Breaking News: No Vote On Fiscal Cliff

Though a deal to avert the fiscal cliff was reportedly in sight, but not yet finalized, NBC News is reporting there will not be a vote tonight. The emerging deal was said to raise tax rates on family income over $450,000 and individual income over $400,000 a year, increase the estate tax rate and extend unemployment benefits for one year.

Stay tuned to the HMS blog for more details as they emerge.

Top Healthcare Story Of 2012

By far, the number one health care news story of 2012 was the U.S. Supreme Court’s decision to uphold the individual mandate outlined by the Patient Protection & Affordable Care Act (PPACA).

In a split decision, with Chief Justice John G. Roberts Jr. casting the deciding vote, the U.S. Supreme Court upheld the cornerstone of President Obama’s healthcare reform law and signature domestic initiative. Roberts joined liberals on the court in upholding the mandate at the heart of the underlying law, saying the mandate could survive as a tax.

Following three days of oral arguments on the law’s constitutionality in March, insiders widely believed the individual mandate, and perhaps the entire healthcare law, was very much in jeopardy. However, the Justice Department argued the mandate does not force people to participate in the market for health insurance, but rather regulates participation in the market for healthcare services.

The high court rejected Medicaid expansion provisions in the new healthcare law. The court ruled that Congress overstepped its authority when it said states must go along with the Medicaid insurance program for low-income people, providing expanded coverage to about 17 million over the next decade.  Connecticut was the first state to participate in the provision which will be funded by the federal government beginning in 2014.

The HMS Blog posted two series on health reform: Understanding Health Reform  and The Impact of Federal Health Reform as well as a Post Election Guide to Health Reform to help sift through the confusion and clarify provisions of the PPACA.

Meaningful Use Monday: Changes To Stage 2 Rule

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule which made changes to the Stage 2 electronic health records meaningful use program. The changes involve replacing some standards with more recent versions and changing or exempting some meaningful use measures to provide more flexibility. This interim final rule with comment period is effective January 7, 2013.

Click here to read more.

New Year’s Resolution: Improved Revenue Cycles

HMS Healthcare Management SolutionsPhysician practices are seeking more efficient ways to improve revenue cycles, reduce expenditures and decrease billing errors. That’s where HMS Healthcare Management Solutions can help. For more than 25 years, HMS has helped our clients optimize their revenue by improving cash flow, increasing operational efficiencies and identifying opportunities for profitable lines of business. Our  services include:

  • Outsourced Billing (U.S. Based Only)
  • Credentialing
  • Consulting & Strategic Services
  • Affordable EHR
  • Social Media Services
  • Revenue & Cash Flow Improvement
  • Increased Claims Accuracy & Payment Rates
  • Decreased Denials and more!

Contact us to see how we can help you maximize your potential by increasing your financial performance today!

Connecticut Health Council Launches,HMS Founding Partner

Earlier this month, the Connecticut Health Council launched at the Connecticut Convention Center in Hartford.  The council is an association of health sector leaders working together to promote Connecticut as a premier center for the development of business, initiatives and technology that improve healthcare and wellness throughout the state and beyond.  In addition, the council will host programs focused on health sector topics including the impact of the Patient Protection & Affordable Care Act (PPACA), the future of healthcare and an overview of the Connecticut Health Insurance Exchange.

HMS Healthcare Management Solutions is proud to be among the list of distinguished founding partners of the Connecticut Health Council. For a full list of initiative partners, click here.

Fiscal Cliff Q&A

As negotiations to avert cuts under the fiscal cliff continue, Kaiser Health News offers some insight into what could happen if a deal is not reached by the end-of-year deadline.

  • How would Medicare be impacted if no deal is struck? Medicare providers would be subject to an across-the-board 2% payment cut under a series of automatic spending cuts known as sequestration.
  • How does the 2% cut in payments to physicians affect the 27% cut in Medicare payments already scheduled to occur in January? Physicians who accept Medicare patients would face the 2% cut on top of an already scheduled 27% reduction in January unless Congress steps in to stop it. The payment formula, known as the sustainable growth rate (SGR), was created in a 1997 deficit reduction law that called for setting Medicare physician payment rates through a formula based on economic growth. A deal on the SGR could be part of the fiscal cliff negotiations. Congress could also pass separate legislation to stop the cuts. Some doctors have indicated they may stop accepting Medicare patients if reimbursements are further reduced.
  • What would a deal mean for Medicare? Some of the proposals include increasing the Medicare eligibility age to 67, asking wealthier Medicare beneficiaries to pay more for their coverage and paying Medicare providers less.
  • How is Medicaid affected, either way? Though Medicaid does not face any automatic cuts on January 1, there is concern reductions in federal Medicaid spending might make governors even more reluctant to expand the optional federal-state program under the Patient Protection & Affordable Care Act (PPACA).
  • What happens to health care for members of the military and veterans without a deal? While the Veterans Affairs health system, however, is exempt from sequestration, the TRICARE program for active members of the military system would be subject to an across-the-board 2% cut.

Stay tuned to the HMS Healthcare Management Solutions blog for more information as the fiscal cliff negotiations continue.

Docs Await Decrease In Medicare Rates

Doctors participating in Medicare are just days away from a large decrease in pay rates as Congress works against the clock to come up with a temporary solution. President Obama returned from vacation in Hawaii to meet with Congress to make one final attempt to avoid huge tax hikes and spending cuts in the New Year. There is currently no deal in place to stop a 26.5% cut under the sustainable growth rate formula, even as lawmakers pledged to prevent the decrease before it hits on January 1.

Click here to read more.

HHS Gives Conditional Approval For Three State Exchanges

Last week, the Department of Health and Human Services (HHS) officials gave conditional approval to three more states which have demonstrated they will be ready to open affordable insurance exchanges in 2014.  Conditional approval was issued to Minnesota, Rhode Island and Delaware, the last of which is the first state which will operate through a partnership with the federal government.

Nine states, including Connecticut, have already been deemed ready to operate state-based exchanges in time for open enrollment in October.