Stories with related Professional Interests

Medicare Muzzle? New Rules May Make Physicians Reluctant to Speak Up - 05/20/2019

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


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. 


Correct Coding Initiative Edits Now Free on Internet - 03/04/2019

Correct Coding Initiative Edits Now Free on Internet


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.


How Will Quality Scores Affect Your 2019 Medicare Payments? Get an EIDM Account ASAP - 07/10/2018

The Centers for Medicare & Medicaid Services on July 1 will release final MIPS scores, performance feedback, and Medicare payment adjustment determinations (bonuses and penalties). But you’ll need an EIDM account to access your report card.


Tell the Feds About MIPS Burdens, Prevent a 2020 Penalty - 04/20/2018

Do you find collecting and reporting Medicare quality data to be challenging, time-consuming, costly, or meaningless? If so, here’s your chance to tell the feds about that burden.


Medicare Bonuses for Primary Care Expire Dec. 31 - 04/19/2018

Primary care doctors who see a high volume of Medicare patients need to brace themselves for a pay cut starting Jan. 1, 2016. A provision in the Affordable Care Act that provided Medicare payment bonuses to primary care physicians is expiring on Dec. 31. That means some Texas physicians will lose hundreds of thousands of dollars with the extinction of the Centers for Medicare & Medicaid Services Primary Care Incentive Payment Program, which aimed to narrow the gap in Medicare payments between primary care physicians and specialists.