Medicare PowerPoint on New Facet Policy
CGS Medicare (KY/OH) has just created a PowerPoint for the new Facet LCD which is in effect today. Since the Facet LCD has been adopted...
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- Apr 23, 2021
EPIC: Denied Claims for No CRNA Electronic Signature
1. Medicare Denials. I have a large anesthesia group undergoing an EPIC implementation. My client advised me that the EPIC programmers...
- Apr 20, 2021
Facet "Gotcha"
One thing I forgot to mention in my article last week regarding the new facet LCDs that take effect on April 25 is that there is a...
- Apr 19, 2021
U/S Billable for Arterial Line Placement
1. U/S for Arterial Line Placements. I have received a formal opinion from the AMA that U/S for placement of arterial lines is...
- Apr 16, 2021
New Facet Policies Nationwide
New Medicare facet LCDs are taking effect around the country on April 25. There are material, onerous changes. All of the Medicare...
- Feb 2, 2021
2021 Back and Knee Brace Denials
1. Overview. If you are getting denials on your back braces and knee braces, it may be because you are in a certain zip-code and you...
- Jan 20, 2021
Landmark Case: HIPAA Fine Reversed
Reversal. Good news on the HIPAA front. A very damaging case has been reversed. On January 14, 2021, the federal 5th Circuit Court of...
- Dec 28, 2020
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...
- 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...
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