POPULARITY
8 episodes with medicare physician fee schedule
7 episodes with medicare physician fee schedule
6 episodes with medicare physician fee schedule
5 episodes with medicare physician fee schedule
5 episodes with medicare physician fee schedule
5 episodes with medicare physician fee schedule
3 episodes with medicare physician fee schedule
4 episodes with medicare physician fee schedule
3 episodes with medicare physician fee schedule
This week in the Breakroom, Jeffrey Davis and Rachel Hollander join Maddie News to break down major payment policies in the 2026 Medicare Physician Fee Schedule proposed rule. Read more in our regs & eggs blog post.
ACRO's SOAP (Spotlight on Advocacy and Policy) Podcast provides public policy awareness to the radiation oncology community. During this episode, our hosts Drs. Tarita Thomas and Anna Brown of the ACRO Government Relations & Economics Committee (GREC) discuss the development of the Medicare Physician Fee Schedule with Dr. Paul Wallner, fellow GREC member, Teri Bedard, Revenue Cycle Coding Strategies, and Jason McKitrick, Liberty Partners Group.
In part three of this three-part series, Dr. Jason Crowell and Max Goldman discuss potential legislative actions affecting the 2025 Medicare Physician Fee Schedule. Show references: Fee for Service Page Webinar sign up link Full Physician Fee Schedule Final Rule
In part one of this three-part series, Dr. Jason Crowell and Matt Kerschner discuss the key updates and changes to the Medicare Physician Fee Schedule for 2025. Show references: Fee for Service Page Webinar sign up link Full Physician Fee Schedule Final Rule
Welcome to this episode of the TMA Practice Well podcast, hosted by Cheryl Krhovjak, Director of the TMA Education Center. In this insightful discussion, we are joined by Robert Bennett, TMA Vice President of Medical Economics, to delve into the significant impact of Medicare 2025 physician fee schedule. With over 65 million beneficiaries, Medicare is a key player in health care, and its spending is projected to surge in the coming years. Robert highlights the recent updates in the 2025 Medicare Physician Fee Schedule, including anticipated reductions in conversion factors unless Congress intervenes. This episode underscores the challenges faced by health care practices due to administrative burdens and payment cuts, which threaten patient access to physicians. The episode also discusses legislative efforts such as the Medicare Payment Access and Practice Stabilization Act of 2024 and the Strengthening Medicare for Patients and Provider Act, aimed at stabilizing physician payments and ensuring fair inflationary updates. Listeners are encouraged to advocate for these changes to protect their practice and patients. Additionally, discover the resources offered by the Texas Medical Association, including the Physician Payment Resource Center, to assist Texas physicians in navigating billing, coding, and payment challenges. Tune in for actionable insights and tips to help your practice thrive in the evolving healthcare landscape. Medicare Payment Reform Center Medicare Patient Outreach Flyer Physician Payment Resource Center (PPRC) 2025 Medicare Physician Fee Schedule Ondemand Webinar
Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers is joined by Jason Resendez, President and CEO of the National Alliance for Caregiving, to discuss the recent finalization of CMS's 2025 Medicare Physician Fee Schedule and how these policies will impact family caregivers and the integration of these individuals into the health care system. Health Affairs's Research and Justice For All podcast returns for its second season, focusing on drivers of health. Check out the first episode. Check out the 200th episode of A Health Podyssey featuring Leemore Dafny of the Harvard Business School discussing vertical integration. Join Health Affairs on November 20 for a virtual event with John Bowblis examining how the loss of public health emergency funds challenges the financial viability of nursing homes.Related Articles:PRESS RELEASE: HHS Finalizes Physician Payment Rule Strengthening Person-Centered Care and Health Quality Measures 11/20/2024: Caregiver Nation Summit (Agenda and Virtual Attendance Options) Subscribe to UnitedHealthcare's Community & State newsletter.
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 4 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 13th Season starts up and Episode 11 features a Newsworthy update on the OIG Work Plan for October 2024. Sonal's Trusty Tip and compliance recommendations focus on reading and analyzing Final Rules as they are released. Sonal shares a few highlights from the 3,088-page Medicare Physician Fee Schedule Final Rule for 2025. Spark inspires us all to reflect on insight and wisdom based on the inspirational words of Mahatma Gandhi. Thanks to HCPro: Check out their Boot Camps: www.hcmarketplace.com Paint The Medical Picture Podcast now on: Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3X Apple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177 Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcast Find Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7A Find Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/ And checkout the website: https://paintthemedicalpicturepodcast.com/ If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com --- Support this podcast: https://podcasters.spotify.com/pod/show/sonal-patel5/support
Rachel Stauffer joins Julia Grabo to discuss the virtual care provisions in CMS' recently released calendar year 2025 Medicare Physician Fee Schedule final rule.
ACRO's SOAP (Spotlight on Advocacy and Policy) Podcast provides public policy awareness to the radiation oncology community. During this episode, Drs. Tarita Thomas and Anna Brown, discuss the comment letter filed with CMS regarding the 2025 Medicare Physician Fee Schedule Proposed Rule. They are joined by Jason S. McKitrick, a Principal with DC based firm, Liberty Partners.
