In CMS
Jan 21st, 2019
Intermountain Healthcare wants the Supreme Court to weigh in on if the False Claims Act’s (FCA) provisions for whistleblowers violates the Constitution. This could affect compliance efforts across healthcare. Medical Judgment No FCA Sanctuary The issue arose last summer when the US Court of Appeals for the Tenth Circuit ruled that medical judgment can’t be ...
In Billing
Jan 16th, 2019
The Centers for Medicare & Medicaid Services (CMS) has released 15 corrections to the 2019 HCPCS Level II code set, all retroactive. Of the 15 codes, five are added, one discontinued, and seven reflect changes to payment or coverage status. One modifier introduced in 2011 CMS ruefully admits was “removed in error” and is reinstated. ...
In CMS
Dec 18th, 2018
Even though U.S. Northern District of Texas Court Judge Reed O’Connor struck down the Affordable Care Act (ACA or Obamacare), there are three good reasons to neither panic nor change your medical practice’s policies or your medical coding. Judge O’Connor ruled the law as unconstitutional, agreeing with 20 state attorneys general that the Individual Mandate ...
In Billing
Dec 6th, 2018
What Does it Take to Get Paid? AMA Morning Rounds (Dec. 5, Henry) discusses remote patient monitoring (RPM) and the “pitfalls you will want to avoid” as your practice implements this latest telehealth service. The article discusses three “pitfalls” to watch out for: Workflow Requirements Data Key requirements of implementing RPM include the coding and ...
In Audit
Nov 29th, 2018
A 5-year demonstration to develop improved procedures for the identification and prosecution of potential Medicare fraud occurring in the Home Health Program will begin in Illinois no sooner than Dec. 10, pending Congressional approval. The Centers for Medicare & Medicaid Services (CMS) will conduct the Review Choice Demonstration for Home Health Services in Jurisdiction M, ...