News & Analysis as of

CMS Issues Rewards and Incentive Guidance to MA Plans

On December 4, 2014, CMS issued additional guidance regarding rewards and incentives programs (“RI Programs”). This guidance elaborates on whether an RI Program can target members with specific diseases, whether rewards can...more

Final Meaningful Use Rule: CMS Loosens its Grip

The Centers for Medicare & Medicaid Services (“CMS”) finalized a rule on August 29th which should give providers some breathing room in complying with meaningful use requirements for the Electronic Health Record (“EHR”)...more

Maryland Health Care Commission Proposes to Extend and Revise EHR Incentive Regulations

On March 21, 2014, the Maryland Health Care Commission (MHCC) published proposed revisions to the existing Maryland Electronic Health Record Incentives regulations at COMAR 10.25.16. The proposed regulations [PDF] would...more

"Meaningful" Errors Require Hospital System To Refund $31M

In what is reported to be the largest repayment to date involving "meaningful use" incentive payments, Naples, Florida-based Health Management Associates, Inc. ("HMA"), with 71 inpatient facilities in 15 states, including...more

CMS Proposes Increased Rewards for Reporting Fraud and Abuse

The Centers for Medicare and Medicaid Services (CMS) recently published a proposed rule modifying certain provisions in their Incentive Reward Program (IRP) to sweeten the incentives for reporting sanctionable conduct....more

CMS Proposes Additional Incentives to Reduce Medicare Fraud Including Increase to Reward for Reporting Fraud

On April 24, 2013, CMS issued a proposed rule that would further incentivize Medicare beneficiaries and other individuals to report suspected Medicare fraud under the Medicare Incentive Reward Program. CMS is proposing to...more

CMS Requests Comments on Redundant Reporting of Clinical Quality Measures

CMS is seeking input regarding ways in which eligible professionals might use clinical quality measures (CQM) data reported to medical boards, specialty societies, regional health care quality organizations or other...more

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