Medicare

On December 2, 2020, CMS published new provisions and exemptions related to the Stark Law (85 Fed. Reg. 77492) and HHS-OIG published new provisions and safe harbors related to the Anti-Kickback Statute (AKS) (85 Fed. Reg. 77684.

Code accurately with the appropriate documentation to substantiate medical necessity.

Only a quarter of Medicare and Medicare Advantage recipients receive an annual wellness visit.

The proposed rule, issued July 13, greatly expanded what was known and understood about RTM but still left many questions unanswered.

If providers fail to follow these new rules, claims will be denied, and eventually, those who are outliers on adherence to appropriate use criteria will be subject to prior authorization.

Don’t let your Medicare Part B reimbursement for advanced imaging be impacted by the CMS Mandate taking effect on January 1, 2022!

Good news on telehealth coding, but lifting of EFRD restrictions will present financial challenges.

80% of older adults have at least one chronic disease, 77% have at least two, supporting the urgent need to increase telemedicine and digital monitoring adoption.

Why has Medicare separated depression and alcohol screenings, and will patients incur cost-sharing with new patient portal E&M codes?

Program focuses on improving quality and reducing cost, while maintaining patient choice.

Most physician compensation structures must comply with Stark laws. The danger is that practices may be in violation without realizing it, putting themselves at risk of fines and exclusion from Medicare and Medicaid.