Medicare Compliance & Reimbursement
Core Starter Set Measures
• Beta blocker at time of arrival for acute myocardial infarction
• Hemoglobin A1c control in patients with Type I or Type II diabetes mellitus
• Low-density lipoprotein control in patients with Type I or Type II diabetes mellitus
• High blood pressure control in patients with Type I or Type II diabetes mellitus
• Angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker therapy for left ventricular systolic dysfunction
• Beta-blocker therapy for patients with prior myocardial infarction
• Assessment of elderly patients for falls
• Dialysis dose in end-stage renal disease patients
• Hematocrit level in end-stage renal disease patient
• Autogenous arteriovenous fistula receipt in end-stage renal disease patients requiring hemodialysis
• Antidepressant medication during acute phase for patients diagnosed with new episodes of major depression
• Antibiotic prophylaxis in surgical patients
• Thromboembolism prophylaxis in surgical patients
• Internal mammary artery use in coronary artery bypass graft surgery
• Pre-operative beta-blockers for patients with isolated coronary artery bypass grafts
Medicare Compliance & Reimbursement
- PHYSICIANS:
PVRP Revisions Help Physicians 'Test the Waters'
CMS tries to assuage docs before tying quality reporting to Medicare payments.
Quality improvement initiatives could [...] - PVRP:
Core Starter Set Measures
• Aspirin at arrival for acute myocardial infarction
• Beta blocker at time of arrival for acute myocardial [...] - OUTPATIENT THERAPY:
Vague Claims Data Poses Challenge To Therapy Trends And Coverage Assumptions
Therapy cap controversy renews focus on coverage and spending growth
Notable growth in outpatient therapy spending [...] - OUTPATIENT THERAPY:
Therapy Caps Tied To Spending, Payment Update
Therapy caps reduce provider spending but threaten to escalate benes' out-of-pocket burden
Upon recommendation from the [...] - SPENDING:
Health Care Spending Shows Signs Of Slowing
Reduced growth stirs up mixed emotions among industry leaders
The 7.9 percent [...] - SPENDING:
Medicaid, Managed Care Restrictions Put The Brakes On Spending Growth
Reduced Rx spending wasn't the only factor playing 2004's declining health care spending growth rate
Prescription [...] - INDUSTRY NOTES:
CMS Confirms Retroactive Physician Payment Adjustments
Plus: Bipartisan bill could extend Part D enrollment deadline
Providers who've been crossing their fingers for [...]
