News & Analysis

November 1, 2017
Medicare Insider

This week’s Medicare updates include the quarterly listing of program issuances, a fact sheet on the federal health exchange’s 2018 open enrollment period, revised instructions for certificate of medical necessity and durable medical equipment information forms, and more! 

November 1, 2017
Briefings on APCs

In July, Utah pain doctor Jahan Imani, MD, and Intermountain Medical Management, P.C., entered into a nearly $400,000 settlement with the OIG to resolve allegations that Imani’s practice submitted false or fraudulent claims due to improper modifier use for payment by improperly using modifier -59 with HCPCS code G0431.

November 1, 2017
Briefings on APCs

Section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA) added a requirement that will dramatically revise the Medicare Clinical Laboratory Fee Schedule (CLFS) effective January 1, 2018.

November 1, 2017
Briefings on APCs

Patient care continues to move from the inpatient setting to outpatient. With this change, the challenge of securing comprehensive documentation that articulates the services rendered and the patient care provided now needs to extend across the care continuum. 

October 26, 2017
Medicare Insider

This week’s note is the second in a series of articles examining coding, billing, and payment rules for rural health clinics.

October 25, 2017
Medicare Insider

This week’s Medicare updates include additional government guidance on wildfires and hurricanes, modifications to proof of delivery requirements, clarification on billing of immunosuppressive drugs, and more! 

Pages