medicare and Medicaid reimbursement? The Rural Health Clinic Service Act of 1977 was established with the intent to increase access to primary care services for Medicaid and Medicare patients in rural communities. Is my clinic eligible to become a Rural Health Clinic (RHC)? To be eligible, clinics […]
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As you may have heard, the CMS 2019 Relative Value Unit (RVU) weighting for E&M visits is proposed to effectively shift to a two-level system, with level 1 visits receiving a minimal weighting and levels 2-5 being weighted equally. CMS has stated that this change is intended to reduce the back-office burden of office visits, […]
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New rules for reporting evaluation and management (E/M) services in most places of service took effect January 1, 2023. The coding and documentation revisions, adopted by the American Medical Association’s CPT Editorial Panel and approved by the Centers for Medicare and Medicaid Services (CMS), substantially simplify code selection and documentation. Effective January 1st, E/M services […]
The Consolidated Appropriations Act of 2023, also known as the “Omnibus” package, was signed into law by President Biden on December 29, 2022. Rural Health Clinics (RHCs) need to be aware of some of the changes that will impact them including new grant opportunities and behavioral health provisions. Opportunities for Rural Health Clinics from the […]
By Pam Swartout, Manager and Jacoby Shade, Staff Accountant at Blue & Co. Many business owners provide a company vehicle to their employees as part of their employment. This is a company benefit that has tax implications and is extremely important for both the employer and employee to understand these implications. Employers can deduct only […]
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