On October 27, 2014, the Governor signed Pennsylvania General Assembly enacted House Bill 1846, which limits both the authority and the reimbursement of physicians and providers other than pharmacies for prescription drugs. It provides as follows:
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CMS has announced its concern regarding the level of compliance for documenting the face-to-face elements necessary for home health care certification.
Attached is an educational piece published by Novitas Solutions on its Part B website.
It lists the qualification criteria for home health benefits:
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In the proposed 2015 Medicare Physician Fee Schedule, CMS is seeking comments regarding expanding coverage for secondary interpretation of diagnostic imaging.
I’m enclosing pages 40370 and 40371 of the proposed Medicare Physician Fee Schedule. The enclosed material sites the Medicare Claims Processing Manual provisions which make is clear that a professional component interpretation service should…
In the recently proposed 2015 Physician Fee Schedule, CMS devoted significant resources to discussing potentially misvalued services, which I believe is code for places where CMS would like to reduce reimbursement. One of the areas is global surgery fees.
CMS has concerns with the 10 and 90 day global surgery fees because these global packages…
CMS has issued the Proposed 2015 Physician Fee Schedule and Fact Sheets for specific issues (ASC, ESRD, Home Health, Physician Quality Programs).
SGR Reduction
Although the Protecting Access to Medicare Act Prohibits any SGR reduction for the first 60 days of 2015, i.e., until March 1, 2015, CMS predicts a 20.9% decrease without legislative action.…
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html
http://online.wsj.com/news/articles/SB10001424052702303456104579490043350808268?mod=djemalertNEWS
The 2 links above should connect you to the total physician payment information by individual and specialty.
President Obama Signs the Protecting Access to Medicare Act of 2014On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients from taking effect on April 1, 2014. This new law |
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| March 31, 2014 – Special Alert: |
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| March 27, 2014 – Special Alert |
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Practical considerations to protect against being ‘out of network’
The disengagement of Highmark and UPMC is looming on the horizon; most of the hospital participation agreements between these two competing healthcare systems end on December 31, 2014. There are some hospital agreements that continue, such as those at Children’s and Magee, but the focus of…
