All Articles In 'Physicians'
Medicare Payment Reform and Quality Improvement: MedPAC Recommendations to Congress on Medical Imaging and Poor Quality Providers
The Medicare Payment Advisory Commission (MedPAC) has made 10 new recommendations to Congress regarding Medicare payment accuracy and financial incentives for medical imaging and other diagnostic testing, and quality improvement, targeting the worse performing Medicare providers [...]
Using Health Information Technology for Chronic Disease Management: AHRQ Webinar
The Agency for Healthcare Research and Quality (AHRQ) is hosting a free webinar on Using Health Information Technology for Chronic Disease Management. Webinar is set for Tuesday, June 21, 2011, at 11:30 am EST. During the 90-minute conference, participants can watch [...]
Medicare and Medicaid Compliance: OIG Advice for Operating an Effective Compliance Program
Comprehensive compliance programs are essential for all hospitals, health systems, physician practices, Medicare Advantage plans, Medicaid health plans, Medicare prescription drug plans, drug manufacturers, medical device makers, long-term care providers, and others doing business with Medicare, Medicaid, or [...]
Accountable Care Organizations: Your Guide to Strategy, Design, and Implementation, by Marc Bard and Mike Nugent
Are you ready to be an Accountable Care Organization (ACO)? Significant new opportunities and challenges face health systems, hospitals, and physician practices as they decide whether to participate in the new Medicare Shared Savings Program and join together to [...]
Compliance Challenges of Health Reform: Questions Compliance Professionals Should Ask as They Prepare for Health Care Reform
With an array of payment reforms, quality and safety requirements, massive expansion of Medicaid, and creation of the new State Health Benefit Exchange marketplace, the Affordable Care Act (ACA) presents extraordinary new challenges for compliance, especially [...]
Direct-to-Consumer Advertising of Prescription Drugs: Legal, Policy, Market, and Public Health Issues for Potential Bans on DTC Advertising of New Brand Drugs
Direct-to-Consumer (DTC) advertising of prescription drugs, especially new brand-named drugs, remains controversial. Some in Congress remain eager to prohibit advertising of brand-name prescription drugs to consumers in the first two years following a drug’s approval by [...]
Medicaid Fraud and Abuse: Investigations, Prosecutions, Spending, and Staffing by State Medicaid Fraud Control Units in 2010
Nearly every State has a Medicaid Fraud Control Unit (MFCU) to investigate and prosecute cases of Medicaid fraud and patient abuse and neglect. MFCUs are a key part of an array of federal and state agencies combating [...]
Primary Care Physicians and Hospital Emergency Departments: Improving Communications
Hospital and emergency room utilization is expected to increase substantially when 35-40 million Americans become newly insured through Medicaid and State Health Exchanges starting in 2014. Today, communication between primary care physicians and hospital emergency departments is [...]
Electronic Health Records: Medicare and Medicaid EHR Incentive Payments for Hospitals and Physicians
Medicare and Medicaid payment incentives are available for hospitals, physicians, and certain other healthcare professionals that implement and use Electronic Health Record (EHR) systems. To receive the payment incentives, eligible providers must engage in meaningful use [...]
Medicare and Medicaid Fraud: Voluntary Self-Disclosure of Potential Fraud by Hospitals, Physicians, and Other Providers
Medicare and Medicaid program integrity efforts – coupled with complex coding and claiming procedures, ever-increasing program requirements, new payment methods, and the growing market share of taxpayer-funded programs – present significant compliance challenges for health plans, hospitals, [...]
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