UCA's Advocacy efforts recently achieved a milestone - inclusion of Urgent Care in the 2025 Medicare Physician Fee Schedule publication issued by CMS. This episode goes into more details about what that means, why it's important, what happens next, and when those efforts might directly impact Urgent Care centers. Guests are Eric Zimmerman from McDermott+ and Kristin Rastatter of the Urgent Care Association.Links mentioned:https://urgentcareassociation.org/uc-advocacy/https://urgentcareassociation.org/about/the-people-behind-uca/kristin-rastatter/
Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs Editor-in-Chief Alan Weil welcomes Liz Fowler, Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services, to A Health Podyssey to discuss the future of health care payments, CMMI's specialty care strategy, mandatory models versus voluntary alternative payment models, CMS' newly-proposed Medicare Physician Fee Schedule for 2025, and more!Related Articles from Liz Fowler on Health Affairs:The CMS Innovation Center's Strategy To Support Person-Centered, Value-Based Specialty Care: 2024 UpdateAdvancing Health Equity Through Value-Based Care: CMS Innovation Center UpdateUpdate On The Medicare Value-Based Care Strategy: Alignment, Growth, EquityOrder the July 2024 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone. Subscribe to UnitedHealthcare's Community & State newsletter.
Chemyeeka Tumblin, a Licensed Marriage and Family Therapist specializing in Perinatal and Maternal Mental Health, outlines the importance of Black Maternal Health Week; Jeffrey Ekoma, ASTHO's Senior Director for Government Affairs, discusses ASTHO's FY25 Governmental Public Health Appropriations Book; and an ASTHO resource will take you through all the changes to the Medicare Physician Fee Schedule. CDC Webpage: Working Together to Reduce Black Maternal Mortality ASTHO Webpage: FY25 Governmental Public Health Appropriations Book ASTHO Webpage: Changes to 2024 Medicare Physician Fee Schedule for CHI Services ASTHO Webpage: Legislative Alerts ASTHO Webpage: Stay Informed
How the AMA is addressing the most significant problems facing doctors in medicine today: Medicare payment reform, fixing prior authorization, reducing physician burnout, as well as making healthcare technology an asset not a burden. AMA Senior Vice President of Advocacy Todd Askew joins AMA CXO Todd Unger for a live chat at this year's National Advocacy Conference.
By Adam Turteltaub The 2024 CMS Medicare Physician Fee Schedule extends no less than ten different pandemic flexibilities related to telehealth. In this podcast, Randi Seigel, partner and Jared Augenstein, managing director, at Manatt take us through all of them, including in-person visit requirements, audio-only services, physician supervision and opioid treatment. They also address: Changes in the structure of the telehealth services list Changes to payment by place of services Remote psychological and therapeutic monitoring Enrollment and revocation A new opportunity for payments for social needs of Medicare beneficiaries Listen in to learn more about what's new, what's the same, and what will sunset at the end of 2024.
Jeffrey Davis joins Julia Grabo to discuss the so-called "doc fix" that would prevent some or all of the 3.37% cut to the Medicare Physician Fee Schedule conversion factor. They also explore what congressional action would look like and address why it's a hot topic now.
The real-world consequences of declining Medicare physician payment. From, 2001 to 2023, Medicare payment has declined 26% when adjusted for inflation. Alice Coombs, an anesthesiologist and internist at Virginia Commonwealth University Health joins to discuss the ways this underpayment impacts physicians and patient care, including longer wait times and less access to care. Dr. Coombs also shares how physicians can advocate for change based on her experience as the president of the Medical Society of Virginia. American Medical Association CXO Todd Unger hosts.
In this episode of the MGMA Week in Review podcast, we welcome MGMA editor and writer Colleen Luckett to the show to share her thoughts on the latest MGMA Stat on the 2024 Medicare Physician Fee Schedule. Sources: MGMA Stat: https://www.mgma.com/mgma-stat/social-determinants-of-health-a-driving-force-in-medical-group-data-collection Physician Fee Schedule: 2024 Medicare Physician Fee Schedule Resources: MGMA Stat: mgma.com/stat Ask an Advisor: www.mgma.com/ask-an-advisor MGMA Membership: www.mgma.com/membership MGMA Advocacy: www.mgma.com/advocacy MGMA Consulting: www.mgma.com/consulting/overview If you would like additional tools and resources related to medical practice leadership or you have stories to share with us, email us at podcasts@mgma.com or email Daniel Williams directly at dwilliams@mgma.com. Thank you again for taking the time to listen to the MGMA podcast network.
Medicare must change, and the AMA is fighting nonstop to make payment reform a reality. Chair of the AMA Board of Trustees Willie Underwood III, MD, MSc, MPH, joins to discuss the AMA's advocacy to fix Medicare now, including the campaign's wins to date and what's next. American Medical Association CXO Todd Unger hosts.
Physician Medicare payment is down 26% since 2001, when adjusted for inflation. When you look at the numbers, it's clear that the government needs to fix Medicare now for physicians. Jason Marino, director of Congressional affairs for the AMA, joins to break down the facts and figures and explain why reforming Medicare physician payment just makes sense. American Medical Association CXO Todd Unger hosts.
Dive into the current cardiology coding landscape and what lies ahead, from understanding "incident to" billing practices and ICD-10 modifications, to navigating the 2024 Medicare Physician Fee Schedule and addressing prevalent denial trends facing cardiology practices. Julie Graham, Infinx Senior Coding Manager, joins us with her vast experience of over 20 years in the field. She sheds light on these topics and offers actionable insights to overcome common challenges. Brought to you by www.infinx.com
Matt Kershner, Director, of Regulatory Affairs & Policy, at the American Academy of Neurology, discusses the 2024 Medicare Physician Fee Schedule Proposed Rule. Show references: https://www.aan.com/advocacy/capitol-hill-report This episode was sponsored by the ExTINGUISH Trial for NMDAR Encephalitis: Call 844-4BRAIN5 to refer patients.
