From the Health and Human Services website:   “The 2006 Tax Relief and Health Care Act (TRHCA) required the establishment of a physician quality reporting system, including an incentive payment for eligible professionals who satisfactorily report data on quality measures for covered professional services furnished to Medicare beneficiaries during the second half of 2007 (the 2007 reporting period). CMS named this program the Physician Quality Reporting Initiative (PQRI).  The PQRI was further modified as a result of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) and the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)  In 2011,…

     As part of the Patient Protection and Affordable Care Act (PPACA) of 2010, there are new compliance regulations aimed at combating fraud and abuse of Medicare and Medicaid programs.  To assist doctors in getting ready for the new regulations, training conferences hosted by the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a combined effort by the Centers for Medicare and Medicaid Services, the Office of the Inspector General for Health and Human Services, and the Department of Justice are being held around the country. In the notes that HEAT provides for the conferences there are 10 tips…

 in The Health Care Blog Come with me to the land of happy health reform. It is a place where Republicans and Democrats find common ground, a place where physicians, hospitals and health insurers sit together as partners, a place where criticism is respectful, not rancorous. It is the world of Accountable Care Organizations (ACOs). What are ACOs, and why have they escaped the general onslaught of opprobrium from Obamacare opponents? The term Accountable Care Organization was originated by Elliott Fisher of the Dartmouth Center for the Evaluative Clinical Sciences, picked up by the Medicare Payment Advisory Commission and then…

Written by Roger Collier in The Health Care Blog In addition to Medicare Advantage payment cuts and potential reductions in fee-for-service payment updates, PPACA includes various provisions intended to facilitate ongoing Medicare cost containment, notably creation of the Independent Payment Advisory Board and the Center for Medicare and Medicaid Innovation. In addition to CMI’s broad scope, PPACA requires specific pilot projects, including (in Section 3022) demonstration of accountable care organizations (ACOs).