HEALTHCARE NEWS
Stay Informed: Latest Updates and Insights in Healthcare!
Medicare Deductible, Coinsurance, Premium Rates and Therapy Cap Values for Calendar Year 2018
1/9/2018
Beneficiaries who use covered Part A services may be subject to deductible and coinsurance requirements. A beneficiary is responsible for an inpatient hospital deductible amount, which is deducted from the amount payable by the Medicare program to the hospital, for inpatient hospital servi...
New York State Workers’ Compensation Board: New Registration Requirement
12/5/2017
Recently, health care providers have started receiving letters from the New York State Workers’ Compensation Board.
Workers’ Compensation Board has initiated a registration process to update and maintain a list of medical providers who are authorized to treat injured workers....
The Merit-based Incentive Payment System (MIPS) Updates for 2018 Have Been Released
12/5/2017
Patients Over Paperwork
CMS has recently launched the “Patients Over Paperwork” Initiative, a cross-cutting, collaborative process that evaluates and streamlines regulations with a goal to reduce unnecessary burden, increase efficiencies, and improve the beneficiary experi...
Attention Managed Care Network Providers! New York State now requires all Healthcare providers to enroll with Medicaid.
11/1/2017
Effective January 1, 2018, Federal law requires that all Medicaid Managed Care and Children´s Health Insurance Program network providers to be enrolled with State Medicaid program.
Enrollment applications must be submitted to the Medicaid by December 1, 2017. Providers have less than 3...
Important reminder for Physicians who bill Certification and Recertification of Home Health Services to Medicare
11/1/2017
Physician’s services involved in physician certification (and recertification) of Medicare-covered home health services may be separately coded and reimbursed.
It is important to understand that the services are only covered for patients who receive Medicare-covered home health ...
New Prior Authorization Program Effective 10/1/2017 at Fidelis Care
10/3/2017
Fidelis Care has engaged eviCore Healthcare (eviCore) to implement a new prior authorization program effective October 1, 2017.
Prior authorization will be required for the following services:
Outpatient high-tech Radiology services
Outpatient Non-Obstetrical Ult...
Prolonged Services Without Face-to-Face Contact Now Separately Payable
8/18/2017
Beginning January 1, 2017, prolonged services without face-to-face contact are now separately payable under the Medicare Physician Fee Schedule. Prolonged services without face-to-face contact do not require face-to-face time with the patient, and may be rendered in an office, outpatient, hospi...
2017 Quality Payment Program Hardship Exception Now Available
8/18/2017
Certified electronic health record technology (CEHRT) is required to participate in the advancing care information performance category. MIPS-eligible clinicians and groups may qualify for a reweighting of their advancing care information performance category score to 0 percent of the fina...
Modernized National Plan and Provider Enumeration System More Responsive and Secure
7/20/2017
The Centers for Medicare & Medicaid Services (CMS) has modernized the National Plan and Provider Enumeration System (NPPES) with a unified login for type 1 and type 2 providers which increases security, provides new surrogacy functionality, has a more responsive user interface (UI) and...
Evaluation and Management: Correct Coding Crucial for Compliance
7/20/2017
In a study report about how “Improper Payments for Evaluation and Management Services Cost Medicare Billions in 2010,” the Office of the Inspector General (OIG) noted 42 percent of claims for Evaluation and Management (E/M) services were incorrectly coded and 19 percent la...
All Providers Must Revalidate Medicare Enrollment Information under Affordable Care Act Criteria Every Five Years; WCH Can Help With Provider Enrollment Revalidation – Cycle 2
7/20/2017
All Providers Must Revalidate Medicare Enrollment Information under Affordable Care Act Criteria Every Five Years; WCH Can Help With Provider Enrollment Revalidation – Cycle 2
In order to maintain Medicare billing privileges, all enrolled providers and suppliers must r...
Increase in Documentation Submitted Without a Valid Provider Signature Affects Payments
7/20/2017
National Government Services (NGS) is reporting an increase in documentation submitted without valid provider signature identification. This leads to claim denials that require time-consuming appeals.
All medical records must have either a written or electronically entered provider sig...
Providers Must Report Enrollment Information Changes By Dictated Deadlines
6/28/2017
All providers must report enrollment information changes to their Medicare Administrative Contractor (MAC) within 30 days for a change in ownership, an adverse legal action, or a change in practice location, or 90 days for all other changes. Failure to do so could result in the revocation of your Me...
Differentiated Coding for Expanded Problem Focused, and Detailed Levels of Evaluation and Management, No Longer Mandatory as of July 1
6/28/2017
Differentiation in examination requirements for Expanded Problem Focused (EPF, 2-5) and Detailed (6-7) levels of service developed by the National Government Services (NGS) will no longer be considered mandatory as of 7/1/2017. This delineation of levels, initiated in response to provider queries a...
New Medicare Cards Offer Greater Protection to More than 57.7 Million Americans
6/28/2017
New Medicare cards, which will begin mailing in April 2018, will no longer include Social Security numbers. This Centers for Medicare & Medicaid Services (CMS) fraud prevention initiative will help combat identity theft and safeguard taxpayer dollars.The new cards will use a unique, randomly-ass...