Howie and Harlan are joined by Melissa Davis, a Yale radiologist and a graduate of Yale SOM's MBA for Executives program, to discuss the ‘whoa' moments and the weaknesses she has encountered using artificial intelligence to help interpret scans. Harlan reflects on the slow progress toward a healthcare system that rewards value rather than volume; Howie reports on new treatments for Alzheimer's disease. Links: “Robert F. Kennedy Jr. suggests covid was designed to spare Jews, Chinese people” “The Medicare Physician Fee Schedule and Unethical Behavior” “Vinod Khosla: Machines will replace 80 percent of doctors” “Affirmative action ruling raises concerns over impact on medical school diversity” Yale School of Management: MBA for Executives Sepsis DX, co-founded by Melissa Davis “Donanemab in Early Symptomatic Alzheimer Disease: The TRAILBLAZER-ALZ 2 Randomized Clinical Trial” “Editorial: Amyloid-Targeting Monoclonal Antibodies for Alzheimer Disease” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.
Howie and Harlan are joined by Melissa Davis, a Yale radiologist and a graduate of Yale SOM's MBA for Executives program, to discuss the ‘whoa' moments and the weaknesses she has encountered using artificial intelligence to help interpret scans. Harlan reflects on the slow progress toward a healthcare system that rewards value rather than volume; Howie reports on new treatments for Alzheimer's disease. Links: “Robert F. Kennedy Jr. suggests covid was designed to spare Jews, Chinese people” “The Medicare Physician Fee Schedule and Unethical Behavior” “Vinod Khosla: Machines will replace 80 percent of doctors” “Affirmative action ruling raises concerns over impact on medical school diversity” Yale School of Management: MBA for Executives Sepsis DX, co-founded by Melissa Davis “Donanemab in Early Symptomatic Alzheimer Disease: The TRAILBLAZER-ALZ 2 Randomized Clinical Trial” “Editorial: Amyloid-Targeting Monoclonal Antibodies for Alzheimer Disease” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.
Alex Kirkland joins Mark Reiboldt to discuss the state of physician compensation and what the future may hold. Hospitals have competed for physician market share in the post-pandemic world, and the influx of private equity investment alongside rising costs has pushed the survey data approach of funding physician compensation models to unsustainable levels. Episode Synopsis Many external factors have impacted physician compensation over the past several years. The extensive list includes pandemic-era volume reductions, volatile survey data, Medicare Physician Fee Schedule changes, rising inflation, and the list goes on! If there is any constant, it is that change is inevitable. With so much uncertainty, how can healthcare systems possibly plan for the future in terms of a sound physician compensation strategy? The answer lies in understanding expected shifts in the physician workforce, and the need for a nimble compensation structure that can adapt to market forces. Extras · Survey Says… What to Expect from the 2021 Market Survey Data (https://cokergroup.com/survey-says-what-to-expect-from-the-2021-market-survey-data/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-115&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=article&utm_marketing_tactic=awareness) · Compensation Best Practices for Physician Enterprises (https://cokergroup.com/compensation-best-practices-for-physician-enterprises/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-115&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=white-paper&utm_marketing_tactic=solution) · How do we address provider compensation misalignment? (https://cokergroup.com/case-study-provider-compensation-misalignment/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-115&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=case-study&utm_marketing_tactic=solution) · How are the 2023 E/M guideline changes impacting your organization? (https://cokergroup.com/2023-e-m-impact-calculator/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-115&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=calculator&utm_marketing_tactic=tool) Podcast Information Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. · Please email us: feedback@cokergroup.com · Connect with us on LinkedIn: Coker Group Company Page · Follow us on Twitter: @cokergroup · Follow us on Instagram: @cokergroup · Follow us on Facebook: @cokerconsulting
Learn how the AMA is #FightingForDocs and access resources from the AMA Recovery Plan for America's Physicians by visiting: https://www.ama-assn.org/recoveryStay up to date on all the latest advocacy news by subscribing to AMA Advocacy Update: https://www.ama-assn.org/advocacy-update
Hospitals and health systems rely heavily on published compensation data for establishing their provider compensation and as part of their documentation for regulatory compliance. Both the pandemic and the Medicare Physician Fee Schedule continue to pose questions as it relates to recently published benchmarks. Emma Miller, FTI Consulting, speaks with representatives from four of the nationally recognized survey companies about the most recent benchmarks and how the data should be utilized. Emma's panel includes Elizabeth Siemsen, AMGA Consulting, Maria Hayduk, ECG Management Consultants, Michelle Mattingly, MGMA, and Bob Madden, SullivanCotter. From AHLA's Hospitals and Health Systems Practice Group.To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
This month we'll look at remote work practices following the end of the emergency declaration, the finalization of the Medicare Physician Fee Schedule, MACRA improvement recommendations, and more.
The 2023 Medicare Physician Fee Schedule, which takes effect Jan. 1, and brings with it a mixed bag of consequences for physicians. TMA experts answer physician member questions about the coming changes. Claim CME for this episode and get the links to resources discussed at www.texmed.org/education.
