Part B News | Part B News

Patient acting up? Don’t hesitate — call the cops to protect your staff

06/13/2016

Question: At what point should I call the police on an unruly patient?

Denial rates of common allergy codes change — but remain tough to get paid

06/13/2016

New allergy skin tests codes added in 2013 haven’t worked out too well for providers. The most recently available Medicare data on those CPT codes show high denial rates for the new codes, continuing a trend with allergy skin test codes.

CMS drops two-midnight rule payment cut; short stays likely to stay under scrutiny

06/06/2016

by: Scott Kraft

CMS has abandoned plans to cut inpatient hospital payments by 0.2% to pay for its “two-midnight rule” following a partial victory by the American Hospital Association in a lawsuit against the agency.

OCR’s sample grievance policy gives your practice a model it can use

06/06/2016

by: Julia Kyles

Practices with more than 14 employees must give patients the means to lodge complaints about discrimination and appoint at least one staff member who will be responsible for investigating and responding in a timely manner. Providers with a procedure in place should review their grievance procedure to make sure they’re in compliance.

Use a good plan, common sense to meet new patient language standards

06/06/2016

by: Roy Edroso

The ways in which the new nondiscrimination rule increases your responsibilities to limited-English-speaking patients aren’t entirely clear, experts tell Part B News — but you should use common sense and stand ready to meet a few specific requirements.

Small practices: Resources, tips to avoid potentially painful impact of MIPS

06/06/2016

by: Richard Scott

Small practices should brace for a rocky landing when the merit-based incentive payment system (MIPS) docks in 2017, as more than half of all solo providers and groups with fewer than 25 clinicians will incur a penalty, CMS expects. Or will they?

In first MIPS year, advanced APM benefits will be rare — and risky

06/06/2016

by: Roy Edroso

You may be glad you and most Part B providers have to perform quality reporting through the merit-based incentive payment system (MIPS) instead of advanced alternative payment models (APMs) in 2017.

Estimates peg 346,000 losers, 412,000 winners in MIPS-associated payments

06/06/2016

by: Richard Scott

Early cost estimates associated with the merit-based incentive payment system (MIPS) may have put a scare into small practices because CMS predicted that nearly nine out of 10 solo practitioners (87%) would receive a penalty as high as 4% of total Medicare payments in the first year of the program.

Don’t use ABNs on Medicare Advantage patients – and watch that ‘waiver’

05/23/2016

by: Roy Edroso

Question: Can I give an advanced beneficiary notice of non-coverage (ABN) to Medicare Advantage patients when I don’t expect payment on a service?

4 questions to ask to challenge the government’s use of extrapolation

05/23/2016

by: Marla Durben Hirsch

Government auditors and investigators use extrapolation frequently to calculate the extent of a provider’s overpayment. But that doesn’t mean you should automatically accept their findings, warns attorney Ross Burris with Polsinelli in Atlanta.

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