You've now got more flexibility to bill Medicare for trying to get smokers to quit via counseling sessions. HHS has expanded Medicare coverage for tobacco cessation counseling (billed via codes 99406 and 99407, which pay $13.64 and $26.18 respectively). The old policy restricted Medicare coverage for counseling to patients who'd been diagnosed with a tobacco-related disease or showed symptoms of such disease. The new policy opens counseling up to any Medicare beneficiary who happens to smoke (read more on expanded Medicare coverage for tobacco cessation) ...

Former HHS Secretary Michael Leavitt says the new health reform law weakens the Medicare program and doesn't add life to the Medicare Part A trust fund. Leavitt, who now runs a health care and food safety consulting firm, called the Medicare Trustees' projection of the law extending the hospital insurance fund an "illusion" in an op-ed in The Washington Post on Friday.

Leavitt maintains that Medicare savings are being counted twice: once to improve the solvency of the Part A program and again to pay for other provisions in the Patient Protection and Affordable Care Act. "The Medicare cuts can be used to improve the government's capacity to finance benefits in the future or to pay for another entitlement," he writes. "But they can't be used for both -- a point the CBO and Medicare's actuaries made in their cost estimates."

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Medical societies and physician groups strongly oppose CMS's methodology to calculate 2012 penalties for failing to adopt electronic prescribing.

CMS detailed its plans for e-prescribing penalty programs in the proposed 2011 Medicare Physician Fee Schedule. Under the proposed rule, any provider who is eligible for the e-prescribing program needs to e-prescribe at least 10 times during the first six months of 2011. Financial penalties would be levied against any eligible provider who does not e-prescribe.

The medical associations believe CMS's penalty program is off. They say providers shouldn't be penalized one year for the previous year's performance.

And, they might be right. The enabling legislation, the Medicare Improvements for Patients and Physicians Act of 2008, for the program says the penalty will apply to "covered professional services furnished by an eligible professional during 2012 or any subsequent year, if the eligible professional is not a successful electronic prescriber for the reporting period for the year."

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Physical therapists from around the country recently received comparative billing reports (CBRs) evaluating use of the modifier KX. The reports compare a provider's KX usage with his or her peers, and are for informational purposes only, says Safeguard Services LLC, a nationwide contractor running the program.

Modifier KX allows providers to bill therapy services for patients who have exceeded Medicare's physical therapy cap of $1,860 or occupational therapy cap of $1,860. Safeguard reviewed 2009 claims from 5,000 providers to see if the modifier was being used properly. The contractor says: "Physical Therapy providers are instructed to use the KX Modifier to indicate that the services that they are rendering are: (1) medically necessary and that justification is documented in the medical records, (2) the physical therapy financial limitation cap has been met, and (3) that the beneficiary's condition is such that they require further treatment."

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One of the most confusing areas of the final meaningful use rule has been a little thing called clinical quality measures (CQMs). Your peers hit CMS again and again with questions on what these are, how many of them must be met, and how they fit into the total number of meaningful use requirements needed to secure up to $40,000 in EHR incentives. Here's how this works, in a nutshell: CQMs are statistics that you report to CMS or, in some cases, to state medical agencies (read more) ...