Healthcare organizations must be compliant with changing healthcare trends, guidelines, laws, and government regulations to minimize risk.  Lineage Consulting will assist your organization with the implementation and strategic plan for multiple healthcare initiatives.

On April 16, 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA makes three important changes to how Medicare pays those who give care to Medicare beneficiaries. 

The law:

  • Repeals the Sustainable Growth Rate (SGR) formula for determining Medicare payments for health care providers’ services

  • Makes a new framework for rewarding health care providers for moving away from fee-for-service and toward payment based on value

  • Combines existing quality reporting programs (EHR Incentive Program, PQRS and VM) into one new system

These proposed changes, which have been named the Quality Payment Program, replace a patchwork system of Medicare reporting programs with a flexible system that allows you to choose from two paths that link quality to payments: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

Most Medicare clinicians will initially participate in the Quality Payment Program through MIPS.

President Obama signed the Protecting Access to Medicare Act of 2014 (PAMA) into law on April 1, 2014. Congress passed the law up against the deadline to prevent Medicare physician payment cuts from taking effect, when efforts to reach an agreement on offsets to pay for a permanent physician payment fix fell short. The legislation also includes extensions for a number of other Medicare and Medicaid policies and some significant policy changes for multiple sectors of the health care industry. 

 

Appropriate Use Criteria for Physicians Ordering Advanced Imaging Services Provision

 

Beginning in 2017, CMS will only allow OPPS and PFS payments to providers for advanced imaging services if the provider furnishing the service includes information on the claim for reimbursement that shows that (1) the ordering physician consulted with appropriate use criteria (AUC) for imaging services before ordering the advanced imaging service; and (2) indicates whether the imaging order adheres with the applicable AUC. 

The Meaningful Use program was introduced by the U.S. government as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, encouraging health care providers to implement and demonstrate Meaningful Use (MU) of certified Electronic Health Records (EHR).  The HITECH Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law by the federal government on February 17, 2009. Under HITECH, eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology (CEHRT) and use it to achieve specific objectives.

 

Meaningful Use is the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that governs the use of electronic health records and compliance with the program. 

CMS is dedicated to improving interoperability and patients’ access to health information. To better reflect this focus, CMS renamed the EHR Incentive Programs to the Promoting Interoperability (PI) Programs. Through this rulemaking, CMS is also streamlining the programs to reduce the time and cost required of providers to participate.

To find out more on how this rulemaking affects Medicare eligible clinicians participating in the Promoting Interoperability (formerly Advancing Care Information) performance category of the Merit-based Incentive Payment System, contact us today!

Compliance Projects

MIPS combines parts of PQRS, VM and the Medicare EHR Incentive Program into one single program in which clinicians will be measured on a scale of 0 to 100 using four performance based categories:  Quality, Resource Use, Promoting Interoperability, and Clinical Practice Improvement Activities. Lineage Consulting can assess and help streamline the collection of the data required by those three existing programs, and help identify additional workflow and requirements under MIPS. 

MIPS ASSESSMENT & STRATEGIC PLAN
Lineage Consulting provides ONC HEALTH IT certification preparation and product analysis services to software vendors. By evaluating your software against the ONC certification criteria, Lineage Consulting aids in the generation of product pathways to achieve modular or complete EHR certification.​
ONC HEALTH IT CERTIFICATION
Lineage Consulting offers expertise in the area of Meaningful Use for Eligible Hospitals and Medicaid Providers.  As the delivery of healthcare is constantly changing, we recognize the need to provide this service to various disciplines in healthcare. Our partnerships and relationships with leading experts in the field allow Lineage Consulting to be one of the few consulting firms that offer this service.
MU ASSESSMENT & STRATEGIC PLAN

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