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Take note of 9 tests granted CLIA waivers starting July 1

04/29/2013

Take note of the nine new lab tests below that will be considered CLIA-waived by CMS, according to CMS transmittal 2671 to the Medicare Claims Processing Manual. Note that the codes listed below won’t appear new — in many instances, other tests billed with these codes are already CLIA-waived, but the specific brand of test is being added.

Navigator proposal set to help patients; be prepared to spot changes in plans

04/29/2013

by: Scott Kraft

A proposed rule defining how patients will receive assistance from qualified health care “navigators” to select the right health insurance exchange plan under the Affordable Care Act (ACA) aims to close the door on insurance broker and health plan participation, as well as any state law efforts to thwart ACA implementation.

Sequestration update: Cuts go through March

04/29/2013

The 2% sequestration cuts to your Medicare payments could continue through March 31, 2014, if Congress takes no action, according to new sequestration Q&As posted on Medicare administrative contractor (MAC) websites such as Palmetto’s.

Advance preview -- 3 tips to prepare to become an ACO plus 5 steps to complete CMS’ application

04/22/2013

by: Karen Long

Practices can start the process May 1 to become accountable care organizations (ACOs) in 2014, but even before that, your practice should take three steps to ensure the ACO’s success.

New EFT form, prospect of fines for out-of-date enrollment information loom

04/18/2013

by: Scott Kraft

You’ll soon have to use a new CMS form to enroll your practice to receive payments via electronic funds transfer (EFT), a payment type set to become mandatory in 2014 under implementation of the Affordable Care Act (ACA).

In-office ancillary service changes could affect patients, practice finances

04/18/2013

by: Karen Long

Physician practices that offer therapy services, radiation therapy and advanced imaging could lose revenue and have to make operational changes if Congress votes to adopt a budget proposal to sharply limit physicians’ ability to bill those services in their offices.

Sequester’s reimbursement hit hurts more with low-margin drugs, services

04/18/2013

by: Roy Edroso

For some specialties, the across-the-board, 2% sequester cut to Medicare that became effective April 1 will be especially painful; experts advise you to prepare for the fallout.

Program integrity targets in HHS budget include enrollment, exclusions, PMDs

04/18/2013

by: Roy Edroso

While the HHS section of President Barack Obama’s budget proposed this month will probably undergo many changes over the coming months, experts tell us the program integrity section — dedicated to combating waste and fraud — gives clues that the department remains serious about squeezing money out of certain physician practice activities.

Save original meaningful use data — even if you switch EHRs — to prepare for audits

04/18/2013

by: Roy Edroso

Secure your $18,000 meaningful use bonus by keeping track of the electronic health records (EHR) documentation that you used when you attested. CMS auditors want to see it — and they prefer the originals.

Watch out for meaningful use pre-payment audits

04/18/2013

by: Roy Edroso

Simple checks, including making sure your enrollment is accurate in the Provider Enrollment, Chain and Ownership System (PECOS), could help you past new CMS meaningful use edits. CMS added pre-payment edits for meaningful use attestation in January.

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