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Public option should promote cooperation with health-care providers

Public option should promote cooperation with health-care providers
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Productivity Bonuses and Profit-Sharing Requirements under Stark Law

Advertisement Physician Group Practices Should Prepare Now for Changes to Productivity Bonuses and Profit-Sharing Requirements under the Stark Law Wednesday, April 28, 2021 Beginning Jan. 1, 2022, the Centers for Medicare and Medicaid Services (CMS) will enforce new Stark Law 1 requirements for physician compensation models in group practices. Group practices that rely on generating revenues through intra-group referrals of “Designated Health Services” (e.g., clinical laboratory services, therapy services, imaging services, outpatient prescription drugs, durable medical equipment, etc.), including for ancillary services billed under the In-Office Ancillary Services exception, should start planning now to ensure that their compensation plans – specifically, their productivity bonuses and profit-sharing plans – will remain in compliance with the Stark Law. The Stark Law is a strict liability statute, meaning even a technical misstep in a compensation plan can mak

New CAQH directory lists FHIR endpoints, 3rd party apps to help with CMS interoperability rule compliance

With new Centers for Medicare and Medicaid Services regulations impacting information sharing for health plans going into effect this year and next, the Council for Affordable Quality Healthcare recently unveiled its CAQH Endpoint Directory to help payers with compliance. WHY IT MATTERS The CAQH Endpoint Directory was developed, with support from IT vendor Edifecs, as a one-stop shop for validated payer FHIR endpoints and third-party applications. To build it, CAQH convened a work group of member health plans to gather feedback about their needs and capabilities, and drew on technology expertise at connectathons and other IT industry events. The nonprofit also worked alongside the FHIR at Scale Task Force launched by the Office of the National Coordinator for Health Information Technology. And it collaborated with interoperability groups such as HL7 Da Vinci Project and CARIN Alliance.

Hospital payments increase 2 8% under CMS proposed rule

(Photo by Alex Wong\Getty Images) The Centers for Medicare and Medicaid Services has updated the Medicare fee-for-service payment rates and policies for inpatient hospitals and long-term care hospitals for 2022.  Before taking into account Medicare disproportionate share hospital payments and Medicare uncompensated care payments, the proposed increase in operating payment rates, increases in capital payments, increases in payments for new medical technologies, increases in payments due to implementation of the imputed floor and other proposed changes will increase hospital payments in FY 2022 by $3.4 billion, or 2.8%. But there is much in the proposed rule beyond payment updates. The proposed rule would require hospitals to report vaccination rates among healthcare staff. CMS is proposing the adoption of the COVID-19 Vaccination Coverage among Healthcare Personnel Measure to require hospitals to report COVID-19 vaccinations of workers in their facilities.

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