Minggu, 16 Maret 2014

CMS Fiddling Around Now With eRX Program To Audit and See If Claims Submitted Failed, They Want To Get Some Money Back As “Their CMS” Programs Have Data Integrity Issues…

Most who have been using an electronic medical records system don’t have to worry about a lot of this as far as the audit.  eRX incentives came out before Meaningful Use and was separate imageand yes there’s some confusion and overlapping.  Most EMR programs do have an e-prescribing module but there are some that do not and e-prescribing can be handled separately.  Most of that was in the “early” EMF days with getting started.  As the link below states this is the year the 2% penalty kicks in for those who have NOT e-prescribed yet. 

eRX CMS Penalty Reimbursement On Medicare Part B Grows to 2% This Year For Those Who Have Not e-Prescribed Yet- Mostly Applies to Doctors Who Are Not Using An Integrated Electronic Medical Records System Yet

Most software used today actually reminds and bugs you about claims that have not been paid or have issues and clearinghouse services scrub and sent them back to providers as well if there’s something not working on the claim information. 

So what else do you expect from CMS these days?  The same folks that brought your Healthcare.Gov on October 1st.  In 2013 those who did not successfully e-prescribe already faced their 1.5 decrease so maybe that’s their issue with not being able to see if they actually did decrease those payments to providers?  I have just never seen anything like this relative to all the complexities we have today to see an agency keep going down the same path in adding more complexities instead of making things less complicated. 

CMS Issues Hardship Exception Information - Who’s Going to Administrate All Of This and Keep Track? Just Get Your Vendor To Vouch for You? Extension Would Have Been Much Simpler In View of All the Other Algorithmic Complexities Happening With Obamacare At Present…

Maybe they are going to put that Cray Appliance to some additional use for the queries as they are doing with looking for fraud?  CMS is  already looking for abusive prescribers and want all doctors to be registered with Medicare.  If they can identify abusive prescribers they should be able to run claims through to find missing data on e-prescribing but even that takes some work and time to prepare the data first….it’s the world we live in today.  BD 

Medicare Looks To Use Analytics to Identify Abusive Prescribers And Require Doctors To Be Registered With Medicare To Write a Prescription-Sounds Like The CMS Cray Computer YarcData Appliance Might Be Getting A Little Busier


“This four-year project will evaluate incentive payment information for accuracy and identify improper payments, with the goal of recovering these payments,” CMS explains in the notice. “Additionally, based on the project’s results, recommendations will be made so that we can avoid future integrity issues.” CMS does not use the word “audit” in the notice.

CMS will analyze data submission, processing and reporting procedures “for potential errors, inconsistencies and gaps that are related to data handling, program requirements and clinical quality measure specification of PQRS and eRx programs,” according to the notice.

http://www.healthdatamanagement.com/news/cms-wants-money-back-from-PQRS-eRx-programs-47454-1.html

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