Payment & Practice Management  |   February 2016
Improper Payments: A Past, Present and Future Problem
Article Information
Practice Management / Payment & Practice Management
Payment & Practice Management   |   February 2016
Improper Payments: A Past, Present and Future Problem
ASA Monitor 02 2016, Vol.80, 68-69.
ASA Monitor 02 2016, Vol.80, 68-69.
If I write the term “MACRA,” you likely think MIPS or APM. However, there is more to the Medicare Access and CHIP Reauthorization Act than repeal of the Sustainable Growth Rate Formula (SGR) and implementation of the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM) payment mechanisms. MACRA imposes new rules on payment errors and will impose new scrutiny on all claims.
Title I of MACRA is SGR Repeal and Medicare Provider Payment Modernization. That part of the legislation has been the focus of a lot of attention, and rightfully so. But MACRA is both wide-ranging and surprisingly detailed. In May 2015, the ASA Payment and Practice Management Department posted a “Timely Topic” article that described some elements of MACRA that are separate and apart from SGR repeal and will be seen and felt by physicians and other health care providers before the 2019 implementation of MIPS/APMs www.asahq.org/∼/media/sites/asahq/files/public/resources/practice%20management/ttppm/2015-05-26-macras-impact-starts-before-2019.pdf?la=en. One of those elements was MACRA Section 505: Reducing Improper Medicare Payments. Our Timely Topic outlined some of the steps each Medicare Administrative Contractor will need to take to increase payment accuracy.
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