Beth Balcom, Brandt Jewell, Alex Kirkland, and Richard Romero presented this webinar for the American Health Law Association. Our team will cover upcoming billing and coding changes affecting healthcare organizations in three areas: coding and compliance, operations, and finance. Podcast Information Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. Please email us: feedback@cokergroup.com Connect with us on LinkedIn: Coker Group Company Page Follow us on Twitter: @cokergroup Follow us on Instagram: @cokergroup Follow us on Facebook: @cokerconsulting Episode Synopsis Upcoming billing and coding changes will affect healthcare organizations in three areas: coding and compliance, operations, and finance. Our team will cover these areas as they discuss how billing changes will impact physician practice operations and economics, including provider compensation and fair market value considerations. Learning Objectives Understand the financial impact of critical changes within the Medicare Physician Fee Schedule proposed rule and what they may mean from a valuation perspective. Discuss the operational implications and considerations resulting from the Medicare Physician Fee Schedule proposed rule. Provide an overview of the expected coding changes and associated compliance considerations. We recommend you speak with your key stakeholders about performing three actions to prepare for the upcoming changes which go into effect on January 1, 2023: Develop a coding communication plan that considers tools and checklists to help front-line resources acclimate to the changes Audit current EHR scheduling templates to ensure they consider the changes Conduct a chart audit to verify the accuracy of coding and documentation If Coker Group can assist you with developing a plan or implementation for any of the above, please get in touch with us to schedule a free consultation to discuss the specific needs of your client(s) or organization. Book Your Free Consultation ---> https://cokergroup.com/contact/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-110&utm_content=book-your-free-consultation&utm_campaign=coding-assessments&utm_source_platform=podcast-app&utm_creative_format=link&utm_marketing_tactic=contact Extras Major Changes to Split/Shared Billing Affect Advanced Practice Providers and Physicians (https://cokergroup.com/major-changes-to-split-shared-billing-affect-advanced-practice-providers-and-physicians/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-110&utm_content=major-changes-to-split-shared-billing-affect-advanced-practice-providers-and-physicians&utm_campaign=physician-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness) How the CY 2022 PFS Final Rule Affects Split/Shared Visits and Critical Care Services (https://cokergroup.com/how-the-cy-2022-pfs-final-rule-affects-split-shared-visits-and-critical-care-services/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-110&utm_content=how-the-cy-2022-pfs-final-rule-affects-split-shared-visits-and-critical-care-services&utm_campaign=physician-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness) Episode 107: How will Split/Shared Visits Change Between APPs and Physicians? (https://cokergroup.com/episode-107-how-will-split-shared-visits-change-between-apps-and-physicians/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-110&utm_content=how-will-split-shared-visits-change-between-apps-and-physicians&utm_campaign=physician-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=podcast&utm_marketing_tactic=awareness)
Matt Kershner, Director of Regulatory Affairs, discusses the Medicare Physician Fee Schedule Final Rule. Show References: https://www.aan.com/advocacy This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.
Dr. Bruce Cohen discusses the new Medicare Physician Fee Schedule Final Rule. Show references: https://www.aan.com/practice/medicare-fee-for-service This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.
Long-awaited and highly anticipated, the Centers for Medicare & Medicaid Services (CMS) Medicare Physician Fee Schedule Final Rule for 2023 released this past week supports the expansion of access to behavioral health and cancer screening, while promoting health equity.The timing of this Final Rule brings to mind the loss of actor Chadwick Boseman of Black Panther fame. Boseman died in 2020, following his battle with colon cancer – an issue addressed in the Final Rule with a focus on cancer screening, as colon and rectal cancers continue to be a leading cause of death in the U.S., with even higher numbers of new cases and death rates for Black Americans, Native Americans, and Alaskan Natives. Reporting our lead story during the next live edition of Talk Ten Tuesdays will be senior healthcare consultant Sharon Easterling, who is writing a series of articles for ICD10monitor on the experience of Black Americans dealing with the country's healthcare system.Other segments during the live broadcast will include the following:RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.Journaling John: John Zelem, MD, FACS, founder and CEO of Streamline Solutions Consulting, will continue with his journal entries.News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer,MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment. The Foundation of Daily Health, AG1 by Athletic GreensUnlock Your Free One Year Supply of Vitamin D3+K2 and 5 free Travel Packs
The Medicare Physician Fee Schedule Final Rule for 2023 includes a provision for telehealth services – this following the temporary expansion of telehealth to beneficiaries during the COVID -19 public health emergency (PHE) that began March 1, 2020. Once the temporary PHE waivers terminate, what are the plans the Centers for Medicare & Medicaid Services (CMS) has for covering telehealth services for Medicare beneficiaries?Join 3M consultant Colleen Deighan-Ejak during the next live edition of Monitor Mondays, when she will outline what is included in the Final Rule for Medicare telehealth services. Other segments will include these instantly recognizable broadcast features:The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of healthcare regulations and the SDoH.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.Legislative Update: Matthew Albright, chief legislative affairs officer for Zelis, will report on current healthcare legislation.The Foundation of Daily Health, AG1 by Athletic GreensUnlock Your Free One Year Supply of Vitamin D3+K2 and 5 free Travel Packs
