MACRA 101: MIPS and the Clinical Practice Improvement Reporting Category

Christine Bulgozdi Associate Editor Loyola University Chicago School of Law, JD 2018   The Merit-based Incentive Payment System (“MIPS”) is one of the two different payment methods that MACRA will use for eligible clinicians. Clinicians will be evaluated based on a single Composite Performance Score from four reporting categories: Quality, Resource Use, Advancing Care Information and …
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MACRA 101: MIPS and the Advancing Care Information Category

Alanna Kroeker Executive Editor Loyola University Chicago School of Law, JD 2017   This article will spell out the details for the Advancing Care Information (ACI) category of the Merit Based Incentive Payment System (MIPS).  This category accounts for 25% of a clinician’s overall composite score and is intended to replace the current Meaningful Use …
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MACRA 101: MIPS and the Resource Use Category

Bherti Patel Associate Editor Loyola University Chicago School of Law, JD 2018   As previously discussed, MIPS will streamline Medicare’s current quality measures into one composite score from four reporting categories: Quality, Resource Use, Advancing Care Information, and Clinical Practice Improvement. This score will then be used to determine the reimbursement to a clinician based …
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MACRA 101: MIPS and the Quality Reporting Category

Christine Bulgozdi Associate Editor Loyola University Chicago School of Law, JD 2018   The Merit-based Incentive Payment System (“MIPS”) is one of the two different payment methods that MACRA will use for eligible clinicians. MIPS replaces the existing fee-for-service model and is expected to be the payment track that most clinicians take. Clinicians will be evaluated …
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Understanding Medicare Documentation Requirements

Brittany Tomkies Executive Editor Loyola University Chicago School of Law, JD 2017   With more than one billion claims processed annually by the Medicare Fee-For Service (FFS) Program for more than one million health care professionals, understanding and identifying common errors encountered by Medicare Administrative Contractors (MACs) and other contractors such as Recovery Auditors (RACs) …
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Compliance During the Holidays: Following Regulations on Employer Anti-Discrimination

Melody Saveall Senior Editor Loyola University Chicago School of Law, JD 2018   With Halloween already past and the holiday season just ahead, it is important to remember the Equal Employment Opportunity Commission’s guidances on respecting employees’ religious beliefs, and reasonably accommodating them. Title VII of the Civil Rights Act of 1964 governs these policies and …
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Effective Compliance Training Methods to Increase Reporting

Brittany Tomkies Executive Editor Loyola University Chicago School of Law, JD 2017   A September 2016 survey from the Society of Corporate Compliance and Ethics (SCCE) found that 83% of compliance professionals said their program prevented misconduct at least once in the last two years with 46% of respondents saying their compliance program prevented five …
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SEC set to change how investors elect board members

Gilbert Carrillo Executive Editor Loyola University Chicago School of Law, J.D. 2017   The Securities and Exchange Commission (SEC) is expected to propose new rules that would make it easier for shareholders to vote on board candidates nominated by investors, versus those pushed by the company’s management. What impact could this have on compliance departments? …
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Tesla autopilot hardware and how it impacts compliance departments

Gilbert Carrillo Executive Editor Loyola University Chicago School of Law, JD 2017   This past week, Tesla announced that all vehicles produced by the company, as of October 19, 2016, will have hardware needed for “full self-driving capability at a safety level substantially greater than that of a human driver” (aka autopilot). Aside from the …
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IRS Ruling Threatens Future of Commercial ACOs, Cost-Reducing Healthcare Providers

Connie Zhang Associate Editor Loyola University Chicago School of Law, JD 2018   Your healthcare may come from an accountable care organization, and you may not even know it. That could soon change now that the IRS has denied one commercial accountable care organization (ACO) the tax-exempt status granted to most nonprofit health care providers. …
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