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MGMA 'pleased' with proposed rule to cut red tape

By Diana Manos , Contributing writer

The Centers for Medicare & Medicaid Services has issued an interim final rule aimed at cutting red tape for providers. The rule won’t be published in the Federal Register until Friday, but so far the Medical Group Management Association has weighed in as being “pleased” and “encouraged” by the proposal.

CMS officials released the proposed rule on June 30, saying it is expected to save doctors, patients and insurers $12 billion. The rule is part of a plan to reduce administrative costs mandated under the Affordable Care Act (ACA).

William F. Jessee, MD, president and CEO of MGMA, said MGMA is pleased that the Centers for Medicare and Medicaid Services (CMS) has adopted many of the Phase I and Phase II operating rules for eligibility and claims status recommended by the Council for Affordable Quality Health Care’s Committee on Operating Rules for Information Exchange (CAQH CORE).

“MGMA championed administrative simplification as one of our primary advocacy initiatives during consideration of the Affordable Care Act, or ACA, and endorsed the CAQH CORE rules,” Jessee said.

“We expect these and the other operating rules mandated by the ACA to have a significant positive impact on the healthcare system,” he added. “This is an important first step in realizing the simplification opportunities included in the ACA.”

[See also: MGMA chief calls on medical groups to help remake healthcare .]

Jessee said that MGMA "is encouraged to see CMS use important MGMA member data in the regulatory impact analysis as a signal that CMS is leveraging real-world experiences to support the implementation of these important rules.”

MGMA would also like to see CMS adopt a machine-readable card for Medicare beneficiaries in place of the current paper cards, which require manual data entry, Jessee added.

According to CAQH CORE the proposed rules would enhance HIPAA transactions by promoting better communication between providers and health plans.

The proposal includes adopting six of the eight CAQH CORE Phase I and all five of Phase II operating rules. The proposal does not require adoption of CAQH CORE operating rules pertaining to acknowledgements or CAQH CORE certification policies.

[See also: CORE helps streamline electronic healthcare payments at point of care.]

Leaders at CAQH CORE said they have begun analysis of the proposal and will be seeking stakeholder input in the coming weeks.

CMS will be accepting comments on the proposal through Sept. 6.

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