Category:Uncategorized
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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The Opening of 2017 in Regulatory Compliance
Ryan Meade Editor-in-Chief Director of Regulatory Compliance Studies at Loyola University Chicago School of Law In continuing to examine the regulatory Wunderkammer of the Federal Register, the first volume of the year holds some interesting items in its opening pages. Page 1 of the 81st volume starts out somberly with Executive Order 13757, “Taking …
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Regulatory Freeze for Review of Pending Rules
Ryan Meade Editor-in-Chief Director of Regulatory Compliance Studies at Loyola University Chicago School of Law As has been the case for every new Administration since 1981, the President has issued a freeze of final regulations that have not gone into effect. The instruction usually comes through the Chief of Staff and is referred to …
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Volkswagen Compliance Chief Steps Down
Mac Matarieh Associate Editor Loyola University Chicago School of Law, JD 2018 Volkswagen installed emission software that allowed more than a half-million diesel cars in the United States to cheat the emissions test set by the Environmental Protection Agency (EPA). Volkswagen has since recalled millions of vehicles and has reached a nearly $15 billion …
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Finalized Rule: Tough Love for Medicaid MCOs?
Kaitlin Lavin Executive Editor Loyola University Chicago School of Law, JD 2017 Last May, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for Medicaid managed care, which told states to stop making pass-through payments to healthcare providers. Pass-through payments have played a critical role in funding safety net hospitals which …
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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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The Latest CCPA Draft, Explained
The California Attorney General’s office released an updated draft to the California Consumer Privacy Act (CCPA) on February 10th. This updated draft follows the four public hearings that were held in December of 2019 and over 1,700 pages of submitted comments. Comments are being heard as of the posting of this article, and if no new changes are made, a final rulemaking record will be submitted.
Regulatory Waivers Under a Public Health Emergency
On January 31, 2020, the Secretary of Health and Human Services (“HHS”) Alex Azar declared a public health emergency (“PHE”) over the outbreak of the new coronavirus. The PHE response requires coordination with a complex set of federal, state, tribal and local laws and effective compliance calls for a comprehensive understanding of the legal implications and ramifications—which impose challenges from adherence to certain federal laws.