Part B News

As value grows, small practices struggle with IT adoption, risk sharing

by: Richard Scott Dec 12, 2016

Investments in health IT and financial risk-sharing are two big obstacles standing in the way of many small practices getting on board with value-based payment models, states a new report from the Government Accountability Office (GAO).

Experts: ACA repeal would double uninsured by 2019, send U.S. health care "someplace worse."

by: Roy Edroso Dec 12, 2016

In a briefing sponsored by Democratic senators, health policy wonks said that if the Trump administration repeals Obamacare as quickly as promised, the number of uninsured Americans will double by 2019 and in some ways, American health care would be worse that before the Affordable Care Act (ACA) passed.

Just in time for the holidays: OIG increases allowed amount for patient gifts by 50%

by: Julia Kyles, CPC Dec 7, 2016

You know the drill - giving your patients gifts or other forms of inducement can influence their decisions to receive health care, which can in turn trigger civil money penalties against the provider who offered the goody. However there are a few safe harbors - for example, inducements to encourage patients to receive preventive services.

Submittingcompleteinformationforthe informal review request doesn't have to be a squeeze.

by: Julia Kyles, CPC Dec 5, 2016

You have until Dec. 7 to dispute physician quality reporting and value-based modifier pay cuts. As Part B News has reported, the requests should be detailed because this is a provider or practice's only chance to convince CMS to take a second look at its decision. However, a subscriber noted that there is a character limit for the narratives that can be submitted with the requests and asked if there were any work-arounds. As it turns out, there are.

CMS is backing into 2017's 99,000+ new edit pairs

by: Julia Kyles, CPC Dec 1, 2016

Usually CMS releases CCI edits and the medically unlikely edits (MUEs) about a month before they go into effect. A week or so later, CMS releases the files that list changes to the edit sets: additions, revisions and deletions to both edit sets. Not this time.

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