Part B News | Editors' Blog

by: Julia Kyles, CPC-A Jan 12, 2016

CMS beat its deadline for issuing a revised value file for the 2016 physician fee schedule, but we've unearthed one surprise in the new file.

Expert: New DMEPOS pre-authorization could be trouble -- and get changed

by: Roy Edroso Jan 8, 2016

We talked to Lisa Maciejewski-West -- president and owner of Gold Star Medical Business Services in San Angelo, Texas, and a faculty member of the Practice Management Institute (PMI) – about the new DMEPOS final rule and its possible impact on providers.

She expects the pre-authorization scheme will be troubled and "revisited and revised until a workable solution is found."

SGR repeal triggered 14-day claims hold

by: Julia Kyles, CPC-A Dec 30, 2015

The SGR is gone, but those pesky claims holds that have heralded the start of each year are still around.

Some MACs announce 14 day claims hold in 2016 (Updated)

by: Roy Edroso Dec 28, 2015

~~Two~~ Three MACs serving 13 16 states, citing "technical errors discovered after publication of the MPFS rule," announce they're holding Part B claims for 14 days in early January. (See Update.)

Doctor groups push Congress to change CMS' biosimilar pricing scheme

by: Roy Edroso Dec 10, 2015

Six medical provider organizations have sent an appeal to Congress, asking that they overturn a CMS rule that puts biosimilar drugs of the same kind under one payment code, saying it will discourage innovation and harm patient safety.

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