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Healthcare News

June 30 deadline approaches for MIPS group reporting
June 19, 2017
Under the new Medicare Access and CHIP Reauthorization Act (MACRA) reporting guidelines, clinicians and groups can chose how to submit their 2017 Quality Measures. A minimum of 90 continuous days of at least one quality measure is required to ensure no negative payment adjustment for 2019 reimbursements.
 
Lucy Carter leads healthcare panel at SuperConference
June 12, 2017
Lucy Carter, CPA, member and practice leader of the KraftCPAs healthcare industry team, led the Healthcare Industry Panel at The Rainmaker Companies SuperConference in June. Held in downtown Nashville, the conference hosted hundreds of accounting professionals from across the country Industry experts made presentations and led panel discussions on specialized topics in banking, healthcare, manufacturing, not-for-profit, technology, real estate and more. Lucy moderated a spirited discussion on the current state of healthcare with some of Nashville's most influential healthcare professionals.
 
ABN form incorporates new effective date
June 6, 2017
The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service) beneficiaries in situations where Medicare payment is expected to be denied. Guidelines for mandatory and voluntary use of the ABN are published in the Medicare Claims Processing Manual, Chapter 30, Section 50.
 
Scott Mertie travels to United Kingdom for NHCC healthcare study mission
May 24, 2017
Healthcare systems are seeing global transformation, with governments and providers trying to reconcile increased costs with rising demand for greater accessibility and higher-quality care. In March, Scott Mertie, president of Kraft Healthcare Consulting, LLC, participated in the Nashville Health Care Council's 2017 International Health Care Study Mission to the United Kingdom. The delegation examined challenges facing Britain's National Health Service (NHS), and discussed how innovations from within the system and private sector alike might resolve the most pressing healthcare issues.
 
KraftCPAs achieves HITRUST CSF Assessor designation
May 11, 2017
KraftCPAs has earned the designation of HITRUST CSF Assessor through the Health Information Trust Alliance (HITRUST). With this achievement, KraftCPAs is now approved to provide services using the HITRUST CSF, a comprehensive security framework that addresses the multitude of security, privacy and regulatory challenges facing healthcare organizations in order to comply with healthcare (HIPAA, HITECH), third-party (PCI, COBIT) and government (NIST, FTC) regulations and standards. KraftCPAs is one of approximately 10 HITRUST CSF Assessors in Tennessee (eight of which are based in Nashville).
 
Kraft Healthcare participates in delegation to Washington, D.C.
May 11, 2017
Less than two months into President Donald Trump's White House tenure, the Nashville Health Care Council's Leadership Health Care (LHC) initiative led a group of more than 100 healthcare leaders on its annual two-day delegation to Washington, D.C.
 
Does your medical practice need a check-up?
April 21, 2017
Is your practice experiencing a decline in net income? Do daily operations feel chaotic with complaints from patients about wait times, billing, etc.? Perhaps your practice is running smoothly enough, but you feel that things could be better.
 
Mertie receives Leadership Health Care award
Dec. 16, 2016
Leadership Health Care (LHC), an initiative of the Nashville Health Care Council to nurture the talent of Nashville's emerging health care leaders, has announced its 2016 award winners in the categories of Health Care Emerging Leader of the Year, Ambassador of the Year and Supporting Organization of the Year. The awards were announced at LHC's annual holiday and awards reception, attended by more than 200 LHC members.
 
Provider-based clinic classification: Impact on the bottom line
April 6, 2015
Consolidation among healthcare providers has increased over the past few years, in part because physician practices experience lower reimbursement rates from Medicare and Medicaid, and they lack the bargaining power to drive up reimbursement rates from their commercial payers. When a hospital purchases a physician practice, the hospital gains additional outpatient revenue streams, and the physician practice is relieved of the lower reimbursement rates -- yielding a win for both parties.
 
Kraft Healthcare Consulting explores Cuba
Nov. 3, 2014
Throughout the years, Scott Mertie, president of Kraft Healthcare Consulting, LLC (KHC), has attended healthcare delegations to China and multiple European countries that have government-run healthcare systems. While Scott was visiting the Republic of Cuba on a personal excursion earlier this year, he envisioned a trip where the activities would allow him to explore the country's national healthcare system.
 
CMS releases four subsets to modifier -59
Sep. 22, 2014
Modifier -59, Distinct Procedural Service "the go-to," "catch-all," "covers everything" modifier, has finally received a much needed update. This catch-all modifier (-59) is widely used due to vague instructions in CPT, which states "modifier -59 should not be used when a more descriptive modifier is available." The broad use of this modifier, combined with the lack of research for a more descriptive modifier, has brought -59 to the forefront of Centers for Medicare and Medicaid Services (CMS). CMS has just released four subset modifiers in Healthcare Common Procedural Coding System (HCPCS) to remedy the widespread use of -59. This addition of new subset modifiers should help to distinguish fraud and abuse, as the subset modifiers are more clearly defined.
 
Kraft Healthcare Consulting prepares for delegation to Cuba
July 25, 2014
Scott Mertie, president of Kraft Healthcare Consulting, LLC (KHC), and his team are preparing to lead a healthcare delegation to Cuba on Oct. 9-12. This trip is custom-crafted for attendees to learn about the challenges and opportunities facing the medical industry in a country with one of the highest life expectancy rates in the Americas.
 
