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Changes to patient assignment, primary care services in Shared Savings Program

07/24/2017

Check out a variety of changes CMS plans to make to the Shared Savings Program in the proposed 2018 Medicare physician fee schedule.

Some provider-based outpatient departments could see facility rates cut in half

07/24/2017

by: Laura Evans, CPC

CMS is proposing to set payments for certain services performed by non-exempt off-campus provider-based hospital outpatient departments at 25% of the hospital outpatient prospective payment rate next year, down from 50% this year.

Payment, policy and coding proposals from the 2018 physician fee schedule proposed rule

07/24/2017

by: Part B News staff

There’s a lot going on in the 815-page rule. We’ve explored the big stories in this issue. Check out a round-up of other, easy-to-miss changes worth noting.

Revised health bill scuttled as more Republican senators voice opposition

07/24/2017

by: John Commins with additional reporting by Richard Scott and Roy Edroso

Senate Republicans unveiled their revised plan July 13 to repeal and replace the Affordable Care Act (ACA) in a version that scrapped a tax cut for the wealthy, increased subsidies for individual coverage, dropped the individual mandate and allowed insurers to offer no-frills plans.

11 specialty groups set for pay boost in 2018; 23 may see cuts

07/24/2017

by: Richard Scott with additional reporting by Laura Evans, CPC

Clinical social workers, psychologists and podiatrists are among 11 specialty groups slated to receive additional payments for their services in 2018, according to projected allowed charges contained in the proposed 2018 Medicare physician fee schedule.

NotPetya computer hack a warning to get serious about IT security

07/17/2017

by: Roy Edroso

As a new computer hack hits health care facilities, experts advise you to tighten up security – not just in expected ways, but also in areas such as password and permission management.

Give your vaccine rates a booster shot to improve health, reduce missed revenue

07/17/2017

by: Richard Scott

Set automatic alerts in your electronic health record (EHR) and strike the right tone with your patients to encourage higher immunization rates and cut back on costly complications — and ace a merit-based incentive payment system (MIPS) quality measure, too.

Malpractice bill clears House; would cap non-economic damages at $250K

07/17/2017

by: Roy Edroso

The House passed a bill June 28 that, if signed into law, would restrict damages on malpractice judgments and even make such suits harder to bring.

Proposed quality payment rule could create snares for EHR quality reporters

07/17/2017

by: Julia Kyles

Under the proposed Quality Payment Program (QPP) rule, providers who report one or more quality measures via electronic health record (EHR) will need to report six measures to receive full credit for the quality category.

Does ‘the patient’s wife insisted’ meet medical necessity?

07/17/2017

by: Roy Edroso

Question: A doctor's note on a patient taking treatment for a shingles outbreak reads, "I did not recommend I&D [incision and drainage], but the patient's wife insisted." Is the provider admitting a lack of medical necessity, rendering the procedure unbillable to insurance (Medicare or other)?

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