New Act: More Money; Surprise Medical Billing
Increased Conversion Factors. The Consolidated Appropriations Act, 2021 (the “Act”) passed by Congress and signed by President Trump...
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- Dec 23, 2020
Proposed Rule to Amend HIPAA
On December 10, 2020, HHS released a 357-page Proposed Rule to amend HIPAA. Proposed rules typically become final about 6 months after...
- Dec 21, 2020
More Government Money Coming
1. More PRF Money. On December 16, 2020 HHS announced it would begin Phase III distributions of an additional $24 Billion in provider...
- Dec 3, 2020
CMS Releases 2021 Medicare Final Rule
The CMS Final Rule for the 2021 Medicare Physician Fee Schedule was released December 1 and contains over 2,100 pages of information. ...
- Nov 24, 2020
CMS Releases New Stark Final Rule
1. Effective Date. On November 20, 2020, CMS issued a Final Rule on Stark. There have been numerous “final” rules on Stark; this is...
- Nov 23, 2020
New OIG Kickback Final Rule
On November 20, 2020, the Government issued two significant Final Rules, one relating to the Anti-kickback statute (“AKS”), and the other...
- Oct 29, 2020
Imminent Ransomware Threat
I received the following email from one of my clients, and I am passing it along in case this threat comes to fruition. We have learned a...
- Oct 28, 2020
Updates to OIG Work Plan
The OIG has released an update to its annual Work Plan particularly geared towards COVID-19 issues. The Work Plan is the OIG’s list of...
- Oct 13, 2020
Facet Overutilization: OIG Audit
1. The "5 Rule." Today, the OIG released the results of a nationwide audit it has conducted on providers overbilling the 5 facet...
- Oct 9, 2020
New Repayment Terms for Medicare Loans Made to Providers during COVID-19
As you may remember, in addition to the Provider Relief Fund, CMS offered a loan program where you could accept a loan against future...
- Oct 2, 2020
Telemedicine Takedown
Just when you thought COVID had everyone locked up in their offices not doing anything, the DOJ just announced the largest fraud and...
- Oct 1, 2020
Another $20 Billion in Provider Relief Funds
Today HHS announced another $20 billion in provider relief funds in what is being called “Phase 3” provider relief funding. You can...
- Oct 1, 2020
PHE Expense Code is Being Paid
Previously I reported that on September 8, 2020, the AMA adopted a new CPT code, 99072, to capture additional PHE expenses. The first...
- Sep 24, 2020
Recent Large HIPAA Settlements
1. Settlements in Excess of $1mm. There have been two HIPAA settlements in excess of $1mm released by the OCR in the past 3 days, and...
- Sep 21, 2020
Update of Provider Relief Fund Reporting Requirements
On September 19, 2020, the Department of Health and Human Services (“HHS”) released a six-page document with updated information on your...
- Sep 17, 2020
New CPT Code for PHE Expenses
1. Effective Date. Effective September 8, 2020, the AMA created a new CPT code for use in the office (not facility) during the PHE...
- Aug 14, 2020
HIPAA: Windows 7
You need to bail out of Windows 7 if you haven't done so already. On January 14, 2020, Microsoft ended support for Windows 7, which...
- Jul 28, 2020
HIPAA Settlement: $1,040,000
The OCR issued a press release yesterday outlining the terms of a settlement with a hospital system in Rhode Island for $1,040,000...
- Jul 24, 2020
No Telehealth Billing Out of the "United States"
Recently a client who was going to be traveling to the UK wanted to know if he could conduct and bill telehealth phone calls while in the...
- Jul 6, 2020
Mandatory New ABN Form
Effective 8/31/20, you must begin using a newly approved CMS ABN form. The ABN form changes approximately every 3 years, and you cannot...
- Jul 6, 2020
You Can Still Apply for a PPP Loan
If you have not applied for your PPP loan, you still have a month to do so. Originally, the PPP loan application process was slated to...
- Jun 19, 2020
CS Modifier - Cost Sharing Waiver
On May 27 and June 16, CMS updated its FAQs regarding COVID-19 billing. The most important updates relate to the CS modifier, but there...
- Jun 17, 2020
Quarterly Reports Delayed for HHS Relief Funds
On June 13, HHS updated its FAQs with information regarding the quarterly reporting required for the Provider Relief Funds. For now,...
- Jun 8, 2020
Quarterly Reports Due on PPP/HHS Funds
The purpose of this article is to remind you that if you received PPP funds or HHS Relief funds in excess of $150,000 (per TIN), you are...
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