White House announces the end date of the (PHE) Public Health Emergency to end on May 11th 2023An announcement on Monday, January 30th, by the White House, OMB (Office of Management and Budget), stated that they plan to end the COVID-19 national emergency and public health emergency on May 11th. Read further to determine the impact to your medical and/or dental practices.
HHS PRF Audits - The top 10 things to preparePRF (Provider Relief Funding) recipients that expended a total of $750,000 or more in federal funds, including PRF payments and other federal financial assistance, during their fiscal year(s) are subject to Single Audit requirements. Read our article on what the requirements are, and to find out if you are compliant.
CMS Final Rule and Physician Medicare Fee Schedule 2023While CMS (the Centers for Medicare and Medicaid Services) are patting themselves on the back for their new policies on access to behavioral health services, the Medicare Physician Fee Schedule Final Rule, released on Tuesday, November 1st, is anything but exciting news. First, the 2023, Medicare Physician Fee Schedule, will end the temporary 3% increase that the COVID pandemic brought for 2021 and 2022. This will decrease the Medicare physician payment to 4.5% from these “statutorily-mandated” cuts.
The New 2023 AMA CPT E/M update are published. What is changing?The CPT Editorial Panel announced this week their approval, for 2023, of additional revisions to the rest of the Evaluation and Management code section. These revisions seek to provide continuity across all the E/M sections allowing for the revisions implemented in the E/M office visit section in 2021 to extend to all other E/M sections, including hospital, SNF and LTNF encounters. Read our Breaking News! article for details on this important update for 2023.
The PHE renewed for the 10th time on 7/15/22, and is good for another 90-days (through 10/13/22), but how does that impact your medical practice?The PHE, Public Health Emergency has been extended a 10th time in 7/15/2022, extending through October 13th, 2022. Please read our update for what has expired, what is still in effect, and how to stay compliant in your Telehealth Services.
Diving in to the SRDPHealth care providers and suppliers face a dilemma when they identify that potentially problematic claims have been submitted to a federal health care program (i.e. Medicare, Medicare Advantage Programs, Tricare and Medicaid Programs, ). Balancing legal disclosure obligations and business interests can be difficult when entities look at short term risks and benefits, to disclose to the OIG or CMS or simply, voluntary refund the overpayment to the provider’s Medicare Administrative Contractor.
Are you a HIPAA entity?
If you have heard the acronym HIPAA thrown around a lot lately, you are probably thinking, “Do I really know what HIPAA means?”. So many are throwing that term around in the falsehood that their legal or privacy rights are being violated in some way as more and more companies are requiring COVID-19 vaccinations.
Kickbacks, False Claims and Billing for a Suspended DoctorIn an update from the Doctors Management Compliance Guy Blog, Sean Weiss discusses the $37.5 million pay to settle allegations of kickback billing for a suspended physician and false claims. Weiss believes that this is a failing of the Department of Justice due to the connection of this bad-actor physician and the Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General.
Interim Final Rule for Surprise BillingNSCHBC member Amanda Waesch walks readers through the newly issued interim final rule which safeguard patients against unforeseen medical bills arising from out-of-network care as part of the implementation of the new bipartisan No Surprises Act. Waesch also details what this rule means for patients, providers, specific health plans, and the rule’s requirements related to surprise billing.
Leadership in Healthcare: Identifying leaders within your staff and fostering growthIn this NSCHBC original article, our expert thought leaders discuss the current state of healthcare leadership, and how practice management can hire potential leaders and train staff to foster their growth as an investment into their healthcare business.
OIG Advisory Opinion on Spinal ImplantsIn this latest Doctors Management update, Sean Weiss discusses the new Advisory Opinion on spinal implants provided by OIG, or the Office of Inspector General. Here, Sean details the proposal where spinal implant manufacturers would offer a reduced price to hospitals under specific conditions, and if the proposal constitutes grounds for the imposition of sanctions.
It’s time to add NPPs to your Practice: How to make them cost effective and profitable – Part 1Adding Non-Physician Providers (NPP’s) such as nurse practitioners (NPs) and physician assistants (PAs) can substantially increase a primary care, specialty and/or surgical practice’s profitability and access by improving patient care and providing additional availability for appointments and practice hours in order to reduce fixed costs per provider and increase profitability for the physician owner.