In this episode, advocacy leaders from the AAOS review proposed payment policy changes for 2023 in the inpatient and outpatient setting including ongoing cuts to reimbursement in the annual Medicare Physician Fee Schedule. They summarize each of the three regulatory rules, highlight changes specific to musculoskeletal care, then discuss the careful balance between stabilizing the system in the short-term while working towards a permanent fix that addresses growing health care costs and incentivizes value-based care. Guest: Karl Koenig (Texas), MD, FAAOS, Chair, AAOS Health Care Systems Committee Host: Douglas Lundy, MD, MBA, FAAOS, Chair, AAOS Advocacy Council Notes: Issue page in the AAOS Advocacy Action Center: https://www.aaos.org/advocacy/advocacy-action-center/payment-policy-changes/ Episode 23 - Economic Effects of Medicare Pay Cuts (recorded Oct. 2021): https://www.aaos.org/publications/the-bone-beat-orthopaedic-podcast-channel/the-bone-beat-advocacy-podcast/episode-23/ Special Episode - Impact of Payment Policy Changes (recorded Sept. 2020): https://www.aaos.org/publications/the-bone-beat-orthopaedic-podcast-channel/the-bone-beat-advocacy-podcast/episode-9/
In this episode of the MGMA Week in Review podcast, we feature articles on stress and burnout, the 2023 Medicare PFS, and FDNY dealing with 9/11-related illnesses. Sources in this episode: Stress and burnout for healthcare leaders -- https://www.mgma.com/data/data-stories/stress-and-burnout-a-growing-concern-for-healthcar MGMA and the 2023 Medicare Physician Fee Schedule proposals -- https://mgma.com/news-insights/press/september-6,-2022-mgma-provides-comprehensive-comm?utm_source=nl-gov-kh-washington-connection-2022-09-08&utm_medium=email&utm_campaign=government-affairs&mkt_tok=MTQ0LUFNSi02MzkAAAGGu_UgilrjV0h2lSrChReRjCibi8TQmIdU39CQ7YIBFDXu9vXD1cG2qnQkBNotRFl-v7Lyrw-HI2gXFNJBkRjkW--N-ZRY4qf8sABuVMIeBA FDNY fatalities from post-9/11 illnesses -- https://abc7ny.com/fdny-911-september-11-world-trade-center/12216375/ Additional resources: To keep up with the latest healthcare legislation, visit mgma.com/advocacy. If you want to become part of the discussion, join the MGMA STAT panel by texting “stat” to 33550 or visit www.mgma.com/data/data-stories/mgma-stat-overview. Keep up with the latest industry news by subscribing to the MGMA Insights Newsletter at mgma.com/insightsnewsletter. Listen to our podcasts at www.mgma.com/listen. Join us at the MPE: Leaders Conference in Boston, Oct. 9-12. To register or learn more go to mgma.com/events/medical-pract…e-leaders-conference If you have a story you want to share with us, email us at podcasts@mgma.com.
Matt Kershner, Director of Regulatory Affairs at the American Academy of Neurology, discusses the 2023 Medicare Physician Fee Schedule Proposed Rule.
What you'll get out of this episodeCarrie talks with American Telemedicine Association (ATA) Vice President of Public Policy Kyle Zebley about how upcoming laws and policies will impact the future of virtual care.Listen to Discover: What the significance of the new bill, H.R. 4040, that was recently passed by the US House of Representatives, is and its chances of being signed into law What this new bill left out with respect to priorities within the telehealth stakeholder community How the proposed Medicare Physician Fee Schedule could shape virtual care in 2023 What kind of movement we're seeing in all 50 states around telehealth and virtual care policy About Our GuestKyle Zebley is Vice President of Public Policy at the American Telemedicine Association (ATA) and Executive Director of ATA Action. He is working with and on behalf of ATA and ATA Action members and like-minded organizations to eliminate barriers to the expansion of telehealth and ensure patients, providers, and payers can realize the benefits of virtual care.Previously, Kyle was the Chief of Staff in the Office of Global Affairs (OGA) at the U.S. Department of Health and Human Services (HHS). He collaborated with senior leadership from HHS, the White House and other cabinet departments to develop, advise, and promote U.S. global health policy, including in such policy areas as drug pricing, medical devices, global health security, and non-communicable diseases. Prior to HHS, he worked in Congress as a Legislative Director, leading a legislative team in developing policy and drafting legislation, particularly on matters concerning the House Committee on Ways and Means, the House Committee on the Budget and the House Committee on Education and the Workforce. Kyle started his career in Washington, D.C. as a Research Assistant at Public Opinion Strategies, where he worked on campaign strategies for clients running for U.S. President, U.S. Senate, the U.S. House of Representatives, state governor and state legislatures. Kyle is a sought-after policy expert and is frequently quoted in major media coverage on the topic of telehealth, including the Associated Press, Bloomberg, Kaiser Health News, Modern Healthcare, NPR, and Roll Call. In January 2022, Kyle was named by Politico as one of the “Four Washington players poised to shape digital health in 2022”.About the American Telemedicine AssociationAs the only organization completely focused on advancing telehealth, the ATA is committed to ensuring that everyone has access to safe, affordable, and appropriate care when and where they need it, enabling the system to do more good for more people.Additional Resources The American Telemedicine Association: “Telehealth. Is. Health. ATA is working to transform health and care through enhanced, efficient delivery.” ATA Action: “ATA Action, the ATA's affiliated trade organization, is our proactive response to the need for expanded advocacy in 2022 and the years to come. “ Connect with Kyle on LinkedIn Join the ConversationAre you a healthcare innovator? Tell us what topics and people you'd like us to cover in future episodes:Decoding Healthcare Innovation on LinkedInDecoding Healthcare on TwitterFollow our daily updates on LinkedIn:CarrieRebeccaAbout Your HostsCarrie Nixon and Rebecca Gwilt are partners at Nixon Gwilt Law, a healthcare innovation law firm exclusively serving Providers, Digital Health Companies, and Life Science Businesses seeking to transform the way we receive and experience healthcare. Find out more at NixonGwiltLaw.com.
