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Response to Medicare's Proposed 2019 E&M Payment Change Print E-mail
Written by Jean Acevedo   
Thursday, 02 August 2018 00:00
By now I'm sure that you have all heard about Medicare's proposed changes to Evaluation and Management (E&M) reimbursement in 2019. The majority of physicians I've spoken to are confused by Medicare's rationale and frustrated with the proposal. A change claiming to lessen the burden of physicians seems to promote the opposite for those physicians seeing primarily level 4 patients. The proposed reduction in payment could force them to see more patients to maintain similar revenue. 

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Last Updated on Friday, 03 August 2018 17:41
CMS Issues Slew of New Rules and Policies to Improve Patient Care, Boost Reimbursements Print E-mail
Written by FHInews   
Tuesday, 08 May 2018 15:20
The Centers for Medicare and Medicaid Services (CMS) has been busy pushing out proposed rules and policy changes that will impact healthcare providers and patients in a variety of ways. Among the proposals it has made is a Data Driven Patient Care Strategy that puts patients at the center of healthcare and makes data more accessible and usable in a way that not only enhances efficiency, but also improves quality while also reducing cost. As part of the strategy, CMS announced it is releasing encounter data from Medicare Advantage plans to researchers on everything from inpatient care to home health.

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Last Updated on Tuesday, 08 May 2018 15:55
OIG Report Finds Improper Billing for Telemedicine Services Print E-mail
Written by Vitale Health Law   
Tuesday, 24 April 2018 17:17

As the push to increase the use of telemedicine grows, so too do concerns over questionable billing practices.

In a recently released report, the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that the Centers for Medicare and Medicaid Services (CMS) paid practitioners for services that did not meet Medicare requirements.

To give you an idea of how much the use of telemedicine is growing, the OIG points out that in 2001, Medicare paid a total of $61,302 for telemedicine services. In 2015, that figure skyrocketed to $17.6 million.

Between 2014 and 2015 the watchdog agency reviewed 191,118 distant-site telemedicine claims that did not have corresponding originating site claims, totaling approximately $13.8 million.

Certain conditions must be met for providers to submit telehealth claims through Medicare Part B. For example, the originating site must be a practitioner's office or a medical facility, not in a patient's home, and the beneficiary must be located in a qualifying rural area.

OIG found that out of 100 sample claims reviewed, 31 claims did not meet Medicare requirements. It breaks down like this...

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Bipartisan Budget Act of 2018 Includes Significant Changes in Medicare, Other Federal Health Programs   Print E-mail
Written by FHI's Week in Review   
Monday, 12 February 2018 18:31

In the aftermath of the recent Federal budget approval on 2.9.18, analysts reveal the new budget's affect on the health sector. In addition to addressing a number of critical budget questions, the legislation includes significant health care policy changes impacting Medicare, Medicaid and...

Read more in the current issue of Week in Review>>

Last Updated on Monday, 12 February 2018 18:38
3 steps to avoid a penalty under MACRA Print E-mail
Written by Jeffrey Herschler   
Monday, 13 November 2017 00:00

Fierce Healthcare's Joanne Finnegan reports on Nov 9, 2017 that "the American Medical Association's president-elect, Barbara L. McAneny, MD, outlined several steps physicians can take to still participate under the Merit-based Incentive Payment System (MIPS), one of two available payment tracks under the Medicare Access and CHIP Reauthorization Act (MACRA)."

Read more in the current issue of Week in Review>>

Last Updated on Tuesday, 14 November 2017 19:38
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