Summary: Dermatologists have seen a slight dip in their share of the Medicare utilization pie for the top six most frequently billed dermatology codes. The other top specialties that bill these codes - mainly primary care - have also seen small drops in their share of utilization as well. Non-physician practitioners (NPPs) appear to be making inroads on these services.

Expect stronger versions of many compliance rules you already follow due to health reform, with stricter documentation and disclosure requirements and steeper penalties for violations. Here's a rundown of the four biggest compliance provisions and how they're likely to impact physician practices.

Your chances of having Congress permanently stop the annual Medicare physician pay cuts this year has fallen sharply, insiders and experts say. "If I was a betting man [I would say] no, [a permanent fix is] not going to happen," an industry lobbyist says in an interview with Part B News.

Your paper enrollment applications will see faster action from your carrier or Medicare Administrative Contractor (MAC) under new CMS mandates that take effect June 21. Your carrier will be required to process 90% of paper applications within 90 days of receipt.

Prevent provider identity theft by storing enrollment login and password credentials in a safe and secure location. TIP: Restrict access to the NPPES database to key employees who need credentialing information to do their job, experts say.

Expect some of your Medicare Advantage (MA) patients to switch from their current plan to a different one or even back to Medicare fee-for-service. Payers are dropping their MA products, and the outcome of health reform efforts may cause many more to follow their lead, forcing beneficiaries to make changes in their Medicare coverage.

You and your peers located in one of 51 "underpaid" areas will receive a pay increase once CMS adjusts practice expense (PE) geographic price cost indices (GPCIs) to comply with provisions in the new health reform law, congressional aides tell Part B News. Your pay boost is retroactive to Jan. 1, according to the language in the law.

When billing for Home Health Certification, what do you list as the date of service? I have received conflicting information with some people saying it is the date the physician signs the certification while others believe it is the first day of the certification period. I'm looking for a cut and dry answer on the CMS website.

Specialties that bill the most allergy test codes to Medicare saw a sharp, across-the-board increase in denials from 2007 to 2008. Several also saw large increases in utilization of these allergy codes, which are among the most commonly billed. NOTE: These specialties were selected for billing the most allergy codes to Medicare; these codes were selected for having the highest annual utilization.

CMS finally may get a permanent boss: Donald Berwick, a Harvard health policy professor and former pediatrician, is expected to be President Obama's choice to helm the agency. The White House has yet to make a formal announcement, but a wide array of news outlets have reported that Berwick is the president's pick.