NSCHBC News

CMS Final Rule and Physician Medicare Fee Schedule 2023

While 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 SRDP

Health 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?
The “Privacy Law” is probably not what you think.

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 Doctor

In 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.

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