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medicare

Are you being underpaid by medicare advantage organizations?

What’s the Problem? Sequestration underpayments have been improperly withheld from provider payments by many Medicare Advantage Organizations [MAO] in violation of CMS guidelines that were issued on May 1, 2013.

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CMS looking to define enforcement for its hospital price transparency rule

Now that hospitals are required to post chargemaster data online for patients to access, the Centers for Medicare & Medicaid Services is exploring the most effective ways to make sure providers comply with the rules.

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CMS looks to expand medicare coverage to CAR-T therapy

CMS plans to cover a specific kind of immunotherapy for cancer patients.

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Fewer doctors are opting out of Medicare

The CMS saw a sharp decrease in the number of providers opting out of Medicare in 2017, after several years where thousands indicated that they did not want to participate in the program.

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Kaiser family foundation introduces a valuable tool for medicare advocates

In the past several years, the Center for Medicare & Medicaid Innovation (CMMI), part of the Centers for Medicare & Medicaid Services (CMS), has designed and implemented demonstration projects and models to try new ways of paying providers to deliver health care to people with Medicare. These tests of new designs attempt to see if […]

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Medicare overpaid docs billions for office visits, OIG says

Medicare overpaid physicians $6.7 billion in 2010 for evaluation and management services, HHS’ Office of Inspector General said in a study released Thursday. The overpayments, which allegedly stemmed from incorrect coding and poor documentation, accounted for more than one-fifth of the $32.3 billion the CMS paid for E/M services that year. E/M services are basic […]

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Medicare revalidations

If you have received a request from Medicare to revalidate your provider information, please complete all steps immediately to avoid interruption of your Medicare payments or cancellation of your contract. All changes can be updated through the Medicare PECOS website:

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Preparing your practice for new medicare beneficiary IDs

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) goes into full effect in April 2019, so now is a good time to start preparing for it. Since Social Security Numbers (SSN) will no longer be a means of identifying patients, updating your physician practice management systems and processes will be imperative to keep […]

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