AMA Senior Vice President of Advocacy Todd Askew discusses the latest advocacy efforts on Medicare physician payment reform and protecting patients' reproductive rights with American Medical Association CXO Todd Unger. Stay up to date on all the latest advocacy news by subscribing to AMA Advocacy Update: https://www.ama-assn.org/advocacy-news Details on AMA's Medicare payment principles webinar here: https://www.ama-assn.org/practice-management/medicare-medicaid/ama-advocacy-insights-webinar-series-medicare-payment
Medicare raised CCM payments in 2022. Medicare now pays $58 – $83 monthly per completed CCM service (99490). Buy your CCM templates NOW! Medicare has posted a booklet with more details. Medicare Physician Fee Schedule
Aletheia Lawry, General Counsel, NextCare Holdings, Inc., speaks with Tony Kouba, Principal, ECG Management Consultants, and Kelsey Jernigan, Partner, K&L Gates LLP, about some of the recent changes to the Medicare Physician Fee Schedule (MPFS) and how provider compensation programs are responding. They discuss the split in how health systems are using the MPFS, how 2021 compensation data surveys will be impacted, and how compensation structures may change as more health systems move to value-based care. Sponsored by ECG Management Consultants.
Alex Kirkland and Matt Jensen join Mark to talk about the latest evaluation and management code updates to the Medicare Physician Fee Schedule. The Centers for Medicare and Medicaid Services (CMS) decreased the conversion factor for evaluation and management (E/M) codes for 2022. Podcast Information Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. Please email us: feedback@cokergroup.com Connect with us on LinkedIn: Coker Group Company Page Follow us on Twitter: @cokergroup Follow us on Instagram: @cokergroup Follow us on Facebook: @cokerconsulting Episode Synopsis CMS increased the RVUs for which they reimburse outpatient E/M services and decreased the conversion factor to remain budget neutral. The conversion factor cuts will affect reimbursement for all services in the fee schedule to increase reimbursement for more cognitive E/M services. Organizations with RVU-based compensation plans need to revalue their wRVU rates to remain economically aligned with the fee schedule, especially if their provider compensation plans tie to wRVU values in the most recent Medicare Physician Fee Schedule. Click to listen to the episode. Extras 2022 E/M Coding Calculator How the CY 2022 PFS Final Rule Affects Split/Shared Visits and Critical Care Services
Health Regulatory Update: Medicare Physician Fee Schedule Impact on Physician Compensation Effective at the start of 2021, the Centers for Medicare & Medicaid Services increased the work relative value units (“wRVUs”) allocated to several evaluation & management physician services. In this podcast, our Fraud & Abuse attorneys discuss the Stark and Anti-Kickback impact of these...
Health Regulatory Update: Medicare Physician Fee Schedule Impact on Physician Compensation Effective at the start of 2021, the Centers for Medicare & Medicaid Services increased the work relative value units (“wRVUs”) allocated to several evaluation & management physician services. In this podcast, our Fraud & Abuse attorneys discuss the Stark and Anti-Kickback impact of these...
In this episode, we are joined by Josh Halverson, Principal at ECG Management Consultants, to discuss the most significant compensation planning challenges facing provider organizations in 2022. Here, he discusses the impacts of the COVID-19 pandemic and the Medicare Physician Fee Schedule on industry benchmarks and how medical group leaders are adjusting their provider compensation plans due to these changes.This episode is sponsored by ECG Management Consultants.
In this episode, we are joined by Josh Halverson, Principal at ECG Management Consultants, to discuss the most significant compensation planning challenges facing provider organizations in 2022. Here, he discusses the impacts of the COVID-19 pandemic and the Medicare Physician Fee Schedule on industry benchmarks and how medical group leaders are adjusting their provider compensation plans due to these changes.This episode is sponsored by ECG Management Consultants.
In this episode of AHLA's monthly series on fraud and abuse issues, Matthew Wetzel, Partner, Goodwin Procter, speaks to Brett McNeal, Vice President of Legal Affairs, CAN Community Health Inc., Rob Yates, Deputy Attorney General, Indiana Medicaid Fraud Control Unit, and Joe Wolfe, Partner, Hall Render, about some of their fraud and abuse predictions for 2022. They discuss the continued aftermath of the 2019 Allinadecision, 340B program enforcement, recently enacted Stark and AKS regulations and Medicare Physician Fee Schedule changes, and developments related to the expansion of telehealth coverage. From AHLA's Fraud and Abuse Practice Group. Sponsored by BRG.
Up to 10% reimbursement cuts may be coming for Medicare Part B for occupational and physical therapy service on January 1, 2022. This is in addition to the OTA Modifier. Up to 6% cuts may be coming for Medicare Part A. Write your legislators today at www.aota.org/takeaction Here is my article on last years Medicare cuts that talk a bit more about the Medicare Physician Fee Schedule https://amplifyot.com/medicaretherapycut/ --- Send in a voice message: https://anchor.fm/amplifyot/message Support this podcast: https://anchor.fm/amplifyot/support
Hospitals and health systems rely heavily on published compensation data for establishing their provider compensation and as part of their documentation for regulatory compliance. A lot of questions have arisen from the recently published benchmarks, related to impacts of the pandemic and comparability challenges associated with implementation of the latest Medicare Physician Fee Schedule. Emma Miller, ECG Management Consultants, speaks with representatives from four of the nationally recognized survey companies about the most recent benchmarks and how the data should be utilized. Emma's panel includes Elizabeth Siemsen, American Medical Group Association, Maria Hayduk, ECG Management Consultants, Meghan Wong, Medical Group Management Association, and Patty Bohney, Sullivan Cotter. From the Fair Market Value Affinity Group of AHLA's Hospitals and Health Systems Practice Group.
