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Prepare for the RACs to take a step back as CMS transitions to the next round of contracts, which will include a fifth RAC focused exclusively on home health, hospice and DME audits.
 
Our wonderful DecisionHealth Daily readers do not shy away from the difficult questions (well, the difficult to read questions, anyway) and have put in their two cents on our query concerning ICD-10, cannibalism and the founding of our great nation.
Exclusion from federal health care programs is one of the OIG’s bigger enforcement hammers and the agency is ramping up its focus on this tool.
 
Physician societies got the chance on Tuesday to weigh in on the latest congressional proposal to repeal the sustainable growth rate (SGR) payment formula at a Congressional subcommittee hearing. They mostly liked what they saw.
EHR vendor Allscripts is defending itself against a class action lawsuit filed by three practices on behalf of 5,000 physicians who bought the My Way product, targeted to small physician groups and offered by a subsidiary of the company.
 
Ambulatory surgery centers (ASCs) can be a very attractive option for patients needing procedures that don’t require an inpatient stay. But declining Medicare reimbursement and competition from hospitals has made the business of running an ASC tough for owners and providers.
 
China is on its way to competing with the United States in one of its strongest markets. But we may just be willing to relinquish this one.
 
Want to get doctors talking (or even shouting)? Mention the Maintenance of Certification program and then stuff some cotton in your ears.
Lawmakers in 16 states have not reached agreements about whether to expand Medicaid under the Affordable Care Act (ACA), leaving you unsure about whether your practice could see an influx of new Medicaid patients next year.
by Scott Kraft
Part B News readers know that billing NPP services comes with its own set of complications, depending upon whether the services are billed directly or under incident-to billing rules.Your private payers have their own rules for NPP billing, which may confuse some of the terms used by Medicare. Huey cited Blue Cross/Blue Shield of Alabama, which defines incident-to differently than Medicare. For example, to bill incident-to, BCBS of Alabama requires the physician to see the patient on the date of service, unlike Medicare.
 

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