CMS Updates Market Saturation and Utilization Data Tool
Question: How has the CMS updated its utilization data tool and what information can be obtained?

Answer: The Centers for Medicare & Medicaid Services (“CMS”) has unveiled an expanded version of a data tool that features interactive maps for market saturation and utilization of several healthcare services at the national, state and county level. The utilization data tool was developed for use by providers to help analyze their service locations and the service utilization rates of Medicare beneficiaries. The CMS uses the data tool’s “market saturation and healthcare service utilization information” to root out fraud, waste and abuse in the Medicare program. The data can also be used to reveal the degree to which use of a service is related to the number of providers servicing a geographic region. Provider services and utilization data by geographic regions are easily compared using an interactive map. There are a number of research uses for these data, but one objective of making these data public is to assist health care providers in making informed decisions about their service locations and the beneficiary populations they serve. Improvements to the tool include an increase in the number of healthcare-service categories from eight to ten. The CMS also added clinical laboratories that bill independently of other facilities and physical and occupational therapy services.

Weekly Charting Tip:

Every practice should have a written employee handbook. It should include your office policy as to dress, use of drugs/medication, sexual harassment, vacation, work hours, holidays, discipline and any other office policy you want memorialized. Then, follow it, review it with your staff on a regular basis! If used, and followed, it will protect you from all sorts of employee litigation.
Your word to the wise!

 - Larry Kobak, Esq.

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