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After WISeR, new ASC prior authorization demo signals a growing trend

10/06/2025

On the heels of the Wasteful and Inappropriate Services Reduction (WISeR) demonstration model for prior authorization comes a new demo targeting ambulatory surgery centers (ASC). Some observers, including physicians and practice consultants, worry that this new development signals a trend toward increased prior authorization in traditional Medicare.

Review the limits of Medicare’s telehealth exceptions

10/06/2025

by: Julia Kyles, CPC

Question: I know we can have audio-only telehealth visits for patients who are being treated for behavioral and mental health conditions after the telehealth waivers expire. Also, Medicare plans to permanently change direct supervision rules to allow doctors to be “immediately available” through a virtual connection. Does that mean a physician, such as a psychiatrist, could meet the “immediately available” requirement for a mental health or substance abuse encounter, if they’re available by phone?

Docs can use signature stamps if ‘disabled,’ and can prove it

10/06/2025

by: Roy Edroso

Question: I just saw a Medicare Learning Network (MLN) fact sheet that says while CMS doesn’t usually accept stamped signatures on medical documents to indicate the providers has written or reviewed them, “according to the Rehabilitation Act of 1973, we allow a rubber stamp for a signature if the author has a physical disability and provides proof of their inability to sign due to their disability.” Can my provider with arthritis start using a stamp now?

Run data, prepare staff for expanded RADV audits in MA space

10/06/2025

by: Dom Nicastro

As CMS accelerates audits across all Medicare Advantage (MA) contracts for payment years (PY) 2018-2024, your practice must prepare for record demands, coder shortages and complex compliance challenges.

After big change in hospital E/M reporting, use held steady

10/06/2025

by: Roy Edroso

Despite significant changes in standards that came in 2023 for hospital inpatient and observation E/M codes, 2024 was a year of stasis for service utilization — and denials.

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