In this episode, Aurora Young, Principal at ECG Management Consulting, breaks down how physician reimbursement and composition changed under the new Medicare Physician Fee Schedule and how healthcare organizations have responded to it. Aurora also discusses what CMS is planning for next year and how organizations should think about their ongoing provider compensation planning moving forward.This episode is Sponsored by ECG Management Consultants.
The Centers for Medicare & Medicaid Services (CMS) released the 2022 Medicare Physician Fee Schedule and Quality Payment Program final rule on November 2, and there are big changes to physician payments. In particular, the Medicare conversion factor, which forms the basis for payments to clinicians, will be lowered by 3.7%. There's nuance in calculating the payments, but you can sum this up as most doctors will take a pay cut in 2022. And since the final rule goes into effect on January 1, 2022, doctors will begin feeling the cuts in Q1 revenue. The rule is specific to Medicare, but there are plans to push similar changes in Medicaid and we all know commercial payers tend to follow CMS' lead. We believe this change will have a ripple effect across the industry. On this episode, I talk with Gail Zahtz, CEO at PropHealth, as part of our ongoing Value-based Payment in 2022 series about what doctors can expect in terms of Medicare FFS payment come January 1, 2022. We discuss this as another example of CMS trying to make Fee-for-Service less “comfy” and expedite the move to value-based payment models. Gail helps us to understand what options exist and we lay out a framework for how to evaluate those options. This is a heavy episode, and there are no clear answers. However, there is a known direction and a viable path forward. We'll try to get you moving in the right direction. For full show notes and links: https://thehcbiz.com/177-doctors-just-took-a-pay-cut-vbp-in-2022-with-gail-zahtz-part-3/
The Medicare Physician Fee Schedule and Final Rule was posted on November 2nd. In this week's episode, Terry goes over the highlights of the new rules, the new conversion factor for 2022, and the status of expanding Telehealth in 2022. Join us for this update. Subscribe and Listen You can subscribe to our podcasts via: […] The post The MPFS and Final Rule is out for 2022 appeared first on Terry Fletcher Consulting, Inc..
In this inaugural CAP Advoacy Recap for the month of August we will review the CAP's opposition to a recent VA initiative, take a look at the 3.5 trillion dollar infratructure bill in congress, and we'll sit down with Dr. Jonathan Myles, chair of the Council on Government and Professional Affairs, to discuss what pathologists need to know about the proposed 2022 Medicare Physician Fee Schedule.
We’ve wrapped up a #FightTheCut virtual rally that brought together PTs, PTAs, and students from across the country to send a clear message to CMS about the flawed 2022 Medicare Physician Fee Schedule it proposed. So where do things stand now? This podcast takes a post-rally look at where we are—and what needs to happen … Continue reading The #FightTheCut Virtual Rally: How Did We Do, and What’s Next?
We've wrapped up a #FightTheCut virtual rally that brought together PTs, PTAs, and students from across the country to send a clear message to CMS about the flawed 2022 Medicare Physician Fee Schedule it proposed. So where do things stand now? This podcast takes a post-rally look at where we are—and what needs to happen … Continue reading The #FightTheCut Virtual Rally: How Did We Do, and What's Next?
What you'll get out of this episodeIn this episode, co-host Carrie Nixon talks to startup veteran and Director of TMC Innovations, Tom Luby, PhD., and Emily Reiser, PhD, Senior Manager of Community Engagement, about how the largest medical center in the world looks at the innovation ecosystem and the future of healthcare.In this episode you'll discover: What the ecosystem of innovation looks like at TMC Innovations; How TMC Innovations helps startups via accelerators, resources, and their venture fund; How they've seen health system partners work with digital health companies; How specific digital health startups are adapting and thriving during the pandemic; and What they think is the most pressing need in healthcare in the next 3 years. This lively conversation is one you won't want to miss if you're a health system leader, a digital health innovator, a startup founder, or a healthcare tech investor. QuotablesPredication: “Access to care holistically and how we all think about accessing our own healthcare is going to change dramatically.” Ep7 of @DecodingHealth1 w/ @NixonGwiltLaw https://sliceofhealthcare.com/category/decoding-healthcare-innovation/ “It isn't just about cost it's about who gets paid, when they get paid, how they get paid, when you're involved…” Ep7 @DecodingHealth1 @NixonGwiltLaw https://sliceofhealthcare.com/category/decoding-healthcare-innovation/ #mpfs2022 Recommended Resources Learn more about Tom Luby and Emily Reiser's work at TMC Innovations What TMC Innovations is doing next Speaking of Innovations: If you're a digital health company and want to submit your feedback about 2022 reimbursement to CMS, you only have until September 13! Click here to find out what we think CMS needs to change in the Medicare Physician Fee Schedule before the final rule comes out in December. Join the ConversationAre you a digital health or health system innovator? Tell us what topics and people you'd like us to cover in future episodes:– Website – LinkedIn – Twitter – Instagram – YouTubeFollow our daily updates on LinkedIn:– Carrie – RebeccaAbout Your HostsCarrie Nixon and Rebecca Gwilt are partners at Nixon Gwilt Law, a healthcare innovation law firm exclusively serving Providers, Digital Health Companies, and Life Science Businesses seeking to transform the way we receive and experience healthcare. Find out more at NixonGwiltLaw.com. This podcast is produced by Slice of Healthcare LLC.
