Administration considering ban on “surprise” medical bills
Politico (5/27, Luthi, Roubein) reports the administration is “floating a plan that would outlaw health care providers from putting patients on the hook for thousands of dollars in expenses” as part of “surprise” medical bills, but the plan has not mandated “how doctors and hospitals would recover their costs from insurers, according to administration officials, Capitol Hill aides and industry lobbyists familiar with discussions.” However, “powerful doctors groups,” such as the American Medical Association, are “wary of a policy that only bans the practice and doesn’t include a way to resolve payment disputes,” contending “the approach would leave health insurers with too much leverage.” AMA President Patrice A. Harris, M.D., M.A., said in a statement, “As there is no balance billing for COVID testing and treatment under most types of insurance, there is no need to rush these significant policy changes as part of the next COVID relief package.”
Politico (5/27, Luthi, Roubein) reports the administration is “floating a plan that would outlaw health care providers from putting patients on the hook for thousands of dollars in expenses” as part of “surprise” medical bills, but the plan has not mandated “how doctors and hospitals would recover their costs from insurers, according to administration officials, Capitol Hill aides and industry lobbyists familiar with discussions.” However, “powerful doctors groups,” such as the American Medical Association, are “wary of a policy that only bans the practice and doesn’t include a way to resolve payment disputes,” contending “the approach would leave health insurers with too much leverage.” AMA President Patrice A. Harris, M.D., M.A., said in a statement, “As there is no balance billing for COVID testing and treatment under most types of insurance, there is no need to rush these significant policy changes as part of the next COVID relief package.”
Critical-access, acute-care hospitals received more than 80% of $100 billion CMS sent to providers during pandemic
Content Provided by: Modern Healthcare
Modern Healthcare (5/20, Cohrs, Subscription Publication) reports, “Acute-care and critical-access hospitals received more than 80% of the $100 billion that CMS sent out to providers to help improve their cash flow as revenue dried up due to the COVID-19 pandemic.” Providers who had “heavy Medicaid payer mixes were eligible for proportionally fewer funds than those with more Medicare patients.” In addition, “Medicaid providers were also disadvantaged by the formula used by HHS to distribute grant funds.”
Content Provided by: Modern Healthcare
Modern Healthcare (5/20, Cohrs, Subscription Publication) reports, “Acute-care and critical-access hospitals received more than 80% of the $100 billion that CMS sent out to providers to help improve their cash flow as revenue dried up due to the COVID-19 pandemic.” Providers who had “heavy Medicaid payer mixes were eligible for proportionally fewer funds than those with more Medicare patients.” In addition, “Medicaid providers were also disadvantaged by the formula used by HHS to distribute grant funds.”
Strategic Alliance Provides a Wealth of Resources for Physician Practices
Cobbe Consulting & Management (CCM) and Acevedo Consulting Incorporated (ACI) today announced a strategic partnership to provide coding, compliance and regulatory training for our physician practices.
This partnership will make multiple programs available for our members that cover topics such as CPT, HCPCS, ICD-10-CM, third-party billing rules, reimbursement, as well as other services necessary to navigate the complex world of healthcare. Acevedo Consulting Incorporated specializes in coding, compliance, appeals, due diligence, HIPAA, education, physician and staff training, and more. All consultants at ACI are credentialed by the AAPC, Health Care Compliance Association and/or AHIMA.
The healthcare industry is ever evolving and so are the guidelines that practices must follow. Working in such a highly regulated industry requires strict adherence for regulatory compliance. Cobb Consulting is working to ease that burden for its members by providing access to a firm that specializes in compliance. The partnership between CCM and ACI helps ensure that physician practices have a trusted resource to help them navigate regulatory compliance.
“Acevedo Consulting Incorporated is known for their professional expertise and does phenomenal work for their clients. This partnership will help us better serve our members by giving them access to such a great firm,” said Fraser Cobbe, CEO of Cobbe Consulting & Management.
