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New Part B drug pay models intended to boost quality would test providers

03/21/2016

The agency noted that to gather a robust enough data set and get valid results, they need every provider to participate, Warren says. With the exception of Maryland, the test will randomly sort all primary care service areas (PCSAs, clusters of ZIP codes that reflect the delivery of primary care) into one arm of the test.

Prepare yourself and your staff for law enforcement searches

03/21/2016

by: Roy Edroso

Make sure everyone at your practice knows the drill in the event that law enforcement conducts an impromptu search and seizure of your files.

Value-based modifier cuts, bumps hit practices; focus on 2016 reporting

03/21/2016

by: Richard Scott

The value-based modifier (VBM) program – a ramped-up version of the physician quality reporting system (PQRS) that scales payment to cost and quality measures – sunk its teeth into 59 practices this year, and those practices will see – pay cuts of as much as 2% for the rest of the year.

Hear, hear: 3 tips to successfully report new cerumen-removal code

03/21/2016

by: Richard Scott

The debut of cerumen-removal code 69209 gave practices a new avenue for reimbursement in 2016, but early indicators show you’ll need to pay close attention to the code’s strict reporting protocol, including modifier use, to ensure reimbursement.

Proposed enrollment rule will have practices rethinking relationships

03/21/2016

by: Julia Kyles

What’s the worst thing that could happen to a practice if one of its partners hasn’t refunded an overpayment to the state’s Medicaid program? Under the proposed enrollment rule released Feb. 25, the practice could have its application denied or revoked if it doesn’t report the debt during the enrollment or revalidation process.

Value-based modifier program tallies $79 million in payments, adjustments

03/21/2016

by: Richard Scott

Some practices are reaping 32% gains this year based on their performance in Medicare’s value-based modifier (VBM) program, according to data CMS released in early March

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