by Caroline Fife, M.D. | Mar 24, 2016 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program
Each performance year, CMS sets a “performance threshold” (PT) which is the number of points at which a provider receives 0% adjustment to their Medicare Part B payments. If, just for the sake of illustration, the PT threshold is 50 points, then a provider earning 50...
by Caroline Fife, M.D. | Jan 6, 2016 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program
2015 is the first year that CMS has distributed Quality and Resource Use Reports (QRURs) to all physicians in the USA. Made available in early September, the QRUR is a confidential report that reflects the quality and cost measure data collected by an eligible...
by Caroline Fife, M.D. | Nov 24, 2015 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program
CMS recently published a final rule that specifies criteria that eligible professionals (EPs) must meet in order to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. EHR Incentive Programs Final Rule Provisions The new...
by Caroline Fife, M.D. | Nov 20, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
In the upcoming November edition of Today’s Wound Clinic, Helen Gelly, MD has written a very informative “Educational Note to Provider.” Helen, and Joe Darrah, the Managing Editor of TWC have graciously allowed me to share this The prior authorization...
by Caroline Fife, M.D. | Nov 17, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Chartbook on Effective Treatment, National Healthcare Quality and Disparities. This Effective Treatment chartbook is part of a family of documents and tools that support the National Healthcare Quality and Disparities Report (QDR). The QDR includes annual reports to...
by Caroline Fife, M.D. | Nov 6, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Hyperbaric physicians unite! Time to speak out and voice your concerns and educated opinions on the limitations imposed by the First Coast Draft LCD. GuideWell Source is the parent company of First Coast Service Options as well as Novitas Solutions. Between these two...
by Caroline Fife, M.D. | Oct 26, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
On September 28, 2015, CMS made available the 2014 Supplemental Quality and Resource Use Reports (QRURs) to every medical group practice and solo practitioner nationwide. Providers are identified in the Supplemental QRURs by their Taxpayer Identification Number (TIN)....
by Caroline Fife, M.D. | Oct 13, 2015 | Quality Payment Program
CMS will be publicly reporting a sub-set of the 2014 Physician Quality Reporting System (PQRS) measures on Physician Compare. Starting October 5, 2015, CMS is has set up a 30-day preview period for select quality measures through the PQRS portal—Provider Quality...
by Caroline Fife, M.D. | Sep 21, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
The Centers for Medicare & Medicaid Services (CMS) has implemented a prior authorization model for non-emergent hyperbaric oxygen therapy in Illinois, Michigan, and New Jersey. It is the position of CMS that it can reduce spending on HBOT services while...
by Caroline Fife, M.D. | Aug 31, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
I mentioned a “pay for performance” model that CMS is trying out for Home Health Agencies. Well, an AHRQ study published in the British Medical Journal explored ways in which data were collected and used in Nursing Homes as a result of participation in a...
