Key Take Away:
This webinar discusses changes in the physician payment landscape arising from several of physician quality reporting system, with particular focus on the Medicare changes resulting from the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). And, addresses the shift in Medicare away from traditional fee for service payment models, towards more value- and quality-based payment by examining the reporting requirements and new compliance difficulties that physicians and physician practices will need to understand.
Overview:
This webinar discusses the history of Medicare's physician quality and value initiatives and recent changes in Medicare reimbursement and Medicare insurance.
Why Should You Attend :
Medicare currently operates several interconnected quality reporting systems. These are:
(1) the Physician Quality Reporting System (PQRS);
(2) the “Meaningful Use” program; and
(3) the Value-based Payment Modifier.
These programs will be incorporated into Medicare’s forthcoming Merit-based Incentive Payment System (MIPS). Data reported today will determine whether physicians receive upward or downward payment adjustments to their compensation in the future.
Currently, physicians face a range of upward and downward payment adjustments to the entire universe of their Medicare Physician Fee Schedule payments; under MIPS, this amount will eventually be +/- 9%. Improper reporting may require repayment of money to Medicare, and may result in exposure under the Federal False Claims Act, which recently had its penalties nearly doubled.
Given the complexity of these systems, and the potential risk associated with improper reporting, physicians must develop effective compliance strategies to minimize their risks.
Areas Covered In This Webinar :
In recent years Medicare has increased the number of programs which track physician-reported data. These programs, which include PQRS, EHR Meaningful Use, and the Value-based Payment Modifier, each bind Medicare physician fee schedule (MPFS) patients to the reporting of data.
The process of reporting such data, however, is complex. Physicians must choose which reporting mechanism is most appropriate for them, and different mechanisms require the reporting of different data. Physicians who fail to report properly may face reductions in MPFS payments.
In addition, there is often a delay of up to two years between when the data is reported and when payment adjustments are applied. Moreover, improper reporting that avoids a payment reduction could result in an overpayment, which could become a false claim under the federal False Claims Act. The Merit-based Incentive Payment System (MIPS) will consolidate much of the current reporting, but will ultimately increase the range of upward or downward payment adjustments for physicians.
Learning Objectives :
• Examine the three physician reporting programs currently in use by Medicare: PQRS, Meaningful Use, and the Value-based Payment Modifier
• Get a brief background for each program, and discuss common problems and areas of overlap between them
• Know MIPS, and how the current systems relate to it
• Understand the False Claims Act liability inherent in both the current systems and in MIPS, and how improper reporting under these systems can potentially result in overpayments
• Learn proactive steps that physician practices can take to help ensure compliance with these systems to avoid such liability
Who Will Benefit :
• Physicians
• Physician Practice Managers
• Compliance Officers for Health Care Providers
• Medical Staff
• Allied Health Professionals
For more information, please visit : https://www.atozcompliance.com/trainings-webinar/healthcare/audit-data-security/quality-and-beyond-recent-developments-in-medicare-reimbursement/daniel-shay/300118
Email: support@atozcompliance.com
Toll Free: +1- 844-414-1400
Tel: +1-516-900-5509
Level:
Intermediate
Speakers Profile:
Daniel Shay
DANIEL F. SHAY is an attorney with Alice G. Gosfield and Associates, P.C. His practice is restricted to health law and health care regulation focusing primarily on physician representation, fraud and abuse compliance, Medicare Part B reimbursement, and HIPAA compliance in the physician context. He also has a keen interest in intellectual property issues, including copyright, trademark, data control, and confidentiality.
He has also focused his attention on provider control of commerce in data, electronic health records license agreements, physician advertising, enrollment in Medicare, quality reporting and quality measurement, physician use of non-physician practitioners, and physician use of social media. He speaks publicly and has published on all of these topics both in the trade press and in major chapters in previous years of the HEALTH LAW HANDBOOK.
He also regularly speaks to resident physicians on what to expect in their employment contracts. Mr. Shay received his Bachelor of Arts degree cum laude in 2000 from Vanderbilt University and his juris doctorate degree from Emory University School of Law in 2003. Mr. Shay is admitted to the Pennsylvania Bar, is a member of the American Health Lawyers Association, and is the Vice Chair of Research and Website for the American Health Lawyers Association's Physicians and Physician Organization Practice Group.
