Expect fights over pay update fix, quality reporting woes, NPI hassles

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article previews Medicare and physician-practice policy developments expected in 2007. It is aimed at practices, coders, and administrators who need to track federal changes affecting reimbursement, reporting obligations, provider identification, and adoption of electronic medical records. The piece summarizes anticipated legislative and CMS activity, the role of specialty organizations, and general implementation issues that could affect day-to-day operations.

Why This Topic Matters

The topics covered could affect how physician practices are paid, how they report quality data, how they handle provider identifiers on claims, and how they plan for health information technology investments. Readers who follow Medicare policy or practice operations will want to know which changes may be coming and what kinds of administrative pressures they may create.

Article Sections

  1. Medicare payment reform outlook

    This section discusses expected congressional and advisory-board activity related to physician payment updates and broader Medicare financing discussions.

  2. National Provider Identifier implementation

    This section covers timing concerns and administrative issues around provider identifier use in claims and data sharing.

  3. Quality reporting and measure development

    This section looks at anticipated growth in quality measures, reporting program questions, and related CMS and specialty-society activity.

  4. Electronic medical records and health IT incentives

    This section addresses possible federal incentives for practices adopting electronic medical records and other information technology.

  5. Medically Unlikely Edits

    This section briefly notes expected implementation of claims edits and general administrative handling considerations.

What You Will Learn

  • How the article frames expected Medicare payment policy changes for the coming year
  • What implementation issues are raised for provider identification on claims
  • Why quality reporting is expected to draw attention from practices and specialty groups
  • What kinds of federal health IT incentives are being discussed
  • How the article characterizes early claims-edit implementation concerns

Who Should Read This

  • Physician practices
  • Medical coders
  • Billing staff
  • Practice administrators
  • Healthcare policy professionals

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