Centers for Medicare and Medicaid (CMS) policy has a tremendous influence on how we practice and receive reimbursement for clinical medicine. Although the initial statutes in 1965 declared otherwise, I think you would agree that it did not take long to show that regulation was a key component for ensuring and promoting quality healthcare in our industry.
The rising costs in Medicare and Medicaid claims, as well as concerns over fraud and abuse, Congress decided by the early 1970s that closer oversight of the medical care system was necessary. It is essential that all healthcare organizations understand these evolutions and potential risks that may impact your organization. Being aware of these changes, benefits, and risks in advance will help provide a pathway for effective management strategies in your organization. The organizational goal is set at meeting the needs of the Medicare and Medicaid patients and also ensuring accurate and compliant reimbursements.