HEALTHCARE NEWS

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...

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...

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...

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...

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...

Effective January 1, 2016, the New York telehealth coverage law prohibited commercial insurers and health maintenance organizations from “excluding from coverage a service that is otherwise covered under an enrollee contract because the service is delivered via telehealth.” (NY State Pu...

Effective July 1, 2017, the Centers for Medicare & Medicaid Services (CMS), in partnership with the New York State Office of the Medicaid Inspector General (OMIG), will be measuring improper payments in the Medicaid and State Child Health Insurance programs under the Payment Error Rate Measureme...

Prescribers licensed under Title Eight of the Education Law in New York to treat people, and who have a Drug Enforcement Administration (DEA) registration to prescribe controlled substances—as well as medical residents who prescribe controlled substances under a facility DEA registration numbe...

Retroactive to July 1, 2016, Medicaid will no longer reimburse the full Medicare Part C copay or coinsurance amount.Pursuant to 2016 changes to Social Services Law, the New York State Department of Health has revised the Medicaid reimbursement methodology for claims containing Medicare Part C (Medic...

The Commissioner of Health has approved a new blanket waiver with respect to the electronic prescribing requirements of Public Health Law (PHL) § 281 and Education Law § 6810. Effective March 26, 2017, this waiver replaces and supersedes the prior blanket waiver, issued by letter dated Mar...

Eligible professionals (EP) who are not meaningful users of certified electronic health record (EHR) technology under the Medicare EHR Incentive Program may be exempt from Medicare penalties if they can show meaningful use would result in a significant hardship.To be considered for an exemption and ...

The New York State Department of Health has determined that many providers are at risk for not being paid for their services because the ordering/prescribing/referring (OPR) provider has not complied with a federal regulation which requires state Medicaid agencies to revalidate enrollment of all pro...

An eligible professional who has never successfully attested to meaningful use under the EHR Incentive Program, and is transitioning to the MIPS in Program Year 2017, may submit this Click here for instructions.  

In January 2017, the Centers for Medicare & Medicaid Services (CMS) approved payment for a new G-code, G0505, which describes assessment and care plan services for patients with cognitive impairment. This code will likely be converted to a permanent CPT code, approved by the CPT Editorial Panel,...

Medicare covers an Annual Wellness Visit (AWV) providing Personalized Prevention Plan Services (PPPS). Medicare covers the AWV for beneficiaries who are not within the first 12 months of their first Part B coverage period and have not received an Initial Preventive Physical Examination (IPPE) or AWV...