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No time to read all those wordy transmittals? Here’s news you can peruse in under 5 minutes. Catch up on the latest Medicare Part A/B news communicated via Medicare Learning Network (MLN) articles on your break. Below are summaries of notable coding and billing changes. FDA Retracts Bamlanivimab EUA The COVID-19 Public Health Emergency (PHE) […]
The post Take 5: Medicare News Flash – May 2021 appeared first on AAPC Knowledge Center.
Suspension of the 2 percent sequestration payment adjustment applied to all Medicare Fee-for-Service (FFS) claims is extended through Dec. 31 of this year. Participating clinicians will continue to receive full payment of their Medicare claims during this time. What’s This 2 Percent Payment Adjustment All About? A 2 percent FFS sequestration payment adjustment has been […]
The post 2% Medicare Pay Cut Suspended appeared first on AAPC Knowledge Center.
No time to read all those wordy transmittals? Here’s news you can peruse in under 5 minutes. Catch up on the latest Medicare Part A/B news communicated via Medicare Learning Network (MLN) articles on your break. Below are summaries of notable coding and billing changes. Do I have to repay the money I received from […]
The post Take 5: Medicare News Flash appeared first on AAPC Knowledge Center.
Alternatives to opioids bring conventional and complementary approaches together to manage chronic pain. In the face of an escalating opioid crisis, at least 100 million people with chronic pain aren’t getting the relief they need and are seeking alternatives. Despite recent advances in our understanding, diagnosis, and management of pain, a pain crisis exists, particularly […]
The post Pain Management: What Does Medicare Cover? appeared first on AAPC Knowledge Center.
Two owners of Guam Medical Transport (GMT) were sentenced to prison terms today for their roles in a health care fraud and money laundering scheme that resulted in a loss to the United States of approximately $ 10.8 million, one of the largest single Medicare ambulance fraud cases ever prosecuted by the Justice Department.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Shawn N. Anderson of the Districts of Guam and the Northern Mariana Islands, Special Agent in Charge Eli S. Miranda of the FBI’s Honolulu Field Office, Special Agent in Charge Justin Campbell of IRS Criminal Investigation (IRS-CI) Seattle Field Office and Special Agent in Charge Timothy DeFrancesca of the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) Los Angeles Regional Office made the announcement.
According to their admissions at the plea hearing, from approximately March 11, 2010, to approximately March 21, 2014, the defendants engaged in a conspiracy to defraud Medicare and TRICARE by submitting claims for reimbursement for medically unnecessary ambulance services that GMT provided to patients with ESRD.
As part of the scheme, the defendants directed GMT employees to remove from internal documents references to GMT patients’ ability to walk because they knew that Medicare and TRICARE would not provide reimbursement for the patients.
The post Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme appeared first on The Coding Network.
A 52-year-old pain management physician from Houston has paid $ 530,000 to resolve allegations he falsely billed Medicare for the use of electro-acupuncture devices, announced U.S. Attorney Ryan K. Patrick.
From March 1, 2019, to Oct. 31, 2019, Dr. Syed Nasir billed Medicare for the implantation of neurostimulator electrodes–a surgical procedure that usually requires use of an operating room.
The post Pain Doctor Pays to Settle Allegations of Deceptive Medicare Billing appeared first on The Coding Network.
Avoid Medicare claim errors and denials.
The post Test Your Medicare Smarts With Claims Q&A appeared first on AAPC Knowledge Center.
Just in time for new COVID-19 vaccine, administration, and treatment codes.
The post Medicare Finalizes COVID-19 Vaccine Payment Amounts appeared first on AAPC Knowledge Center.
Physician Fee Schedule proposed rule lays the groundwork for payment and policy changes in 2021.
The post CMS Proposes Medicare Telehealth Coverage in 2021 appeared first on AAPC Knowledge Center.
CMS distributes a prospectively determined amount of uncompensated care payments to “Medicare disproportionate share hospitals” based on their relative share of uncompensated care nationally.
As required under law, this amount is equal to an estimate of 75 percent of what otherwise would have been paid as Medicare disproportionate share hospital payments, adjusted for the change in the rate of uninsured people.
In this rule, CMS proposes distributing roughly $ 7.8 billion in uncompensated care payments in FY 2021, a decrease of approximately $ 0.5 billion from FY 2020.
For FY 2021, CMS proposes to use a single year of data on uncompensated care costs from Worksheet S-10 of the FY 2017 cost report to distribute these funds, in part because we have conducted audits of this data. Mindful of the unique challenges facing Indian Health Service and Tribal hospitals and Puerto Rico hospitals,
CMS proposes to continue to use data regarding low-income insured days (Medicaid days for FY 2013 and FY 2018 SSI days) to determine the amount of uncompensated care payments for Puerto Rico hospitals and Indian Health Service and Tribal hospitals for one more year (FY 2021), similar to the FY 2020 methodology.
In addition, CMS is proposing for all eligible hospitals, except Indian Health Service and Tribal hospitals, to use the most recent available single year of audited Worksheet S-10 data to distribute uncompensated care payments for all subsequent fiscal years.
We expect there to be an increasing number of hospitals audited for Worksheet S-10 with future cost reporting years.
As a result, we have confidence that the best available data in future years will be the Worksheet S-10 data for cost reporting years for which audits have been conducted.