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  2. Medicare Access and CHIP Reauthorization Act of 2015

    en.wikipedia.org/wiki/Medicare_Access_and_CHIP...

    Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), (H.R. 2, Pub. L. 114–10 (text)) commonly called the Permanent Doc Fix, is a United States statute. Revising the Balanced Budget Act of 1997 , the Bipartisan Act was the largest scale change to the American health care system following the Affordable Care Act in 2010.

  3. Physician Payments Sunshine Act - Wikipedia

    en.wikipedia.org/wiki/Physician_Payments...

    The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS).

  4. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    These digits are not intended to reflect the placement of the code in the regular (Category I) part of the CPT codebook. Appendix H in CPT section contains information about performance measurement exclusion of modifiers, measures, and the measures' source(s). Currently there are 11 Category II codes. They are: (0001F–0015F) Composite measures

  5. Medicare Prescription Drug, Improvement, and Modernization Act

    en.wikipedia.org/wiki/Medicare_Prescription_Drug...

    These programs were known as "Medicare+Choice" or "Part C" plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the compensation and business practices for insurers that offer these plans changed, and "Medicare+Choice" plans became known as "Medicare Advantage" (MA) plans.

  6. Prospective payment system - Wikipedia

    en.wikipedia.org/wiki/Prospective_payment_system

    In 2000, CMS changed the reimbursement system for outpatient care at Federally Qualified Health Centers (FQHCs) to include a prospective payment system for Medicaid and Medicare. [2] Under this system, health centers receive a fixed, per-visit payment for any visit by a patient with Medicaid, regardless of the length or intensity of the visit.

  7. National Practitioner Data Bank - Wikipedia

    en.wikipedia.org/wiki/National_Practitioner_Data...

    The National Practitioner Data Bank (NPDB) is a database operated by the U.S. Department of Health and Human Services that contains medical malpractice payment and adverse action reports on health care professionals. Hospitals and state licensing boards submit information on physicians and other health care practitioners, including clinical ...

  8. Clinical documentation improvement - Wikipedia

    en.wikipedia.org/wiki/Clinical_documentation...

    Clinical documentation improvement (CDI), also known as "clinical documentation integrity", is the best practices, processes, technology, people, and joint effort between providers and billers that advocates the completeness, precision, and validity of provider documentation inherent to transaction code sets (e.g. ICD-10-CM, ICD-10-PCS, CPT, HCPCS) sanctioned by the Health Insurance ...

  9. Minimum Data Set - Wikipedia

    en.wikipedia.org/wiki/Minimum_Data_Set

    MDS information is transmitted electronically by nursing homes to the MDS database in their respective states. MDS information from the state databases is captured into the national MDS database at Centers for Medicare and Medicaid Services (CMS). Sections of MDS (Minimum Data Set): Identification Information; Hearing, Speech and Vision