A jury in New Orleans has convicted four employees of medical service clinics for their roles in a $50 million Medicare fraud scheme. Assistant Attorney General Leslie R. Caldwell of the Justice Department's Criminal Division, U.S. Attorney Kenneth A. Polite of the Eastern District of Louisiana, Special Agent in Charge Michael J. Anderson of the FBI's New Orleans Field … [Read more...] about New Orleans jury convicts two doctors, a nurse, and an office manager for roles in $50 million fraud scheme
Billing and collections
SGR repeal emphasizes move to value-based payments
After a long and winding road, the sustainable growth rate (SGR) is finally part of history and the move to value-based payments has renewed urgency now that the Medicare Access and CHIP Reauthorization Act of 2015 (Act) has become law. The Act became law April 16, 2015, repealing the SGR and establishing the following conversion factor updates: 0.0% for January 1, 2015 through … [Read more...] about SGR repeal emphasizes move to value-based payments
Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
By Judy Monestime bio Chapter 21 in ICD-10-CM contains codes for factors influencing health status and contact with health services. There are differences in ICD-10-CM from what is currently found in ICD-9-CM. Some categories in Chapter 21 have rephrased titles to better reflect the situations the codes classify. For example, elective, legal, or therapeutic abortions have … [Read more...] about Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
Miami medical office manager convicted of Medicare fraud
A former office manager of a Miami-based physical and occupational therapy clinic was convicted, following a four-day trial, for her participation in a scheme that involved the fraudulent submission of more than $3.3 million in false billing to Medicare. Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, and Shimon Richmond, Special Agent in … [Read more...] about Miami medical office manager convicted of Medicare fraud
ICD-10 research reveals physicians’ views
Clinical documentation and reimbursement lead the list of concerns that physicians have about ICD-10, according to new research from the CAREinnoLab of Care Communications, Inc., a provider of health information solutions, and the Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh. Patty Sheridan, … [Read more...] about ICD-10 research reveals physicians’ views
How to choose the electronic medical records vendor that’s right for you
Choosing the right electronic medical records vendor for your practice can seem like an overwhelming task—and getting it right is crucial. Before any other considerations, you want to be sure than any vendor you are considering is HITECH certified for 2014, so that you can achieve meaningful use stages one and two. This will also ensure HIPAA compliance. Beyond that the options … [Read more...] about How to choose the electronic medical records vendor that’s right for you
Money motivates EHR adoption
The Department of Health and Human Services' Office of the National Coordinator released a data brief in December addressing what motivates physicians to implement electronic health records (EHR) and the answer is … money. The data briefing reveals that financial incentives and reimbursement are currently the top reasons physicians decide to implement EHR. Physicians are … [Read more...] about Money motivates EHR adoption
Is your practice an OIG enforcement target in 2015?
The Office of Inspector General (OIG), which oversees Medicare and Medicaid enforcement, has issued its 2015 Work Plan highlighting the compliance risk areas that it will target in its review and enforcement efforts. You will see some familiar topics, which the OIG also included in last year's plan, such as chiropractic services, place of service reporting, physical therapy, … [Read more...] about Is your practice an OIG enforcement target in 2015?
CMS Medicare physician fee schedule for 2015 Final Rule released
The Physician Fee Schedule Final Rule was published November 13, 2014. It provides not only new payment rates but also changes to Medicare payment policies. Here is a summary of some changes that could affect your medical office. Telehealth services. Specific telehealth services must be included in the list of Medicare telehealth services and meet other conditions for … [Read more...] about CMS Medicare physician fee schedule for 2015 Final Rule released
HIPAA audits looming and small practices far from compliant
A recent survey on HIPAA compliance within small practices and billing companies, conducted by NueMD, a provider of cloud-based medical practice management software for small practices, and The Daniel Brown Law Group, a firm specializing in health care law, finds medical practices and billing companies are struggling to comply with regulations under the Health Insurance … [Read more...] about HIPAA audits looming and small practices far from compliant