Centers for Medicare and Medicaid Services

On March 9, 2020, the Department of Health and Human Services (HHS) announced final rules seeking to give patients more access to, and control of, their health data. The final rules were issued by the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare and Medicaid Services (CMS). The ONC

The Centers for Medicare and Medicaid Services (CMS) requested an audit by the Office of Inspector General (OIG) of Medicare Part D eligibility verification transactions (E1) transactions. The OIG recently released its report which found that the majority of the providers evaluated used E1 transactions for some inappropriate purpose other than to bill for a

The Centers for Medicare & Medicaid Services (CMS) recently issued guidance intended to help clinicians eligible for the Merit-based Incentive Payment System (MIPS) navigate an attestation required thereunder concerning the prevention of information blocking. MIPS was implemented via CMS’s Quality Payments Program final rule with comment period released in 2016, and represents one avenue for payment reform under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Health industry stakeholders, and providers in particular, have repeatedly cited difficulty in communicating between electronic health record systems as a major impediment to effective health care reform (including due to so-called “information blocking” practices). In response, MIPS seeks to incentivize clinicians to promote the interoperability and compatibility of certified electronic health record technology (CEHRT).
Continue Reading CMS Addresses Lingering Uncertainties and Raises Others via MACRA Information Blocking Guidance

The Centers for Medicare and Medicaid Services released a final rule permitting “qualified entities” to sell Medicare claims data to providers and others for use in improving quality of care. The rule expands on CMS’ Qualified Entity Program, which permits organizations to apply to become qualified to receive Medicare Parts A, B, and D claims