The comment period for the CMS CY 2025 Physician Fee Schedule (PFS) Proposed Rule recently closed on Monday, September 9th. Based on previous years, the Final Rule can be expected
Continue Reading CMS Proposed Rule Decreases Physician Payments, Expands Telehealth, and Much MoreTwo landmark cases fraught with False Claim Act (“FCA”) allegations of fraudulent billing for prescription drugs against food and pharmacy chains are making their way from the Seventh Circuit to
Continue Reading Is it Really Fraud? The Supreme Court Will Decide
Medical record requests by payors are commonplace for health care providers. Typically, these requests are received by a front desk employee who responds to the inquiry in short order. Yet,
Continue Reading THE ABC’S OF THE S.I.U.: What Providers Need to Know
As many people are discussing methods to improve healthcare, the Centers for Medicare & Medicaid Services (CMS) is giving stakeholders an opportunity to send in their thoughts on this topic.
Continue Reading CMS Requests “National Conversation” About Improving Medicare
The Centers for Medicare & Medicaid Services (“CMS”) recently introduced a new education initiative for Chronic Care Management (“CCM”) patients and providers. The initiative, called Connected Care, is intended to
Continue Reading CMS Introduces New Education Initiative for Chronic Care Management
The Medicare incentive programs with which you and your medical practice are familiar will soon be no more. As of January 1, 2017, these programs (including the Electronic Health Records
Continue Reading Are You Ready for the New Medicare Quality Payment Program? (Part 2): Basics of the MIPS and How to Qualify in 2017
The long-anticipated implementation of ICD-10 coding finally began this past Thursday, October 1, 2015. As of that date, government and commercial payors ceased to accept claims under the old coding
Continue Reading The Switch to ICD-10
OIG has announced its priorities for 2013 and some are of special interest to physicians.
Continue Reading OIG Announces 2013 Priorities
Recent press releases provide notice of activities that draw the government’s ire — and result in serious criminal consequences. Focusing on these issues is a helpful exercise for any physician trying to stay within the law.
Continue Reading Enforcement Update – Bad Actors Continue to Pay
A recent court decision concerns the method of rotating teaching physicians between multiple surgeries and billing Medicare for those services, and “whistleblower” claims when improperly done.
Continue Reading Court Ruling Broadens Hospital Exposure To Whistleblower Claims For Teaching Physician Medicare Billing