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Issue #145 - March 17, 2010
AAPC EdgeBlast

Senate Votes to Further Delay Pay Cut
The Senate passed (62-36), on March 10, the American Workers, State, and Business Relief Act of 2010 (HR 4213), which includes provisions to extend the zero percent Medicare payment update to physicians until Sept. 30 and the therapy cap exception process until Dec. 31.

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Medicare Ends Fox Insurance Drug Plan Contract
The Centers for Medicare & Medicaid Services (CMS) terminated its contract with Fox Insurance Company, March 9, after an onsite review of the drug plan and its services confirmed suspected noncompliance. More than 123,000 Fox enrollees have until May 1 to choose a new Medicare prescription drug plan. In the interim, beneficiaries can obtain their prescription drugs through the Limited Income Newly Eligible Transition (LI NET) program, run by Medicare and administered by Humana.

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United Desists Faxed Request for Medical Records
Health Net, United Health Group and United subsidiary Ingenix have discontinued efforts to collect medical records for Medicare Advantage members in Connecticut due to numerous inquiries and complaints from physicians and the state’s department of insurance regarding their methods. Letters requesting the information were faxed, which sent up a red flag for many physicians.

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President Obama Cracks Down on Health Care Fraud
President Obama signed a presidential memorandum March 10 that directs all federal departments and agencies to expand and intensify their use of payment recapture audits under their current authority to crack down on waste and fraud in Medicare, Medicaid, and other government programs. He also announced his support for the Improper Payments Elimination and Recovery Act, which would expand the ability of government agencies to fund the audits with recaptured payments.

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ONC Issues NPRM for Health IT Certification
The Office of the National Coordinator for Health Information Technology (ONC) has issued a Notice of Proposed Rulemaking (NPRM) for the establishment of two certification programs—one temporary and one permanent—for the purposes of testing and certifying electronic health record (EHR) systems and other health information technology (HIT).

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OIG Testimony Hints to 2011 Work Plan
Office of Inspector General (OIG) investigations in 2009 resulted in $4 billion in health care fraud settlements and court-ordered returns, and this is just the “tip of the iceberg,” Inspector General Daniel R. Levinson said in his March 4 testimony before the subcommittee on Labor, Health and Human Services, Education, and related agencies of the House Committee on Appropriations.

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MedPAC Releases March 2010 Report to Congress
The Medicare Payment Advisory Commission (MedPAC) released its March 2010 “Report to the Congress: Medicare Payment Policy” on March 1. The report contains annual rate adjustment recommendations for Medicare’s various fee-for-service (FFS) payment systems.

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Insurance Execs Discuss Rates with HHS
Health insurance executives and commissioners gathered in the Roosevelt room at the White House with Health and Human Services (HHS) Secretary Kathleen Sebelius March 3 to discuss insurance rate hikes that have occurred or are set to occur across the country.

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White House Adopts Military EHR
The Military Health System (MHS) set up a version of its Armed Forces Health Longitudinal Technology Application (AHLTA) electronic health record (EHR) system for use in the White House.

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Coding Tips
AMA CPT® Update Includes New and Revised Codes
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April 2010 OPPS Update Sets the Record Straight
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CMS Clarifies Consult Code Reporting
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NGS Instructs Providers on How to Bill for Stelara
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Protect Yourself from a Data Security Breach
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PET Gains Popularity Among Non-radiologists
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Medical News

FDA Selects Flu Viruses for 2010-11 Vaccine
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Panel Advocates New VBAC Guidelines
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Gaucher Disease Treatment Therapy Approved
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Featured Items
Senate Vote
Insurance Drug Plan
Medical Records
Health Care Fraud
Health IT Certification
2011 Work Plan
2010 Report to Congress
Insurance Execs
Military EHR
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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