This article will review selected aspects of the proposed rule so clinicians can begin preparing for MIPS and Advanced APMs, which go into effect on January 1, 2017. The need to start preparing now is vital. Continue reading →
“Scope Creep” in Appeals is Dead CMS has instructed MACs and QICs to limit their review to the reason(s) the claim or line item at issue was initially denied. For redeterminations and reconsiderations of claims denied following a complex prepayment review, a complex post-payment review, or an automated post-payment review by a contractor, Limiting the scope of review on redeterminations and reconsiderations of certain claims. MLN Matters Number SE1521.