About Cobbe Consulting & Management
Cobbe Consulting & Management is an Association Management Company that specializes in representing medical associations across the country with a strong presence throughout the State of Florida. With over 20 years of experience in organized medicine, CCM represents some of the largest and historically significant organizations in the state including: Bones Society of Florida, Dade County Medical Association, Duval County Medical Society, Florida Orthopaedic Society, Florida Society of Nephrology, and the Physicians Society of Central Florida. CCM specializes in delivering unique programs and services and educational opportunities to the thousands of physicians and medical executives they represent in their family of organizations.
About Acevedo Consulting Incorporated:
Our consulting staff is nationally recognized for its expertise and our consultants are credentialed by the Health Care Compliance Association (HCCA), American Academy of Professional Coders (AAPC) and/or the American Health Information Management Association (AHIMA). The consultants’ 100+ years of combined and varied experience in the health care field are invaluable to the firm’s clients. Besides the requisite coding and compliance credentials and expertise, our consultants’ experiences range from serving in upper-level administrative and compliance positions for large hospital-based physician organizations and health plans. Members of our team are often lecturing at national organization and specialty society conferences, serving as an Investigative Consultant for the Department of Justice (DOJ) and as the IRO for organizations under a CIA. Acevedo Consulting often serves as an expert witness, renders opinions on expected fraudulent billing, assists with overpayment appeals, and conducts pre-acquisition and pre-employment Due Diligence.
Cobbe Consulting & Management (CCM) and Acevedo Consulting Incorporated (ACI) today announced a strategic partnership to provide coding, compliance and regulatory training for our physician practices.
This partnership will make multiple programs available for our members that cover topics such as CPT, HCPCS, ICD-10-CM, third-party billing rules, reimbursement, as well as other services necessary to navigate the complex world of healthcare. Acevedo Consulting Incorporated specializes in coding, compliance, appeals, due diligence, HIPAA, education, physician and staff training, and more. All consultants at ACI are credentialed by the AAPC, Health Care Compliance Association and/or AHIMA.
The healthcare industry is ever evolving and so are the guidelines that practices must follow. Working in such a highly regulated industry requires strict adherence for regulatory compliance. Cobb Consulting is working to ease that burden for its members by providing access to a firm that specializes in compliance. The partnership between CCM and ACI helps ensure that physician practices have a trusted resource to help them navigate regulatory compliance.
“Acevedo Consulting Incorporated is known for their professional expertise and does phenomenal work for their clients. This partnership will help us better serve our members by giving them access to such a great firm,” said Fraser Cobbe, CEO of Cobbe Consulting & Management.
About Cobbe Consulting & Management
Cobbe Consulting & Management is an Association Management Company that specializes in representing medical associations across the country with a strong presence throughout the State of Florida. With over 20 years of experience in organized medicine, CCM represents some of the largest and historically significant organizations in the state including: Bones Society of Florida, Dade County Medical Association, Duval County Medical Society, Florida Orthopaedic Society, Florida Society of Nephrology, and the Physicians Society of Central Florida. CCM specializes in delivering unique programs and services and educational opportunities to the thousands of physicians and medical executives they represent in their family of organizations.
About Acevedo Consulting Incorporated:
Our consulting staff is nationally recognized for its expertise and our consultants are credentialed by the Health Care Compliance Association (HCCA), American Academy of Professional Coders (AAPC) and/or the American Health Information Management Association (AHIMA). The consultants’ 100+ years of combined and varied experience in the health care field are invaluable to the firm’s clients. Besides the requisite coding and compliance credentials and expertise, our consultants’ experiences range from serving in upper-level administrative and compliance positions for large hospital-based physician organizations and health plans. Members of our team are often lecturing at national organization and specialty society conferences, serving as an Investigative Consultant for the Department of Justice (DOJ) and as the IRO for organizations under a CIA. Acevedo Consulting often serves as an expert witness, renders opinions on expected fraudulent billing, assists with overpayment appeals, and conducts pre-acquisition and pre-employment Due Diligence.
