Stories with related Professional Interests

Put Patients Over Paperwork, TMA Tells CMS - 08/19/2019

Allow physicians to use electronic health records how they see fit, eliminate prior authorization requirements, lift the ban on physician-owned hospitals, and allow a real out-of-network option. Those are among the 15 recommendations the Texas Medical Association presented to the Centers for Medicare & Medicaid Services, which is seeking to reduce administrative burdens and red tape in the Medicare program.


Medicare Muzzle? New Rules May Make Physicians Reluctant to Speak Up - 08/02/2019

New Medicare rules on local coverage determinations may make physicians reluctant to speak their minds.


Get Paid for End-of-Life Care Discussions With Patients - 07/18/2019

Since 2016, the Centers for Medicare & Medicaid Services has used two Current Procedural Terminology (CPT) payment codes for conversations about end-of-life treatment.


Will You Get a Medicare Bonus or Pay Cut Next Year? - 07/11/2019

 If you participated in the 2018 Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP), it’s now possible to check whether you’ll receive a Medicare payment bonus or cut next year.  Physicians should check their 2018 MIPS performance feedback and 2020 payment adjustment as soon as possible in case the Centers for Medicare & Medicaid Services (CMS) made mistakes when calculating your data, which happened last year. 


Use Modifiers to Override Correct Coding Initiative Edits - 05/28/2019

Correct Coding Initiative Edits Now Free on Internet


Medicine to Feds: Back Off Prior Authorization Requirements - 03/07/2019

The Texas Medical Association, American Medical Association, and a host of other medical societies are trying to stop onerous, care-impeding prior authorization requirements from overrunning Medicare Advantage plans.


Medicare Enrollment Application Revised - 03/04/2019

A new Medicare enrollment application form for physicians and nonphysician practitioners will go into effect May 1.


How to File a Medicare Extended Repayment Plan - 03/04/2019

  Extended repayment plans (ERPs) are an option for returning overpaid money to Medicare. Ideally, you should request an ERP immediately after receiving the initial demand letter. However, you can request an extended payment plan any time while the overpayment is outstanding. 


Medicare Billing Guidelines for NPs, CNS, and PAs - 03/04/2019

Billing Guidelines for Nurse Practitioners (NP),Clinical Nurse Specialists(CNS),and Physician Assistants (PA)


Texas Clinics Repay Medicare for Improper Claims - 03/04/2019

Several Texas dialysis clinics in El Paso and the Dallas-Fort Worth area have had to repay Medicare for treating people in the country illegally.


Novitas Mails Medicare Revalidation Letters - 03/04/2019

On March 1, Novitas, the Texas Medicare claims processor, began sending physicians in the Medicare program letters asking them to revalidate their enrollment information. Physicians not on the March 1 mailing list will receive their letters either March 15 or March 29.


How's Novitas Doing? - 03/04/2019

Medicare wants to know what you think of the job Novitas Solutions is doing administering the Medicare program in Texas.


CMS Sends Home Health Reports - 03/04/2019

The Centers for Medicare & Medicaid Services (CMS) sent physicians comparative billing reports on home health services. The reports contain peer comparisons that give you insights into your coding and billing practices through tables and graphs that compare your billing and payment patterns to your peers both statewide and nationally.


Government Shutdown Won't Affect Medicare Claims - 03/04/2019

Medicare claims will continue to be paid despite the government shutdown, the American Medical Association says.


Cornered: Proposed Medicare Fee Overhaul Could Box In Doctors - 02/05/2019

Proposed overhaul to Medicare payments for complex patient care visits and same-day office-based procedures could box in Texas physicians.


Review Your Physician Compare Data Before Jan. 7 - 12/20/2018

The Centers for Medicare & Medicaid Services (CMS) recently opened its Physician Compare preview period, which will allow you to check out your 2017 QPP performance data and 2016 clinician utilization data before it’s publicly reported on Physician Compare in early 2019. CMS will close the preview period on Dec. 31, so you’ll want to review your information and check for errors as soon as possible.


It’s Time to Pick Your Medicare Status - 12/12/2018

For Medicare physicians, it’s annual par/nonpar decision time. That is, you have until Dec. 31 to change your status as a participating (par) or nonparticipating (nonpar) physician in the Medicare program, starting Jan. 1. If you decide to continue with your current status, do nothing. If you want to change your status, you’ll need to notify Novitas Solutions by mail. 


Help Your Medicare Patients Keep Their Favorite Doctor (You) - 11/28/2018

Medicare’s open enrollment runs through Dec. 7, and some of your patients might be evaluating their plan options. Do they know what plans you take?


MIPS Audit? Here’s What You Need to Know - 11/19/2018

Are you planning to submit data to the Merit-Based Incentive Payment System under the 2018 Quality Payment Program? If so, the Centers for Medicare & Medicaid Services could tap you for a MIPS audit in the future. Here are some things to know to prepare your practice.


Too Big a Step? Medicine Urges CMS to Reverse New Step Therapy Policy - 11/02/2018

Medicine urges CMS to reverse new policy allowing “fail-first” drug programs known as step therapy.


Medicare Needs Your Help Creating Cost Measures - 10/30/2018

The Centers for Medicare & Medicaid Services and its contractor, Acumen, are field testing 13 cost measures before considering their potential use in the cost performance category of the Merit-Based Incentive Payment System of the Quality Payment Program in 2020 and beyond.


The Results Are In: Physicians Finally See How They Fared in First Year of MIPS - 10/16/2018

Physicians finally see how they fared in the first year of Medicare's "MIPS" quality payment program.


PAI Backs Medicare Move Toward Site-Neutral Payments - 10/04/2018

A Texas Medical Association-backed not-for-profit is on board with efforts to reverse current Medicare policy that pays more for the same service when it’s provided in a hospital outpatient department versus a physician’s office.


Three Things to Know About the New Medicare Cards - 07/25/2018

New Railroad Retirement Board Medicare cards are in the mail, and new Medicare cards for Texans will “mail soon,” according to the Centers for Medicare & Medicaid Services. Here are three things to know about the new cards and the new Medicare Beneficiary Identifier.


Feds Release Final Medicare Quality Scores - 07/17/2018

You’ve been waiting all year, and it’s finally here: Now you can find out if you’ll get a bonus or cut in your Medicare payments next year.