Billing
OIG Releases 2012 Work Plan
Among the new areas of focus for the Office of Inspector General (the “OIG”) is increased scrutiny for incident-to services performed by non-physician practitioners. Specifically, the OIG is planning on investigating whether the non-physician practitioners are qualified to be performing the incident-to services that are being billed by physicians. This concern and others are highlighted… Read More »
New Program Changes the Way Medicare Reimburses Health Care Providers
A pilot program called the Bundled Payments for Care Improvement Initiative (the “Bundling Initiative”) has recently been unveiled by The Department of Health and Human Services (the “Department”). The program is designed to change the way Medicare reimburses health care providers. Under the current method, Medicare makes separate payments to each provider. In an effort… Read More »
REDUCTION IN MEDICARE REIMBURSEMENTS TAKES EFFECT
On March 1, 2010, the 21 percent overall cut in Medicare reimbursements to physicians became effective. However, it could still be averted by a month-long stay that the U.S. House passed on February 25, 2010; action is pending in the Senate. In the meantime, more physician practices are considering not accepting new Medicare patients. Many… Read More »
FTC Red Flag Rules Enforcement Delayed Until June 1, 2010
The Federal Trade Commission (“FTC”) has again extended enforcement of the Red Flag Rules, now until June 1, 2010. The latest delay comes at the request of Congress, which is considering a bill that amends the identity theft rule by eliminating entities with fewer than 20 employees from complying. The House of Representatives passed that… Read More »
MGMA Releases Proposed 2010 Medicare Physician Fee Schedule Analysis –
The Centers for Medicare & Medicaid Services (“CMS”) recently released the 2010 Medicare proposed physician fee schedule along with a related press release and fact sheet. The regulation includes provisions that confirm a 21.5 percent reduction in 2010 Medicare physician payments unless Congress enacts legislation to reverse this cut. The regulation also proposes to “remove physician-administered drugs… Read More »
How to Select a Third-Party Billing Entity
Selecting a third-party billing entity (“TPBE”) can be a difficult process for medical group administrators and their organizations. A TPBE usually offers medical billing services, which may include charge-data entry, billing, electronic claims submission, payment posting and collection follow-up. Upon beginning a search for a TPBE, a medical group must first set its own… Read More »
