February 28, 2020

CMS Opens Medicare Open Payments Network Reporting for Calendar Year 2019

Surgeons who are treat Medicare patients are required to submit information under the CMS Open Payment system. Medicare Reporting entities are currently submitting Program Year 2019 data. In order to participate in upcoming Open Payments program activities, physicians and teaching hospitals must be registered in the Open Payments system: If you registered last year, you do not need to register again. If it has been over 180 days since you logged in, your account is deactivated for security purposes. Contact the Open Payments Help Desk. The review and dispute period is targeted to begin in April 2020. For more information: Open Payments Resources Contact the Help Desk at openpayments@cms.hhs.govor 855-326-8366 (TTY: 844-649-2766)
February 28, 2020

CMS 2019 Data Submission Period is Now Open

The Centers for Medicare & Medicaid Services (CMS) has opened the data submission period for Merit-based Incentive Payment System (MIPS)-eligible clinicians who participated in the 2019 performance period of the Quality Payment Program. Data can be submitted and updated until 8:00 p.m. EDT on March 31. The data submission period through the CMS Web Interface for ACOs and pre-registered groups and virtual groups is also open, closing March 31. Quality measures reported via Medicare Part B claims have been submitted throughout the 2019 performance period. Sign in to qpp.cms.gov for your preliminary feedback on Part B claims measure data processed to date. We’ll update this feedback at the end of the submission period with claims processed by your Medicare Administrative Contractor within the […]
February 28, 2020

EHR Vendor Practice Fusion Pays $145 Million Fine

On Jan. 27, the Department of Justice announced the Electronic Health Record (EHR) technology developer is paying $145 million to settle allegations that Practice Fusion extracted unlawful kickbacks from pharmaceutical companies in exchange for implementing clinical decision support (CDS) alerts in its EHR software designed to increase prescriptions for their drug products. The CDS alerts that Practice Fusion agreed to implement did not always reflect accepted medical standards. In discussions with pharmaceutical companies, Practice Fusion touted the anticipated financial benefit to the pharmaceutical companies from increased sales of pharmaceutical products that would result from the CDS alerts. Between 2014 and 2019, health care providers using Practice Fusion’s EHR software wrote numerous prescriptions after receiving CDS alerts that pharmaceutical companies participated […]
February 28, 2020

ISASS asks CMS to Review Medicare Physician Payment Rates for CPT 22867

In a letter submitted Feb. 10, 2020, Dr. Morgan Lorio, Chair of the ISASS Coding and Reimbursement Task Force, asked the Centers for Medicare and Medicaid Services (CMS) to review the Relative Value Units (RVUs) assigned to CPT 22867, Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level (Co-Flex) and identify the procedure as misvalued under the Medicare Physician Fee Schedule in the 2021 Medicare Physician Fee Schedule Proposed Rule. ISASS argued that the recent Medicare valuations of 22867 was undervalued by CMS in 2015 when it was added to the Medicare Physician Fee Schedule as a result of a flawed process and flawed assumptions made in the review process. […]