10/26/2017

Healthcare’s Biggest Distruptor: Blockchain & EHR Interoperability

As patients and regulators press for better care at lower costs, the healthcare system appears to be poised to experience a dramatic digital disruption.

05/17/2017

Focus on Healthcare: Proposed American Healthcare Act

On May 4th the House of Representatives passed a bill by a 217 to 213 margin to repeal the Affordable Care Act (ACA) and replace it with The American Health Care Act (AHCA). If enacted in its current form, the new law would eliminate most of the taxes the ACA put in place. The House bill is now in the hands of the Senate where it will likely undergo significant changes.

11/30/2016

Focus on Healthcare: Relief for Small Practices Under Final MACRA Ruling

In 2015 the Medicare Access and CHIP Reauthorization Act (MACRA) was passed which was a bipartisan agreement to move towards a value-based system of care. The Act would create a new approach to paying clinicians for the value and quality of care they provide. At the time of the Act’s passage nearly a year ago, it was unknown how it would be implemented or the exact details of how it would work.

07/25/2016

Focus on Healthcare: MACRA – A Move to a Value-Based System of Care

In 2015 the Medicare Access and CHIP Reauthorization Act (MACRA) was passed which was a bipartisan agreement to move towards a value-based system of care. Prior to MACRA, physicians providing care to Medicare patients were subject to a reimbursement formula known as the Sustainable Growth Rate (SGR). The SGR was established to help control the rate of increases in physician spending and compared total spending among all Medicare-participating physicians to an overall budgeted target.

01/18/2016

Focus on Healthcare: CMS Releases 2016 Calendar Year Changes to the Medicare Physician Fee Schedule

In November, the Centers for Medicare & Medicaid Services (CMS) released the new Physician Fee Schedule (PFS). The PFS sets forth the payments physicians and other practitioners receive for their various services, including but not limited to, office visits, surgical procedures, diagnostic tests and certain preventative services. Payments are based on the relative resources that are typically necessary to provide a service. Relative value units are applied to each service provided by the physician, in addition to factoring in practice expense and malpractice.

01/14/2016

Focus on Healthcare: Affordable Care Act Reporting Deadline Extension for Forms 1094 and 1095

The U.S. Treasury and Internal Revenue Service recently extended the 2015 Affordable Care Act (ACA) information reporting deadlines to give employers and payroll service providers more time to fulfill these requirements.

08/21/2015

Focus on Healthcare: CMS Issues Proposed Changes to Medicare Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on July 8, 2015, updating payment policies, payment rates and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) for calendar year 2016.

06/17/2015

Focus on Healthcare: Refresher on the Affordable Care Act and What’s Required for 2015

As we head into the last half of the year, it is important to understand and prepare for the employer reporting requirements of the Affordable Care Act. Many pivotal elements of this law went into effect at the beginning of 2014. While employer information reporting was optional for calendar year 2014, it will become mandatory for all applicable large employers starting in early 2016 for calendar year 2015.

06/05/2015

Focus on Healthcare: All Healthcare Organizations Are Targets of Cyber Breaches

The largest healthcare security breaches lately have been at payer organizations (e.g., Anthem). The recently announced Beacon Health System breach of 220,000 patient records is evidence that providers are equally targeted. In fact, providers are targeted far more often as cyber criminals go after providers large and small in order to gain access to personally identifiable information and personal healthcare information. 

05/18/2015

Focus on Healthcare: Employers with UNDER 50 FTE’s: June 30, 2015 ACA Deadline

For employers with under 50 full time equivalents, June 30, 2015 is the deadline for transitioning employees over to the SHOP marketplace or other insurance that meets the market reform requirements of the Affordable Care Act.

03/06/2015

Focus on Healthcare: Supreme Court Hears Arguments in Affordable Care Act Subsidies Case

This week the Supreme Court heard arguments in King v. Burwell, a case centered on the issue of the constitutionality/legality of insurance premium subsidies received by individuals purchasing health insurance on the federally run health insurance exchange.

02/19/2015

Focus on Healthcare: New Guidance on Health Coverage Reimbursement Including Employers Increasing Employee Compensation to Allow Employees to Purchase Health Insurance

IRS, DOL, HHS issue further guidance on certain health coverage reimbursement arrangements – including guidance on rules around employers increasing employee compensation to allow employees to purchase their own health insurance.

12/15/2014

Focus on Healthcare: New Guidelines Issued Regarding Employer Compliance with Affordable Care Act

Recently, the United States Department of Labor (DOL), the Internal Revenue Service (IRS) and the Department of Health and Human Services (DHHS) issued new guidance to deter implementation of certain strategies being marketed to employers that reduce costs associated with complying with the requirements of the Affordable Care Act.

