The President and Congress extended Medicare telehealth coverage in the Consolidated Appropriations Act, which also included additional Ukrainian relief.
On Tuesday, March 15, 2022, President Biden signed the Consolidated Appropriations Act, 2022 (“2022 CAA”). This new law includes several provisions that extend the Medicare telehealth waivers and flexibilities, implemented as a result of COVID-19 to…
Highmark Health issued a Press Release on February 7, 2022 announcing that it’s Financial Investigations and Provider Review (FIPR) department generated more than $245 million in savings related to fraud waste and abuse in 2021, the majority of which was in Pennsylvania–$184 million.
Click here to see to what the Highmark FIPR Department has identified…
There has been much discussion and controversy over the new CMS position on billing for split/shared services in facility settings.
As originally proposed, and starting in January 2022, if the service was shared among providers (such as physicians and physician assistants), the provider who performed the substantive portion of the visit would be the provider…
There is almost universal agreement regarding predictions for 2022 federal enforcement in the following areas:
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Under the Federal Ethics in Patient Referrals Act (more commonly known as “Stark”), if a physician[1] has a financial relationship with an entity, the physician may not refer patients to the entity for medical services payable by Medicare unless the financial relationship complies with the Stark safe harbors. Thus, entities that lease or sublease…
In MLN Matters article MM 12159, CMS has published summaries of the following:
Mike Cassidy will be one of the panelists discussing “The Myths About Telehealth: Telefraud vs. Telemedicine Fraud” at the virtual CTeL Digital Health Summit on Thursday, December 16, 2021.
CMS has announced a delay to implementation of PECOS Multi-Factor Authentication in the MLN Connects publication on Thursday, December 9, 2021: 2021-12-09-MLNC | CMS. This is a link to the publication and in the link you will find links to the PECOS announcements.
A recent Wall Street Journal article in their “The Future of Everything” commentary stream discusses the use of artificial intelligence (AI) to “tap the treasure trove of information locked in electronic health records to treat people in real time”.
An interesting concept. Not all that long ago this would have been disparaged as…
The Centers for Medicare & Medicaid Services (CMS) issued an interim final rule requiring COVID-19 vaccinations for workers in most institutional care settings. A copy of the CMS press release can be found at https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care.
This rule applies to those facilities subject to CMS regulations. Several facilities are regulated by the CMS, but this…
