Medicare dollars set aside for treating illegal aliens have been exhausted in ten states, one of which shares a direct border with Mexico.

The ten Physician Quality Reporting Initiative (PQRI) measures listed below had the highest acceptance rates in 2007, according to a CMS report.

Imagine if the Medicare Payment Advisory Commission (MedPAC) was suddenly able to set the payments you get under the physician fee schedule and control coverage policies through transmittals - gaining powers now held by both Congress and CMS.

Successfully participating in the Physician Quality Reporting Initiative (PQRI) will get your provider's name on a list available to the public on Medicare's website. The public disclosure is not optional and that's got physician advocates worried.

With cases of the H1N1 or swine flu expected to rise with the onset of colder weather, be prepared to use a new ICD-9 code for diagnosing the new disease.

You and your peers are keeping patients in observation longer while evaluating if they should be admitted as inpatients or sent home, a Medicare Payment Advisory Commission (MedPAC) study shows. But watch out, observation services will be scrutinized by your carrier, as well as the HHS Office of Inspector General (OIG), due to the skyrocketing rate these services have been billed in recent years, Part B News predicts.  

Efforts to move forward on comprehensive health reform are stalled in both houses of Congress and lawmakers will postpone final action on the reform bill until after the Aug. 7 recess, Part B News has learned.

If CMS has its way, you'll need to meet a series of new guidelines to be accredited by January 2012 if you want to be paid for providing the technical component (TC) of advanced imaging services. The accreditors will also be required by CMS to disclose certain findings about your practice.

You and your peers would be required to report quality measures for a set minimum number of patients in order to receive a 2% payment bonus under the Physician Quality Reporting Initiative (PQRI) program in 2010, according to CMS's proposed 2010 Medicare Physician Fee Schedule. The agency is planning several other new wrinkles to the voluntary program, including reducing or removing claims-based reporting after 2010 and using electronic health record (EHR) systems to report quality measures.

Download this month's tool from DecisionHealth Professional Services from Part B News' NEW website, www.partbnews.com. The DecisionHealth Professional Services tool for this month is an observation services audit sheet. This form will help you accurately and consistently audit billed observation services. The sheet should be used with chart notes to determine the appropriate service level billed - cutting down on overbilling and ensure compliance.