CMS makes changes to extended history of present illness guidelines
Oct. 4, 2013
Professional services provided on or after Sept. 10, 2013, will be allowed by CMS to use the 1997 Documentation Guidelines (DG) concerning the extended History of Present Illness (HPI) in conjunction with the 1995 guideline for extended HPI.
 
Physicians closing up shop, being acquired
June 17, 2013
As national health reform begins arriving at our door step, more and more physicians are taking down their shingles and joining hospitals or emerging national healthcare practice companies as employees.
 
Mertie attends healthcare delegation in France
April 30, 2013
Scott Mertie, president of Kraft Healthcare Consulting, LLC, was part of a delegation of approximately 30 healthcare leaders to visit Paris in April a trip spearheaded by the Nashville Health Care Council (NHCC).
 
RAC myths busted
Feb. 1, 2013
On Dec. 17, 2012, the Centers for Medicare & Medicaid Services (CMS) released Medicare Fee-For-Service Recovery Audit Program Myths. In this article, CMS works to debunk industry-wide myths to help facilities better understand the role the Recovery Auditor Contactors (RACs) play in ensuring proper payment for medically necessary services rendered to Medicare patients.
 
2nd Generation Capital instrumental in sale of large physician practice to public company
Jan. 4, 2013
2nd Generation Capital, LLC, the merchant and investment banking firm affiliated with KraftCPAs PLLC, announced on Wednesday the successful acquisition of its Chattanooga-based client, Anesthesiologists Associated, P.C. (AA) by MEDNAX , Inc. (NYSE MD). 2nd Generation represented Anesthesiologists Associated through its licensed broker-dealer subsidiary, 2nd Generation Financial, LLC. The transaction was closed and effective as of Dec. 31, 2012.
 
Kraft Healthcare Consulting presented with Leadership Health Care award
Dec. 21, 2012
Leadership Health Care (LHC), an initiative of the Nashville Health Care Council to nurture the talents of future health care leaders, has announced its 2012 award winners in the categories of Health Care Emerging Leader, Volunteer of the Year and Supporting Organization of the Year.
 
Healthcare providers to be reimbursed for transitional care management (TCM) services
Dec. 12, 2012
Healthcare providers are justifiably worried about cuts in reimbursement, but some are finding other services they already perform that can add legitimate revenue to the business if they are coded properly. As the healthcare industry coding system evolves, it is critical to understand code changes along with the relative reimbursement value of each change.
 
CMS approves RAC review of E/M services
Sep. 27, 2012
Despite opposition from the American Medical Association, the Medical Group Managers Association and numerous state specialty societies, The Centers for Medicare & Medicaid Services has approved RAC review of E/M services.
 
Take a Closer Look at Your Superbill to Ensure Accurate Billing
Sep. 19, 2012
Superbills aren't necessarily supposed include every code a physician might report. The superbill is typically a one-page reference of the most common codes used in a particular practice.
 
CMS begins meaningful use audits
Aug. 1, 2012
The Electronic Health Record Initiative program established by the Centers for Medicare and Medicaid Services (CMS), for eligible healthcare professional and facilities, is currently being implemented, and CMS is preparing to begin compliance audits related to the "meaningful use" reporting rules.
 
CMS 60-day rule
March 16, 2012
Last month, CMS issued a proposed rule for comments on "Reporting and Returning of Overpayments". This rule, if finalized, would require persons (providers and suppliers) to "report and return overpayments by the later of the date which is 60 days after the date on which the overpayment was identified; or any corresponding cost report is due, if applicable." CMS is proposing to implement section 1128J(d) of the Act for Medicare Part A & B providers and suppliers only at this time. This will be addressed at a later date for other "stakeholders" such as MAOs and Medicaid MCOs according to CMS.
 
Are Post-Acute Care Transfers a Goldmine for RAC Audits?
March 9, 2012
What happens after a patient leaves a facility can have a huge impact on reimbursement.
 
RACs Plan to Spotlight IRFs
Feb. 10, 2012
CMS has announced that their contracted Recovery Audit Contractors will focus their attention on Inpatient Rehabilitation Facilities (IRFs) in 2012 to determine if IRFs are submitting data compliantly.
 
New court ruling on Disproportionate Share Calculation
Feb. 6, 2012
Last month Catholic Health Initiatives Iowa (CHI) received a summary judgment in their favor from the District Court for Washington D.C. related to their FYE: June 30, 1997 cost report. This judgment favored CHI's position on Medicaid days that, where the Medicare inpatient Part A benefits were exhausted, those days were still includable in the Medicaid portion of the Disproportionate Share (DSH) fraction.
 
Scott Mertie travels to England and Scotland for health care study mission
June 14, 2010
Scott Mertie, member-in-charge of Kraft Healthcare Consulting, LLC, traveled to London, England and Edinburgh, Scotland on a Health Care Study Mission this spring. The Nashville Health Care Council and the Nashville Area Chamber of Commerce partnered with British economic development agency UK Trade and Investment to host the Study Mission.
 
KraftCPAs affiliates, Mertie and Crumbo, accompany Governor on China and Japan trade missions
Nov. 11, 2009
Scott Mertie, member-in charge of Kraft Healthcare Consulting, LLC, and Kevin Crumbo, member-in-charge of KraftCPAs Turnaround & Restructuring Group, PLLC, recently accompanied Governor Bredesen and Economic Community Development Commissioner Matt Kisber on individual trade missions to China and Japan.