Electronic Health Records

Centers for Medicare & Medicaid Services

Ordering, referring denial edits will begin Jan. 6, 2014

by Nicole Freeman

The Centers for Medicare and Medicaid Services (CMS) has announced a January 6, 2014 starting date for the second phase of denial edits. Here is the full message from CMS: CMS will instruct contractors to turn on Phase 2 denial edits...

ONC: Meaningful use incentives will continue despite shutdown

by Jennifer Bresnick

Squabbling lawmakers can’t stop meaningful use from marching on, says outgoing National Coordinator Dr. Farzad Mostashari.  Despite the government shutdown now dragging into its second week, and the furlough of more than half...

What the government shutdown means to Medicare, Medicaid

by Kyle Murphy, PhD

UPDATE: The federal government has agreed to a temporary plan to reopen the government. For news on the latest impact of the government shutdown on Medicare and Medicaid, visit HealthPayerIntelligence.com. For the Department of Health...

AHA survey: Medicare RAC audits up 47% since last year

by Jennifer Bresnick

The number of Recovery Audit Contraction (RAC) requests for medical claims reviews has increased “dramatically” since 2012, according to the American Hospital Association’s (AHA) newest RACTrac survey.  More than...

Knee and hip replacement readmissions may cost $265,000

by Jennifer Bresnick

Readmitting a patient after an elective knee or hip replacement?  Prepare for a quarter of a million dollar fine from Medicare.  New accountable care guidelines institute harsh penalties for hospitals that are unable to prevent...

MGMA: Medicare must complete ICD-10 end-to-end testing

by Jennifer Bresnick

Last month’s revelation that CMS and Medicare does not plan to complete comprehensive ICD-10 end-to-end testing ruffled some industry feathers, and caused a great deal of concern among health information management (HIM)...

What’s behind the 17% EHR Incentive Program dropout rate?

by Jennifer Bresnick

The pace at which eligible providers are leaving the EHR Incentive Program is higher than most high school dropout rates, according to the latest data from CMS.  Seventeen percent of providers who collected a 90-day incentive payment...

Should docs stop taking insurance to save time, EHR expense?

by Jennifer Bresnick

In a move bold enough to make headlines, a family physician in South Portland, Maine has stopped taking all forms of insurance and listed his prices online, due in cash by the end of the visit.  Dr. Michael Ciampi announced to his...

Senators call for greater Medicare claims data transparency

by Kyle Murphy, PhD

Apparently, recent attempts by agencies within the Department of Health & Human Services (HHS) to increase transparency haven’t done enough to satisfy two members of Congress. In a joint statement issued yesterday, Senators...

State laws vary widely on telehealth insurance coverage

by Jennifer Bresnick

With the spreading net of broadband internet coverage reaching into the most rural areas and accountable care rising in popularity, the time seems right for telemedicine to take center stage in the debate about how to extend cost-saving...

AHA Supports Bill to Improve Medicare Audits, Work of RACs

by Kyle Murphy, PhD

The American Hospital Association (AHA) applauding the sponsoring of a new bill to improve the work of Medicare Recovery Audit Contractors (RACs). In a letter to Senator Roy Blunt (R-MO), sponsor of Medicare Audit Improvement Act of 2013...

Rural hospitals fall behind on EHR adoption, mortality rates

by Jennifer Bresnick

Critical access hospitals (CAHs) are often the only inpatient facilities available to rural populations, and provide a vital safety net for millions of Americans.  The federal government has exempted CAHs from revealing patient...

Medicare, meaningful use sequestration cuts start April 1

by Jennifer Bresnick

April fools?  Unfortunately not.  The 2% cut to Medicare reimbursements rolled up in the nation’s sequestration policy went into effect yesterday, April 1, and the impact remains uncertain.  A recent poll indicates...

Physicians like EHRs, ACOs, but see major flaws in healthcare

by Jennifer Bresnick

Despite high satisfaction with EHR software and continued interest in tools like clinical decision support and e-prescribing, physicians are generally pessimistic about the future of medicine, with half believing that incomes will take a...

Meaningful use incentives get chopped under sequestration

by Jennifer Bresnick

Anyone hoping that the EHR Incentive Program would be spared the axe after sequestration took hold late last week will be disappointed.  CMS has officially announced that the 2% reduction in Medicare will extend to meaningful use...

AHA on Medicare Cuts: Don’t Do More with Less, Just Do Better

by Jennifer Bresnick

Richard Umbdenstock, CEO of the American Hospital Association (AHA), addressed falling hospital reimbursements tied to a slashed Medicare budget and upcoming sequestration cuts in Nashville this week, urging hospitals to make the most of...

Medicare billing increases in EDs with EHRs: fraud or sicker patients?

by Jennifer Bresnick

Billing fraud has been a top concern for the Centers for Medicare and Medicaid Services (CMS) and the Government Accountability Office (GAO) since the widespread adoption of EHRs began.  Worried about the possibility of physicians...

HHS finalizes higher payments to primary care physicians

by Jennifer Bresnick

Health and Human Services (HHS) secretary Kathleen Sebelius has announced the final rule implementing higher payments to primary care physicians treating Medicare and Medicaid patients. The new rule raises reimbursement rates to ensure...

EHR Incentive Program statistics for August 2012

by Kyle Murphy, PhD

Early in September, the Centers for Medicare & Medicaid Services (CMS) released estimates for the Electronic Health Record Incentive Programs through August 2012. The numbers are now final, and here’s a rundown of who’s...

Will sequestration hurt ACOs and health IT initiatives?

by Kyle Murphy, PhD

Last week in our interview with the Medical Director of Beacon Health Partners, Jacqueline Delmont, MD, touched on a significant challenge in forming a physician-led accountable care organization. “One of the big things is to...



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