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CMS targets overcoding, unintentional errors in new 60-day overpayment final rule

02/22/2016

Providers may have a shorter look-back period under the new 60-day overpayment final rule than originally proposed, but the rule sets rigorous standards for determining what an overpayment is — including “overcoded” E/M claims.

Check FCC broadband map to see whether MU hardship exception applies

02/22/2016

by: Roy Edroso

CMS is offering providers a hardship exception to two meaningful use measures based on the broadband rates in their counties — and it’s worth a few minutes’ work to make sure you qualify.

Plans for new quality measures revealed

02/22/2016

by: Julia Kyles

Some providers who are juggling 50 to 100 different measures across various payers have something to look forward to: a total of 21 uniform measures that they’d report to all payers.

Some deleted vaccine codes may cause billing headaches in 2016

02/22/2016

by: Scott Kraft

Keep track of which vaccine codes you use because some previously frequently billed codes were deleted for 2016.

MACs to send warning letter prior to start of enrollment revocation

02/15/2016

by: Scott Kraft

Practices that fail to update their enrollment information in a timely fashion after changing practice locations will get a temporary reprieve before the Medicare administrative contractor (MAC) initiates enrollment revocation.

Gain an MU hardship exception because of CMS’ delayed final rule

02/15/2016

by: Richard Scott

Providers gained an easy path to avoiding meaningful use penalties for the 2015 reporting period, according to recently issued CMS guidance. Specifically, you can cite the meaningful use program’s late-arriving final rule in 2015 as a reason to file a hardship exception, and you won’t need to provide supporting documentation.

How to handle immediate firing of employee: Act quickly, even-handedly

02/15/2016

by: Roy Edroso

Protect yourself and your practice by taking action if an employee steals or harms colleagues or patients or otherwise provides “cause for immediate termination.”

CMS plans for RAC reviews of MA programs threatens practices’ bottom lines

02/15/2016

by: Joshua Poltilove

Medicare Advantage plans soon may come under the scrutiny of recovery auditors (RACs), and if the auditors begin recouping money from the plans, the rates you receive may get even worse.

FDA suggests vendors work with providers to boost medical cybersecurity

02/15/2016

by: Roy Edroso

The Food and Drug Administration (FDA) signals with a new guidance document that it will give manufacturers of medical devices more leeway to solve their own medical cybersecurity problems — and experts believe that will get providers more involved in the troubleshooting process.

Inpatient denial rates climb for both initial, subsequent hospital care

02/15/2016

by: Richard Scott

Providers saw a subtle increase in denial rates for most inpatient codes covering initial and subsequent hospital care from 2011 to 2014, according to an analysis of the most recent Medicare claims data available.

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