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Reimbursements collected directly from patients are increasing in size and value, and as opposed to Medicare or insurance companies, are comparatively difficult to collect, resulting in the erosion of bottom lines across the industry.

It’s time for new 2017 CPT® code updates. Moderate sedation is no longer included in any procedures, telemedicine codes have been added, the surgery section has the largest number of code changes and there are new codes for dialysis circuits.

As the International Classification of Diseases, 10th Revision - also known as ICD-10 - enters its second year, be prepared to use the thousands of new codes introduced on October 1, 2016.

Consolidation in health care facilitates the ability to reduce costs through economies of scale and the participation in the ACA risk sharing payment models. It also increases costs due to increasing market share and negotiating clout against private insurers.

The Centers for Medicare & Medicaid Services has released the Medicare Physician Fee Schedule Final Rule. 2017 will be the first year for Merit-Based Incentives Payment System. CMS finalized a data collection strategy to reduce the reporting burden.

As per the Affordable Care Act, all 'covered entities' must 'take steps to provide meaningful access' to Limited English Proficient patients. Covered entities include hospitals, health clinics and nursing homes.

The Medicare Access and CHIP Reauthorization Act (MACRA) replaced SGR with a new payment approach known as the Quality Payment Program. CMS has made its position clear that our health care system will be moving away from a fee-for-service world.

The recently completed and released Physician Fee Schedule Final Rule for 2017 focuses on improving primary care payments for services provided by primary care physicians and other practitioners.

The Centers for Medicare and Medicaid (CMS) reported an update last week to the proposed implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) offering physicians 4 different approaches to implement MACRA in their practices.

With health care reform, the only item unresolved longer than ICD-10 is the issue regarding the repeal of the sustainable growth formula (SGR formula). There are efforts to either temporarily or permanently repeal the SGR formula used to calculate Medicare physician payments.

The results of unnecessary health care can have a dramatic financial impact on both the patient’s wallet and the overall health care costs. Even more disturbing is the physical harm that can be done to patients who had received unnecessary health care.

The Centers for Medicare and Medicaid Services issues October 1, 2015 as the compliance date for ICD-10. CMS has posted ICD-10 timelines and is directing providers to begin or continue implementation efforts now. Be prepared to comply with the transition to ICD-10.

The Senate voted to repeal the SGR and avert a reduction in Medicare payments to physicians. The House repealed this legislation. Congress passed the Medicare Access and Children’s Health Insurance Program Reauthorization Act. There are three major components.

In preparing for the coming risk environment, hospitals and physicians will need to shift their focus from quantity to quality and efficiency. It is expected Accountable Care Organizations will be the vehicle by which the objective of less costly and higher quality health care is achieved.

The wording in the Affordable Care Act suggests that subsidies can only be paid to enrollees from state-controlled exchanges. The implication of a negative ruling by the high court could place a number of enrollees in a position where they can no longer afford their health care premiums.

The Merit-Based Incentive Payment system was set up as a compromise by the Health and Human Services Department to replace the Medicare Part B Sustainable Growth Rate. MIPS annually measures Medicare Part B providers in 4 performance categories.

The Senate voted to approve HR 2, the Medicare Access and CHIP Reauthorization Act. The bill passed the House of Representatives in March. This legislation repeals the Medicare Sustainable Growth Rate (SGR) formula. Here are highlights of the bill.

Rallying cries for accountable care, the sharing of responsibility for the control of costs, and the measurement and reporting of improved outcomes have lead up to a large probability of reimbursement being based heavily on quality of care. How well are hospitals performing?

The IRS issued proposed regulations addressing investment of earnings in U.S. property as it relates to controlled foreign corporations. These regulations were to address questions arising from various changes in tax law.

The U.S. government accuses Caterpillar of tax fraud by improperly shifting billions of dollars of sales on replacement to its Swiss subsidiary. Caterpillar says it is cooperating with the authorities and vigorously contesting the IRS.