News and Updates From Our Blog

When reimbursement is tied to performance (as it currently is in the Physician Quality Reporting System (PQRS) 2016 reporting season), how do we navigate between what is “right” and what will get us paid?

Registries are in high gear now reviewing boatloads of data as providers finalize their 2016 PQRS submissions. What is the best way to honor the supposed Center for Medicare & Medicaid Services (CMS) “spirit” and intention of the program (to improve quality and patient care) and still receive the maximum reimbursements to which the provider believes s/he is entitled to receive for services rendered? As a qualified registry, that has been vetted by CMS, we walk the fine line everyday of providing a balanced response to this question.

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2017 is almost upon us! Are you freaking out because we’re in the last few weeks of 2016 PQRS reporting and you haven’t actually participated in the program yet? Have you just received a letter from CMS telling you that you were penalized from last year, and you’re not sure what to do about any of it? Fear not, there’s…

While it may seem daunting to consider all the 2017 changes while in the midst of the current 2016 PQRS reporting period, consider it we must. The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) ended the sustainable growth rate (SGR) averting annual congressional action necessary to stop negative adjustments to the Medicare Physician Fee Schedule (PFS). As part of…

It’s that time of year again where everyone eagerly awaits their “Report Cards” from CMS; in other words, the Quality & Resource Use Reports (QRUR)  are coming!  Most folks don’t even know the reports come directly from CMS via their EIDM account, NOT from their registry or EMR vendor. So, let’s start by getting everyone to understand where to get…

"Better late than never" is not just a phrase, it’s a way of life for those finding out about quality metric reporting at the 11th hour. Doctors and medical providers in general are well-known for our procrastination. We can perform in a pinch and, hell, we are trained to react in emergencies, not plan for them—save for our training. However,…

Few know the federal False Claims Act (FCA; today found via 31 U.S.C. Sections 3729 through 3733) dates back to 1863 when the US government was battling to maintain geographic solvency amidst the Civil War and clashing with swindlers selling decrepit livestock, malfunctioning weapons, and rancid rations to the Union Army. In short, then and now, the FCA simply affords…