The trouble with consultations
In a rather surprising move, the Centers for Medicare and Medicaid Services (CMS) included in the proposed rule on the 2010 Medicare physician fee schedule a proposal to remove codes for consultations...
View ArticleSunny with a chance of gloom
There is potential good news on the Medicare horizon as far as family physicians are concerned. However, the silver lining is attached to a big, black cloud that could rain on everyone's parade unless...
View ArticleMedicare shoots first and asks questions later
On Oct. 5, 2009, the Centers for Medicare and Medicaid Services (CMS) quietly began implementing system edits intended to assure that Medicare Part B providers and suppliers bill for ordered or...
View ArticleCMS issues a temporary cease fire
As a follow-up to my last posting ("Medicare shoots first and asks questions later," Nov. 19), I wanted to let readers know that the Centers for Medicare and Medicaid Services (CMS) announced on Nov....
View ArticleA familiar tune
The end-of-year holiday season is upon us. I can always tell it is because of the displays in the stores, the songs on my radio, and the phone calls I receive asking about the status of next year's...
View ArticleThe perils of the 2010 Medicare physician fee schedule
Like an old-time movie serial, my last post (see "A familiar tune" on Dec. 23, 2009) left the 2010 Medicare physician fee schedule dangling over a precipitous 21% drop and clinging to the hope that...
View ArticlePerformance measurement: Curiouser and curiouser
In response to the pressures of health care cost inflation, the Centers for Medicare & Medicaid Services (CMS) and other payers have been investigating "value-based purchasing" initiatives. These...
View Article2010 Medicare physician fee schedule: What next?
When we last left the 2010 Medicare physician fee schedule (see "2010 Medicare physician fee schedule: the saga continues," Jan. 27, 2010), it was headed down the tracks towards a "Bridge Out!!" sign...
View Article2010 Medicare physician fee schedule: Stop me if you've heard this one before
I know that it's April 1, but this is not a joke. The U.S. Senate dropped the ball again, and Medicare payment allowances for physicians dropped 21 percent today. As you will recall from my last post...
View ArticleCMS giveth and Congress taketh away
In March (see "CMS extends cease fire on referring/ordering edits" on March 17), I reported that the Centers for Medicare & Medicaid Services (CMS) had extended the delay in implementation of new...
View Article2010 Medicare physician fee schedule: Here we go again!
I feel like a broken record. On April 1 (see "2010 Medicare physician fee schedule: Stop me if you've heard this one before"), I shared with you how the Senate had again failed to pass legislation...
View ArticleNew time limit for filing Medicare claims
Historically, as authorized by statute and the Centers for Medicare and Medicaid Services (CMS), physicians had a minimum time limit for filing Part B claims of 15 months and a potential maximum of 27...
View ArticleAccountable care organizations and the future of physician payment
This week, the Federal Trade Commission (FTC), the Centers for Medicare and Medicaid Services, and the Office of the Inspector General in the U.S. Department of Health and Human Services (HHS)...
View ArticleThe 2011 Medicare physician fee schedule is here
This week, the Centers for Medicare and Medicaid Services (CMS) unveiled its final rule on the 2011 Medicare physician fee schedule. An initial review shows positive news with respect to the primary...
View ArticleFrom CMS, the better late than never department
Like the buddy who swears he will pay you the $20 he borrowed from you months ago, the Centers for Medicare and Medicaid Services (CMS) announced recently that it will finally reprocess a large number...
View ArticleFacing the new face-to-face requirement for Medicare home health services
Did you know that Medicare will soon begin enforcing a requirement that a physician who certifies a patient as eligible for Medicare home health services must see the patient either within 90 days...
View ArticleThe old "new patient" conundrum
In its most recent Medicare Quarterly Provider Compliance Newsletter (PDF download) the Centers for Medicare and Medicaid Services (CMS) highlighted an issue that apparently continues to be a problem...
View ArticleMedicare RVU proposals: Two out of three ain't bad
On June 6, the Centers for Medicare & Medicaid Services (CMS) published a proposed notice in the Federal Register, in which it laid out its initial decisions related to the Five-Year Review of work...
View ArticlePrior authorization: It's not just for private payers anymore
Prior authorization has been a longstanding tool used primarily by private payers for a variety of purposes, including controlling costs. To date, public payers, such as Medicare, have used it less...
View ArticleICD-10 delay may be in the works
With 5010 implementation effective Jan. 1, 2012, the next major hurdle facing physicians and the rest of the health care system is implementation of International Classification of Diseases, 10th...
View ArticleThe Office of Inspector General looks at evaluation and management services
The services that family physicians report most often are evaluation and management (E/M) services. The codes for these services represent the "bread and butter" of family medicine. Thus, it's a big...
View ArticleMedicare physician fee schedule redux
In a previous blog, I posted about the proposed rule on the 2013 Medicare physician fee schedule. I subsequently received questions regarding whether or not the American Academy of Family Physicians...
View ArticleAAFP responds to proposed rule on 2013 Medicare physician fee schedule
On Aug. 22, 2012, the American Academy of Family Physicians (AAFP) responded to the proposed rule on the 2013 Medicare physician fee schedule. As promised, I am sharing that response with you. Here...
View ArticleRethinking your Medicare participation options?
With just a little more than three weeks left before the wheels could fall off Medicare payments, you may be rethinking your level of involvement with the program.Congress may step in again this year...
View ArticleMedicare's impending fiscal cliff for physicians
If the federal government does go over the "fiscal cliff" in a little more than a week, don't expect those overseeing physician reimbursements to pad the fall.The Centers for Medicare and Medicaid...
View ArticleDude, where's my enhanced Medicaid payment?
We're halfway through 2013, and many physicians still have yet to see the Medicare parity in Medicaid payments promised at the beginning of the year. But help is on the way.Last week, I participated in...
View ArticleMedicare adds flexibility to E/M documentation guidelines
The Centers for Medicare & Medicaid Services (CMS) recently added a small measure of flexibility to the documentation guidelines for evaluation and management services.Historically, CMS has...
View ArticleMedicare sets dates for ICD-10 testing
If you remember "mid-terms" in school, they were tests administered to gauge your level of knowledge and understanding of a course ahead of the big exam at the end of semester. When it comes to...
View ArticlePenalty for unsuccessful e-prescribers coming in 2014
Were you a successful electronic prescriber under either the 2012 or 2013 Medicare Electronic Prescribing (eRx) Incentive Program? If so, congratulations! If not, expect slightly smaller Medicare...
View ArticleCMS looks to tweak Open Payments reporting for CME events
The Centers for Medicare & Medicaid Services (CMS) Open Payment initiative hasn't truly gone into effect yet and its framers already want to change it.The Open Payment program, which tracks and...
View Article
