You're likely to continue having to answer patient questions and concerns regarding the spread of the H1N1 influenza virus, or swine flu. The flu virus strain is showing no sign of slowing down as the World Health Organization (WHO) raised its pandemic alert to the highest level June 11.

Last week we examined Medicare spending growth broken down by broad type-of-service categories such as imaging services and office visits (PBN 6/8/09). This chart gets more specific by looking at spending changes for E/M services. Like last week's Benchmark, all data comes from an April 2009 report by the AMA called "Estimated change in SGR spending from 2007 to 2008."

You wouldn't see the 21% cut to your Medicare payments set to take effect Jan. 1 under a House of Representatives health care reform bill that eliminates the "flawed Sustainable Growth Rate (SGR) formula." The bill, released June 9, came out of the House Ways and Means, Energy and Commerce and Education and Labor committees, who promised to pass major health care reform by August. The Tri-Committee Health Reform proposal would replace the SGR formula used to calculate Medicare payments.

You will need to check with your carrier's local coverage determinations (LCDs) for coverage instructions regarding four inhaler drug codes. The July 2009 update to the physician fee schedule includes this change and introduces three new Q codes.

Here are important dates to help you plan for the 5010 HIPAA standard switch (see story, pg. XXXXX). Keep these dates in mind when speaking to your software vendors about obtaining upgrades for your claims processing system.

Medicare won't pay for patient assessment and management services done by phone, but you're free to bill patients - and many practices are starting to, Part B News has learned. One pain management practice is beginning to bill patients for phone services using non-covered codes because of the rising costs. "A physician can only afford to pay his staff so much for their time, and yes, patients will keep you on the phone for a long time," says Cindy Rhyne, practice administrator for Douglas D. Pritchard MD, a small pain management practice in Statesville, N.C.

Pick up the phone this week and call your vendor - there are three questions you need answers to as soon as possible if you're going to be ready for the transition to the 5010 HIPAA standard. That's the urgent message CMS's Chris Stahlecker, the director of the Division of Medicare Billing Procedures in CMS's Office of Information Services, delivered during a June 9 telephone conference.

The economy is getting better and the recession should end by the fourth quarter of 2009, according to about 93% of economists surveyed by the National Association for Business Economics (NABE). But many of your peers have yet to see the positive signs take place in their practices. At least that's what a dozen practice executives had to tell Part B News at the 2009 Medicare Enrollment Workshop from June 8 to June 10 in Denver.

Good news: There are only three situations a Recovery Audit Contractor (RAC) can use an automated review to determine a claim was an overpayment - and demand you pay up. Even better, knowing what the three scenarios are, you can predict how likely it is that you'll be seeing RAC letters in your mailbox.