In one of the first of what will likely be a flood of enforcement actions, the Texas parent of an Iowa nursing home has agreed to repay $214,200 in federal monies for not following coronavirus safety protocols during an outbreak at the facility from April through July 2020. Among other things, the nursing home didn’t properly screen employees or require them to wear personal … [Read more...] about Provider pays $214K for violating federal COVID-19 workplace protocols
Billing & collections
Getting Medicare reimbursement for telehealth services: The new CONNECT for Health Act
Like most cliches, the one about the COVID-19 pandemic’s transformation of medicine forever is laden with truth. Telemedicine is Exhibit A. Of course, telemedicine goes back decades. But the pandemic accelerated the breakdown of resistance on the parts of providers, regulators and above all, patients. It was supposed to be just temporary. But to use still one more cliché, now … [Read more...] about Getting Medicare reimbursement for telehealth services: The new CONNECT for Health Act
CMS reweighting 2020 MIPS cost performance category
The Centers for Medicare & Medicaid Services (CMS) recognizes the impact of the COVID-19 pandemic public health emergency (PHE) on clinicians across the country and continues to offer flexibilities to provide relief where possible. Under § 414.1350(d)(3), the Merit-based Incentive Payment System (MIPS) cost performance category weight is 15% of the final score for the 2020 … [Read more...] about CMS reweighting 2020 MIPS cost performance category
5 tech resources improving medical practice efficiency this year
By Alison Foster bio There was a notable increase in the adoption of healthcare technology by practices and providers in 2020. This continues in 2021, especially as the COVID-19 pandemic shows no signs of letting up. Many practices are short on both human and financial resources and need to increase efficiency to the maximum. Here are some forms of healthcare technology you … [Read more...] about 5 tech resources improving medical practice efficiency this year
Medicare payment upped for COVID-19 vaccine
The Centers for Medicare & Medicaid Services (CMS) has increased the Medicare payment amount for administering the COVID-19 vaccine. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting … [Read more...] about Medicare payment upped for COVID-19 vaccine
New devices, technology dominate 2021 CPT code changes
By Lisa Eramo bio There is a whole slew of new and revised CPT codes—329 changes to be exact—effective since Jan. 1. This includes 206 new codes, 54 deletions, and 69 revisions. Interestingly, the majority of changes pertaining to new technology and devices, giving medical practices the opportunity to provide high-quality patient care while also receiving reimbursement. This … [Read more...] about New devices, technology dominate 2021 CPT code changes
Two data deadlines approaching this month
Two deadlines are coming up for physician practices: The Quality Payment Program Doctors and Clinicians Preview Period will close on March 25. And the data submission period for Merit-based Incentive Payment System eligible clinicians who participated in the 2020 performance year of the Quality Payment Program (QPP) ends March 31. Preview your performance information CMS opened … [Read more...] about Two data deadlines approaching this month
The physician enterprise model: a non-employment alternative
By John W. McDaniel bio Hospitals are seeking new and innovative ways to affiliate with physicians that differ from tactics used in the 1990s, These new relationships involve a more formal type of relationship with physicians, which might reflect lessons learned through previous less‐than‐satisfactory relationships. Most hospitals have physician integration strategies as a … [Read more...] about The physician enterprise model: a non-employment alternative
Updated info for Pfizer-BioNTech vaccine
On Dec. 11, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the Pfizer-BioNTech COVID‑19 Vaccine for the prevention of COVID-19 for individuals 16 years of age and older. Review Pfizer’s Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) regarding the limitations of authorized use. During the COVID-19 … [Read more...] about Updated info for Pfizer-BioNTech vaccine
Impact of reimbursement and compliance to WRVU-based compensation
By John McDaniel bio All physician contracts including any form of WRVU based compensation may need to be reviewed and probably amended because of the increase in WRVUʹs (work relative value units) associated with E&M CPT codes effective Jan. 1, 2021. This has been necessitated by CMS whereby the final decision involved eliminating CPT Code 99201 and leaving CPT Code … [Read more...] about Impact of reimbursement and compliance to WRVU-based compensation