The wait is finally over. You no longer need to feel like you are breaking the rules of Medicare by using an ABN form that expired in March 2020. CMS was delayed in approving the new ABN form; however, on June 24th, they updated their website and released the latest version.
Changes occur to CPT procedure codes every January 1st. Some get deleted, some updated, and others added. The list of new codes added for 2020 include 2 new procedure codes for dry needling: 20560 and 20561.
In an effort to reduce reporting burden, CMS would like “feedback on the RFI questions related to the MVP (MIPS Value Pathway) participation framework. Please see the proposed rule for instructions on how to submit comments.
The Chiropractic Medicare Coverage Modernization Act of 2019 (H.R. 3654) would allow Medicare beneficiaries access to the chiropractic profession’s broad-based, non-drug approach to pain management, which includes manual manipulation of the spine and extremities, evaluation and management services, diagnostic imaging and utilization of other non-drug approaches that have become an important strategy in national efforts to stem the epidemic of prescription opioid overuse and abuse.
The Medicare Administrative Contractor (MAC) National Government Services (NGS) notified providers that they will no longer accept handwritten 1500 claims as of June 2019. If you are still submitting handwritten claims to NGS, you do have alternative options.
3rd Party Billing and Collections
Starting June 6, 2019: If you are a network provider with VA you need to pay close attention to the many changes that have occurred over the past year regarding how you receive referrals, where supporting documentation is sent, how claims should be billed and who pays the claims. Many times, the process required the provider to connect with a variety of sources; some internal with VA and others via 3rd party carriers or network administrators.
There was a story circulating recently about a woman who suffered a stroke after practicing an advanced yoga pose. The story gave details about how the pose had caused a small tear in her carotid artery which, in turn, caused a small stroke.
If you are confident that you have a solid HIPAA and/or OIG compliance process in place, you can stop reading now; but if you have even the smallest concern that you’re not compliant, we’re here to help you sort it out.
The UW Medicine had 974,000 patients’ Protected Health Information exposed online due to accidental removal of protections on a website server. As a result, internet searches allowed “sensitive patient information to be accessed by unauthorized individuals...
CMS provided some clarification on why it is important to continue to check your 2019 MIPS eligibility status and what the difference is between voluntary reporting and opting in. Be sure you know all the facts in order to avoid any payment adjustments.
The Interoperability and Patient Access Proposed Rule outlines opportunities for patient data to be more transferable through open, secure and standardized formats while “reducing restrictive burdens on healthcare providers.” Some of the significant proposed items that may impact providers are:
Walgreens Pharmacy has paid the penalty for a mix up in their billing and for ignoring federal rules when providing discounts. The article states, “Walgreens configured its systems so that pharmacists couldn’t dispense less than a full box of five insulin pens, and then it submitted false data in reimbursement claims indicating that the total number of daily doses didn’t go over program limits.” In other words, they provided a product but reported (billed) a different amount.
Yep, another doctor on the OIG Report. What was the violation? The report states, " These improper payments occurred because the doctor did not have any policies and procedures to ensure that chiropractic services provided to Medicare beneficiaries were medically necessary and sufficiently documented.
HHS Website is Refreshed and Ready for 2019
Click here to check out the new layout on the HHS website. The website contains an improved search engine and simplified layout of important updates and notices. Be sure to include in your scheduled first of the year compliance duties a quick check of what's new for OIG.
What's New for 2019? Check it out here.
3rd Party Billing and Collections
The night before the December 15th deadline to enroll in marketplace health plans, a Texas Federal judge ruled the Affordable Care Act (ACA) as unconstitutional.
As of December 19, 2018, CMS streamlined their process for accessing the Quality Payment Program (QPP) website.
CMS has announced that they will no longer provide access to the PQRS Feedback Reports. You have until December 31, 2018 to download these reports. Since the final performance period for PQRS ended in 2016 and the final payment adjustment year is 2018, access to these reports will not be maintained by CMS.
Legislation championed by the American Chiropractic Association (ACA) to expand Medicare coverage of services provided by chiropractors within the scope of their license has been introduced in the U.S. House of Representatives.
Patients Over Paperwork-What does it Mean for You?
The Patient Over Paperwork initiative has focused on reducing administrative burden so that physicians could concentrate more on patient care. Stakeholders have found that many aspects of the required E/M documentation are redundant. You probably have heard the rumors - such as, new CPT codes, new fee schedule and less documentation required. This is a quick summary of what we currently know for sure.
What will happen in 2019?
Patients are choosing their plans for 2019 - Marketplace, Employer Based or Medicare
It’s that time of year again. Patients are choosing their plans for 2019 - Marketplace, Employer Based or Medicare. Don’t wait until January 1st to familiarize yourself with these new plans. Keep the lines of communication open with your patients to ensure that they are keeping their chiropractic benefits in mind when making their decisions. Some patients may know, as early as December, which plans they are...