Bill Correctly for Medicare Telehealth Services (2/2020)
In a recent report, the Office of Inspector General (OIG) determined that the Centers for Medicare & Medicaid Services (CMS) improperly paid practitioners for some telehealth claims associated with services that did not meet Medicare requirements. CMS released the Medicare Telehealth Services video to help you bill correctly.
Additional resources:
Source: CMS
In a recent report, the Office of Inspector General (OIG) determined that the Centers for Medicare & Medicaid Services (CMS) improperly paid practitioners for some telehealth claims associated with services that did not meet Medicare requirements. CMS released the Medicare Telehealth Services video to help you bill correctly.
Additional resources:
- Telehealth Services (PDF) Medicare Learning Network Booklet
- Medicare Claims Processing Manual, Chapter 12 (PDF), Section 190
- Medicare Telehealth Payment Eligibility Analyzer
- List of Covered Telehealth Services webpage
- CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements OIG Report
Source: CMS
Over 1,500 health care organizations hit with successful ransomware attacks since 2016, report says
HealthIT Security (2/13, HealthITSecurity) reports “more than 1,500 health care organizations have been hit with successful ransomware attacks since 2016, costing the sector over $160 million during that time, according to a recent report from Comparitech, a company that provides consumers with privacy information, tools, and comparisons.”
HealthIT Security (2/13, HealthITSecurity) reports “more than 1,500 health care organizations have been hit with successful ransomware attacks since 2016, costing the sector over $160 million during that time, according to a recent report from Comparitech, a company that provides consumers with privacy information, tools, and comparisons.”
House committee approves surprise billing legislation
The Hill (2/11, Sullivan) reports the House Education and Labor Committee approved a bill that would protect patients from surprise medical bills. The article says that the bill will now be sent to the full House alongside competing bills.
The Hill (2/11, Sullivan) reports the House Education and Labor Committee approved a bill that would protect patients from surprise medical bills. The article says that the bill will now be sent to the full House alongside competing bills.
House Ways and Means Committee releases legislation on surprise medical bills
The Hill (2/7, Sullivan) reported the House Ways and Means Committee “released their legislation to protect patients from getting massive, surprise medical bills, as congressional action on the subject intensifies.” Reps. Richard Neal and Kevin Brady, the committee’s leaders, both support the legislation, which “would protect patients from getting bills for thousands of dollars when they go to the emergency room and one of their doctors happens to be outside their insurance network.”
The Hill (2/7, Sullivan) reported the House Ways and Means Committee “released their legislation to protect patients from getting massive, surprise medical bills, as congressional action on the subject intensifies.” Reps. Richard Neal and Kevin Brady, the committee’s leaders, both support the legislation, which “would protect patients from getting bills for thousands of dollars when they go to the emergency room and one of their doctors happens to be outside their insurance network.”
310 ASCs with total joint replacements
Source: Becker's Healthcare
Written by Laura Dyrda | April 29, 2019
Total joint replacements are moving to the outpatient setting, with more than 300 ASCs across the country including total knee and hip procedures.
Here is a list of those centers. To add a center to this list, contact Laura Dyrda at ldyrda@beckershealthcare.com.
Written by Laura Dyrda | April 29, 2019
Total joint replacements are moving to the outpatient setting, with more than 300 ASCs across the country including total knee and hip procedures.
Here is a list of those centers. To add a center to this list, contact Laura Dyrda at ldyrda@beckershealthcare.com.
South Carolina
- Carolina Bone & Joint Surgery Center (Myrtle Beach, S.C.).
- Carolina Coast Surgery Center (Murrells Inlet, S.C.)
- Charleston Surgery Center (North Charleston, S.C.)
- Lowcountry Outpatient Surgery Center (Summerville, S.C.)
- Midlands Orthopedic Surgery Center (Columbia, S.C.)
- Spartanburg (S.C.) Surgery Center
- Surgery Center at Pelham (Greer, S.C.)