09/10/2014

Focus on Healthcare: Federal Appeals Courts Issue Conflicting Rulings on Healthcare Law

Recently, two federal courts (Court of Appeals for the District of Columbia and Court of Appeals for the Fourth Circuit in Richmond, Virginia) issued conflicting rulings with respect to whether consumers who meet certain income criteria can continue to receive government subsidies for health care coverage bought on the Affordable Care Act’s federal exchange.

07/14/2014

Focus on Healthcare:  IRS Prohibits Employers from Reimbursing Employees for Health Insurance Premiums on a Pre-Tax Basis

The IRS recently issued a clarifying notice reiterating that employers are prohibited from using employer payment plans to reimburse employees, on a pretax basis, for health insurance premiums that employees pay for individual health insurance policies.

02/12/2014

Focus on Healthcare Reform: Employer Mandate Delayed For Some Businesses Until 2016

On Monday, February 10, The U.S. Department of the Treasury and the Internal Revenue Service issued final regulations implementing the employer responsibility provisions under the Affordable Care Act (ACA) that take effect in 2015. 

11/06/2013

Focus on Healthcare: Self Referral Situations For Physicians

Two recent reports from the US Government Accountability Office (GAO) and the Office of Inspector General (OIG) stress the importance of understanding self referral situations.

The GAO report found that the rate of Intensity-Modulated Radiation Therapy (IMRT) used by self referring urologists grew from 13.1% to 32.3% from 2005 to 2010 as compared with growth of 14.3% to 15.6% among non-referring urologists for the same period.  There has been some disagreement about the validity of the data and this may stem from the question of who should perform radiation therapy procedures, oncologists or urologists.

09/18/2013

Focus on Healthcare Reform: Employers Should Provide Notice to Employees by October 1 Regarding Insurance Exchanges

On October 1, 2013, the health insurance marketplaces created by the Affordable Care Act will open. Under the law, it is required that employers provide notice to their employees about these marketplaces, also known as exchanges.

08/15/2012

Focus on Healthcare: Medical Loss Ratio Rebate Checks

As a part of the Affordable Care Act, health insurers providing coverage that do not meet the medical loss ratio (MLR) must provide an annual rebate to each enrollee under such coverage, on a pro-rata basis.

01/05/2012

Focus on Healthcare: An Overview of the 2012 Office of Inspector General Work Plan on Healthcare Providers

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently published its 2012 Work Plan.

06/29/2011

Focus on Healthcare: Availability of Medicare Data for Performance Measurements

The Department of Health and Human Services (HHS) continues to draft regulations to support the implementation of The Patient Protection and Affordable Care Act (a.k.a. “Health Care Reform”).

12/27/2010

Focus on Healthcare: Registration to Apply for EHR Incentives Will Begin January 3rd, 2011

As you may recall, the American Recovery and Reinvestment Act of 2009 ("Act"), which was signed into to law on February 17, 2009, provided financial incentives to those eligible health care providers that deploy and use certified electronic health record (EHR) technology.

12/22/2010

Focus on Healthcare: Physician Fee Schedule Cuts Postponed

During 2010, physicians had to deal with the uncertainty of the Medicare physician fee schedule being cut by 25%.

12/16/2010

Focus on Healthcare: Final Electronic Health Record Incentive Program Regulations

If you deploy and use certified electronic health record (EHR) technology, you may be eligible for financial incentives.

01/31/2010

Focus on Health Care: Electronic Health Record Incentive Program

As a part of the American Recovery and Reinvestment Act of 2009 ("Act"), which was signed into to law on February 17, 2009, financial incentives were made available to those eligible healthcare providers that deploy and use certified electronic health record (EHR) technology.

12/03/2009

Focus on Healthcare: Medicare’s Recovery Audit Contractor Program for 2010

For the past three years, the Center of Medicare and Medicaid Services (CMS) has been piloting a program to review claims paid under the Medicare program.

10/08/2009

Focus on Healthcare: Proposed Regulations Reduce the Physician Fee Schedule by 21 percent in 2010

As Congress debates healthcare reform, the Center for Medicare & Medicaid Services (CMS) continues to issue regulations to implement laws that are currently in place.

03/16/2009

Focus on Health Care: American Recovery and Reinvestment Act of 2009

On February 13, 2009, Congress passed the American Recovery and Reinvestment Act of 2009 ("Act").

01/14/2009

Focus on Health Care: Managing a Physician Practice in Uncertain Times

In July, Congress passed the Medicare Improvement for Patients and Provider Act of 2008. On July 1, 2008, the Medicare physician fee schedule was set to be reduced by 10.6 percent, with another 5.4 percent cut on Jan. 1, 2009.

10/26/2008

Focus on Health Care: Highlights of the 2008 AICPA National Healthcare Industry Conference

The American Institute of Certified Public Accountants (AICPA) recently held the 2008 National Healthcare Industry Conference in San Diego, California.