Industry Notes: Prepare for Quality Measure Contract Discussions

Why This Topic Matters

These updates can affect reimbursement arrangements, claims handling, compliance exposure, and administrative planning across multiple healthcare settings. It is most relevant to revenue cycle, compliance, billing, and operations professionals who need to monitor regulatory and payer-related changes.

Article Sections

1. Quality-focused hospital-insurer contract discussion

   An industry note on a payer-provider contract that emphasizes quality measures and care coordination. It discusses broader reimbursement trends affecting hospitals and health plans.

2. CMS delays POS rule until April 2013

   A Medicare billing update addressing a delayed implementation date and related clarifications. The section focuses on global diagnostic services and payment locality considerations.

3. Practice size doesn’t matter when it comes to HIPAA settlements

   A compliance update describing a HIPAA enforcement action involving a hospice organization. It centers on privacy and security oversight concerns for electronic protected health information.

4. MACs focus on Medicare payments for illegal immigrants

   A Medicare claims administration note about beneficiary eligibility status and recovery of certain paid claims. It also mentions the appeals process for denials tied to this issue.

5. Louisiana eliminates Medicaid coverage for hospice care

   A state policy update describing a Medicaid coverage change affecting hospice services. It notes related impacts on patients and other care settings.

6. Learn expert strategies for a smooth ICD 10-CM transition

   An educational announcement about preparing for ICD-10-CM adoption in home health operations. It emphasizes planning, training, implementation, and attendee questions.