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Blog Posts by Author: Leigh Polk

Preparing for the No Surprises Act: Learn How Your Billing Solution Can Help

Effective January 1, 2022, the No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing for services received from out-of-network providers. The Act applies to emergency and non-emergency services provided by all healthcare providers and all commercial health plans. The No Surprises Act is not applicable to Medicare and Medicaid programs,...

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2022 MIPS Final Rule Changes and 8 Key Takeaways for Pathology Practices

Based on their practice size, specialty, location, or patient population, clinicians have two tracks to choose from in the CMS Quality Payment Program: Participants who qualify as Advanced APM participants receive a 5% incentive for achieving threshold levels of payments and patients. All other eligible clinicians are required to participate under...

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2022 PAMA Reporting Requirements and Reimbursement Cuts Will Impact Hospital and Independent Labs

Update 1/4/2022: Since the publication of this blog, legislation was passed to halt the 2022 reimbursement cuts and reporting requirements. Visit XIFIN’s PAMA Headquarters to view the revised PAMA schedule. After two years of PAMA reporting delays and one year of 0% PAMA related fee cuts, applicable laboratories (including hospital outreach laboratories) need to start preparing for 2022 PAMA...

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Proposed Changes to Hospital Price Transparency Rule: Radiology, Laboratory and Pathology Impacted

The Hospital Price Transparency Rule was introduced to help patients identify the cost of hospital items or services before receiving care.  Under the rule, hospitals are required to provide clear, accessible pricing information online in two ways:A comprehensive machine-readable file containing standard charges for all items and services provided by the hospital. A consumer-friendly list of...

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CMS Offers MIPS Reporting Flexibilities for Pathologists During COVID

The Quality Payment Program (QPP) was established by CMS as part of the Medicare Access and CHIP Reauthorization Act of 2015. The QPP transformed the Medicare payment system to focus more on value of service than volume. Under QPP, there are two payment tracks, Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM), both of which involve levels of financial...

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