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MiraMed’s eAlerts are distributed via email every Wednesday, and contains the latest industry information regarding business process outsourcing solutions, helpful coding news, or any number of relevant topics in the fast-paced, ever-evolving world of healthcare. To subscribe, simply complete the form below. Below the subscription form, you will find the archived eAlerts available.

Medicare Reimbursement Policy Changes Under the 21st Century Cures Act

July 5, 2017

The 21st Century Cures Act (CCA) has been proclaimed by some policymakers to be “the most important legislation” Congress passed in 2016.  Among many important provisions relating to precision medicine, drug innovation, telemedicine and mental health reform, the CCA also includes several potentially high-impact Medicare reimbursement policy changes set to take effect starting this year and into 2019.  Those policy changes include site-neutral payment exceptions, adjustments to the penalty calculation formula under the Hospital Readmissions Reduction Program, new codes to bridge outpatient and inpatient surgical procedures, and suspension of the 25 Percent Rule for long-term care hospitals.

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How Physician Compare’s New Five-Star Ratings Will Impact Clinicians and Healthcare Organizations

June 21, 2017

In late 2017, the Centers for Medicare and Medicaid Services (CMS) will implement a new benchmark and five-star quality rating system for clinicians and group practices on Physician Compare, the website mandated by the Affordable Care Act (ACA) to help patients, families and caregivers make more informed choices regarding healthcare services.  The changes will ramp up the level of information readily available to patients and others about individual clinician and group practice performance on clinical quality measures, and push healthcare providers into a new phase of accelerated transparency.  Healthcare consumer sites such as Healthgrades and Vitals are likely to incorporate the information into their own portals.

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CHRONIC Care Act Proposes Big Boost in Home, Telehealth Services

June 14, 2017

On May 18th, the Senate Finance Committee unanimously approved a bill designed to improve care for Medicare beneficiaries with chronic conditions.  The Creating High-Quality Results and Outcomes Necessary to Improve CHRONIC Care Act (CCA) of 2017 would increase access to telehealth services for Medicare beneficiaries with chronic illnesses—including those in Medicare Advantage (MA) plans—as well as provide more incentives for enrollees to receive care through accountable care organizations (ACOs).

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Feds Take Aim at Medicare Advantage Insurers - Physicians Should Also Take Heed

June 7, 2017

Medicare Advantage (MA) insurers have gotten themselves into hot water lately with the federal government.  The U.S. Justice Department (DOJ) is suing UnitedHealth Group (UHG), accusing the nation’s largest MA provider of exploiting the program by providing inaccurate information about the health of its enrollees. DOJ alleges the practices have led to damages of more than $1.14 billion from 2011-2014.

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