Healthcare Reform - 2013

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Increased Medicaid funding
New funding available to state Medicaid programs choosing to cover preventative services for patients at little to no cost; goal to expand reach of preventative care efforts.
Effective Jan. 1, 2013

Stage 2 of ‘meaningful use’ begins
Stage 2 of CMS’ EHR Incentive Program starts, requiring eligible professionals and hospitals to prove “meaningful use” for federal payments.
Effective January 2013
UPDATE: In April 2012, CMS released proposed clinical quality measures for the Stage 2 requirements; in February 2012, CMS announced it would extend attestation for Stage 1 rules into 2013 and Stage 2 attestation will begin in 2014.

‘Bundled’ payments
National pilot program established to encourage teamwork among hospitals, physicians, and other providers to coordinate and improve care; team would be paid a “bundled” flat rate for an episode of care versus current fee-for-service system by Medicare.
Effective Jan. 1, 2013 at the latest

Medicaid payment boost
States to pay primary-care physicians no less than 100 percent of Medicare payment rates in 2013, 2014 for services; increase is fully funded.
Effective Jan. 1, 2013

ICD-10 implementation
Claims for services to CMS must use ICD-10 codes for medical diagnosis and impatient procedures; CPT codes for outpatient services will continue to be used.
Effective Oct. 1, 2013
UPDATE: HHS announced in April 2012 it would delay compliance for ICD-10 from Oct. 1, 2013 to Oct. 1, 2014.