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Deadline Extended: Apply for a MIPS Reporting Exemption - 12/02/2020

Did your practice face an unusual extreme hardship this year, such as financial or staffing difficulties related to COVID-19? If so, you could qualify for an exception to the Merit-Based Incentive Payment System (MIPS) reporting requirements for the 2020 performance year. The application deadline has been extended to Feb. 1, 2021. The previous deadline was Dec. 31, 2020.


2020 MIPS Data Submission Deadlines Approaching - 12/02/2020

As the year comes to a close, it’s time to start preparing to submit 2020 performance data if you participated in Medicare’s Quality Payment Program (QPP) under the Merit-Based Incentive Payment System (MIPS).


List Cost on Medicare Radiopharma Claims - 12/01/2020

When billing Medicare for radiopharmaceutical procedure codes, you must list the total acquisition cost on the claim.


Timing for Annual Medicare Mammograms - 11/20/2020

Medicare counts 11 full months after the month in which the patient received her screening


CMS Relaxes Lookback Period for Medicare Overpayments - 11/20/2020

The Centers for Medicare & Medicaid Services (CMS) has spoken, finalizing a controversial rule and relaxing the lookback period physicians must adhere to when returning Medicare overpayments. In 2012, CMS proposed requiring physicians to return Medicare overpayments going back 10 years. The agency announced last week the required lookback period will be six years.


AMA Reiterates Cannabis Remains a “Serious Public Health Concern” - 11/19/2020

As more states relax marijuana use and possession laws, delegates at the American Medical Association’s Special Meeting voted Tuesday to clarify AMA policy to say that the association “believes that cannabis is a dangerous drug and as such is a serious public health concern.”


AMA Advocates for 24/7 Prior Authorization Processing - 11/19/2020

AMA delegates passed new policy on Tuesday that advocates for insurers and benefit managers who require prior authorization to have staff available to process  those approvals 24 hours a day, year-round, “including holidays and weekends.”


Delegates Support Expanding Telemedicine, Financial Relief Programs - 11/19/2020

As telemedicine expands because of the COVID-19 pandemic, physicians at the American Medical Association’s Special Meeting of the House of Delegates approved a measure on Tuesday that called for telemedicine’s use to continue beyond the national public health emergency.


AMA Policy Calls on Medicine to Oppose Racism, Recognize It as a Public Health Threat - 11/18/2020

At a Special Meeting of the American Medical Association House of Delegates, the nation’s physicians confronted racism nationwide by adopting several policies that recognize racism as a public health threat.


AMA Adopts Standards for “Public Option” - 11/18/2020

Delegates at the virtual Special Meeting of the American Medical Association passed new policy allowing AMA to advocate that any so-called “public option” proposal to expand health insurance coverage to the nation’s uninsured and underinsured must adhere to a set of standards that include protections for patients and physicians.


AMA Pushes to End National Clinical Skills Exams for U.S. Medical Students - 11/18/2020

American Medical Association (AMA) delegates called on AMA to urge the speedy end to the clinical skills part of the United States Medical Licensing Examination (USMLE) Step 2 and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 2 for U.S. medical students.


Physicians’ Hard Work Should Not Be Undone by Politics, AMA President Tells Delegates - 11/16/2020

Physicians nationwide will continue to tackle COVID-19’s unique and unforeseen challenges, American Medical Association President Susan R. Bailey, MD, said in opening remarks to the AMA House of Delegates as the November Special Meeting  kicked off Friday evening.


CMS Increases Advanced APM Thresholds for 2021 - 11/13/2020

If you participated in Medicare’s Quality Payment Program (QPP) this year as a Qualifying Alternative Payment Model Participant (QP), you’ll need to keep an eye on your status for 2021.


Texas Residents and Students Win AMA Leadership Posts - 11/10/2020

Several Texas residents and students nabbed American Medical Association leadership positions this past weekend during the AMA’s special interim meeting, which is being held virtually this year because of the COVID-19 pandemic.


TMA Questions QPP Data Showing Most Clinicians Will Receive Medicare Bonus in 2021 - 11/05/2020

The Centers for Medicare & Medicaid Services (CMS) has released preliminary data for the 2019 Medicare Quality Payment Program (QPP), which shows more than 95% of participating clinicians earned an incentive payment that they’ll see next year. However, Texas Medical Association experts are skeptical of the preliminary data.


CMS Announces Plans to Cover COVID-19 Vaccine - 10/29/2020

The Centers for Medicare & Medicaid Services (CMS) has released a rule to make COVID-19 vaccines available at no cost to Medicare, Medicaid, and CHIP patients.


Support Medicare Payment Parity for Another Year, TMA Tells Lawmakers - 10/26/2020

TMA is calling for passage of a bill that would require at least a one-year waiver of budget neutrality adjustments, which were part of the Centers for Medicare & Medicaid Services’ (CMS) proposed 2021 Medicare physician fee schedule, released in August.


TMA Balks at Proposed Medicare Payment Cut, More Changes to QPP During Pandemic - 10/12/2020

Physicians who renew their medical licenses after Sept. 1, 2020, are required to take one hour of CME that addresses human trafficking. TMA has now published its own CME course to educate physicians on how to identify, treat, and respond to people who are at risk or who have been trafficked.


Last Chance to Start Certain 2020 MIPS Reporting Tomorrow - 10/02/2020

If you participate in Medicare’s Quality Payment Program (QPP) under the Merit-Based Incentive Payment System (MIPS), you will have to report on the required measures – Promoting Interoperability and Improvement Activities – starting Saturday, Oct. 3.


TMA Opposes Bill Defining Clinical Psychologists as Physicians in Medicare - 09/28/2020

A broad swath of organized medicine, including the Texas Medical Association, is asking congressional leadership to oppose a bill that legally would consider clinical psychologists to be physicians within Medicare, saying it “inappropriately” expands psychologists’ scope of practice.


Code Carefully for Bilateral Procedures - 09/23/2020

Coding for bilateral procedures can be confusing. Many payers accept CPT modifier 50 as an indicator of a bilateral procedure, but they differ in how they apply it to their coding and payment policies.


All Things Medicare - 09/22/2020

Need help with Medicare payment issues or with Medicare coding? Do you need information about Medicare enrollment or about participation options? Or are you looking for information about the future of Medicare – what about the payment update, new provisions in the federal Affordable Care Act, new bonuses or new compliance requirements?


The X{EPSU} Modifiers Further Define Modifier 59 - 08/13/2020

Modifier 59, the distinct procedural service modifier associated with Medicare National Correct Coding Initiative edits, is one you might find confusing (many practices do). Follow these guidelines


Don’t Miss New and Revised LCDs - 08/13/2020

Take a look at these new and revised Medicare local coverage determinations (LCDs) and article updates from Novitas Solutions. Remember, Novitas will reject claims that don’t adhere to LCDs.


CMS’ 2021 Fee Schedule Proposal Could Lower Physician Pay - 08/12/2020

Payments to some physicians who treat Medicare patients would fall from 2020 levels under the Centers for Medicare & Medicaid Services’ (CMS’) proposed physician fee schedule for 2021. CMS last week released the annual draft rule, which also recommends updates to the Quality Payment Program (QPP).