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October 2017
Health Plans Can No Longer Charge Providers Egregious Fees for Electronic Fund Transfers A recent survey by the Medical Group Management Association (MGMA) showed that 1 in 6 practices are paying fees for Electronic Fund Transfer (EFT), due to the payor using what is called a "Virtual Credit Card (VCC)" in order to accept electronic payments. These fees range from 2%-5% of the medical services payment. MGMA has been working with CMS to change this and require that plans charge a more reasonable fee for EFT. This week, CMS released guidance on this issue. Here's What You Need to Know 1. Health plans that are sending VCC payments must stop if a practice notifies the payor it wants to receive payments via EFT. 2. Plans cannot charge unsanctioned fees for the use of EFT. The amount must be similar to bank transaction fees - which are usually about 34 cents per transaction. Signing up for EFT doesn't allow the plan to deduct funds from your account unless you have entered into a contract with the plan that allows them to do this. Read more FAQs about EFT and VCCs on theCMS web site. If you are an MGMA member, access the MGMA member-benefit EFT/ERAGuidefor more information and a sample letter to request payment via EFT. Source: KarenZupko & Associates July 13, 2017
CMS looks to drop payment for off-campus services by half The CMS wants to drop by half what Medicare pays when patients receive healthcare at medical facilities that are owned by hospitals but located off their campuses. The Obama administration last year finalized a rule that paid hospital off-campus facilities the same as hospital-based outpatient departments if they started billing Medicare after Nov. 2, 2015. The proposal, outlined in the proposed 2018 physician fee pay rule released Thursday, would drop that rate from 50% to 25% of what they would have been paid under outpatient rates. "At a time when the nation is moving toward value-based payments, this proposal makes no sense. In essence, it removes all incentives to provide care out in the communities rather than at the hospital, and ultimately will lead to higher overall Medicare spending," said Blair Childs, senior vice president of public affairs for Premier, a consulting firm. The prioir, more generous payment made to off-campus facilities has led to hospitals acquiring physician practices at a rapid clip. But hospitals say the facilities, while increasing their operating costs, allow them to provide greater access to healthcare, especially in underserved areas. The Trump administration's proposed changes would save $25 million next year. Among the services affected would include pain management treatment, some x-rays and radiation therapies as well as some behavioral health services. "The CMS proposal will result in an unsustainable payment rate that will further reduce access for people in chronically underserved communities, health care deserts, and the hospitals on which they rely," Dr. Bruce Siegel CEO of America's Essential Hospitals said in a statement. Congress passed what's called the site-neutral policy after a 2013 Medicare Payment Advisory Commission report that found Medicare was paying 141% more for a echocardiogram in an outpatient setting than for the same procedure in a doctor's office. Comments on the proposed rule are due by Sept. 11. Source: Modern Healthcare |
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May 30, 2017 - Legislative Alert
Mandatory Use of the Prescription Drug Monitoring Program
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Gov. Henry McMaster Announces Resignation Of S.C. Department Of Health And Human Services Director
March 30, 2017
For immediate release
Contact: Brian Symmes, 803-673-9437
BSymmes@governor.sc.gov
COLUMBIA, S.C. - Governor Henry McMaster today announced Christian L. Soura's resignation as Director of the South Carolina Department of Health and Human Services, effective April 7, 2017.
"Christian has been a tremendous asset to the Department of Health and Human Services and to South Carolina as a whole," said Gov. McMaster. "His strong leadership and commitment to the agency's mission has improved the lives of South Carolinians, and we look forward to working with stakeholders from around the State to find someone who will continue that legacy to lead what is one of our most complex and important agencies." Read the Press Release
March 30, 2017
For immediate release
Contact: Brian Symmes, 803-673-9437
BSymmes@governor.sc.gov
COLUMBIA, S.C. - Governor Henry McMaster today announced Christian L. Soura's resignation as Director of the South Carolina Department of Health and Human Services, effective April 7, 2017.
"Christian has been a tremendous asset to the Department of Health and Human Services and to South Carolina as a whole," said Gov. McMaster. "His strong leadership and commitment to the agency's mission has improved the lives of South Carolinians, and we look forward to working with stakeholders from around the State to find someone who will continue that legacy to lead what is one of our most complex and important agencies." Read the Press Release
New DEA registration renewal policy
New DEA registration renewal policy creates new headaches for doctors
Effective Jan. 1, 2017, the DEA will eliminate the informal grace period for physicians to renew their registration - and doctors who miss their renewal deadline face daunting consequences:
Click here to read more about this policy change and the AMA's opposition.
Effective Jan. 1, 2017, the DEA will eliminate the informal grace period for physicians to renew their registration - and doctors who miss their renewal deadline face daunting consequences:
- Online registration after the expiration date will no longer be available.
- Paper renewal applications will not be accepted the day after the expiration date.
- Physicians who miss their expiration date will have to complete new registration applications.
Click here to read more about this policy change and the AMA's opposition.