In the recent Medicare Physician Fee Schedule proposed rule for CY 2022, CMS has proposed adding a new category of reimbursable digital health services with new CPT codes classified as remote therapeutic monitoring (RTM). In this episode, Leah D'Aurora Richardson and Sarah Staples explain what RTM is, how it is different from remote physiologic monitoring (RPM), and the uncertainty regarding which practitioners will be able to furnish and bill for RTM services.
Join us as Claire Ernst, JD shares legislative updates on the recently announced CMS 2022 Proposed Rule that includes proposed changes to the Medicare Physician Fee Schedule, Telehealth and Congressional updates.Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLCFor more information on critical RCM updates, be sure to follow RevDive on our social channels:- Website - Facebook - LinkedIn - Twitter - YouTube
A discussion with Todd Askew, the AMA's Senior Vice President of Advocacy in Washington, D.C., about the recently released proposed rule for the 2022 Medicare Physician Fee Schedule, telehealth developments and advocacy efforts in the fight against the National Overdose Epidemic.
In this episode Sean and Scott Kraft discuss a few of the more pressing sections of the MPFS 2022 Proposed Rule including the Conversion Factor reduction and clinical labor cost reductions (Potential Specialty Financial Losers), Changes to Physical and Occupational Therapy and the use of PTAs and OTAs, and Split/Shared Service propsed rule changes. This is definitely not an episode you want to miss.
Hosted by Thomas K. Varghese Jr., MD, MS, the “Beyond the Abstract” program explores the “whys” behind articles in The Annals of Thoracic Surgery and discusses next steps with authors and thought leaders. In the latest episode, Alan M. Speir, MD, joins Dr. Varghese to discuss “easily one of the biggest issues that impacts the care of cardiothoracic surgical patients today”—the Medicare reimbursement cuts. In December 2020, Congress approved legislation that prevented the Centers for Medicare & Medicaid Services from implementing the cuts. But what was happening—much behind the scenes—to help earn this major victory for cardiothoracic surgeons and their patients? Dr. Varghese and Dr. Speir take a deep dive into this topic, covering the potential rationale for the “Draconian” cuts in reimbursement and the details of the close coordination and collaboration with other surgical societies that helped make a difference. Dr. Speir also shares his thoughts on future advocacy efforts. Read the related Annals article online: STS Advocacy Concerning CMS Reduction in the 2021 Medicare Physician Fee Schedule to Cardiac and Thoracic Surgeons.
ONS member Zac Pitts, MSN, NP-C, certified family nurse practitioner at Winship Cancer Institute of Emory University in Druid Hills, GA, and member of the Metro Atlanta ONS Chapter, joins Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS, to discuss what advanced practice providers need to know about billing for their services and updates to reimbursement through the Centers for Medicare and Medicaid Services (CMS). The advertising messages in this episode are paid for by Sanofi Genzyme. Episode Notes Check out these resources from today's episode: NCPD contact hours are not available for this episode. ONS Voice article: Billing and Coding Breakdown Helps Nurses Recognize the Realities of Reimbursement Additional ONS resources for oncology advanced practice RNs American Medical Association's Current Procedural Terminology (CPT) and other billing and coding resources CMS coding and billing information CMS: Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2021 U.S. Department of Health and Human Services: Billing for Telehealth During COVID-19
Michele Kramer is joined by Keely Kent to discuss the CMS Release of the 2021 Final Rule. The centers for Medicaid and Medicare Services (CMS) issued the CY 2021 Medicare Physician Fee Schedule (PFS) Final Rule, which has taken effect on January 1, 2021. This includes: Updated Payment Policies Payment Rates Telehealth Policies Quality Provisions
Alex Kirkland joins Mark to discuss changes to the Medicare Physician Fee Schedule (MPFS) final rule. On December 27, 2020, Congress passed and the President signed into law the Consolidated Appropriations Act. The stimulus bill provided temporary relief by partially mitigating cuts to the conversion factor in 2021. Podcast Information Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. Please email us: feedback@cokergroup.com Connect with us on LinkedIn: Coker Group Company Page Follow us on Twitter: @cokergroup Follow us on Instagram: @cokergroup Follow us on Facebook: @cokerconsulting Episode Synopsis Many payers use the Physician Fee Schedule (PFS) as the foundation for their rates and how they set their conversion factor. Although the stimulus bill only affects Medicare reimbursement for physician professional services, the impact will extend beyond Medicare. The stimulus package provides support only during 2021, so the full 10% cut to the conversion factor is still expected in 2022. Medical groups need to analyze their financial impact through a CPT level revenue and wRVU compensation analysis. The important concept is compensation increases should not outpace reimbursement, meaning you can’t afford to pay more than your revenue allows. There are also fair market value (FMV) and commercially reasonable (CR) implications and issues to consider. The new regulations state that a hospital may not value a physician’s services at a higher rate than a private equity investor or another physician practice. Click the play button to listen to the episode. Extras Estimate the Financial Impact of 2021 E/M Coding Changes Episode 82: How the MPFS Final Rule Impacts Medical Practices (and What to Do about It) Webinar Replay: 2021 E/M Coding Changes: What Healthcare Professionals Need to Know
AANP director of reimbursement and regulatory affairs, Frank Harrington, speaks about the latest rules, regulations, payment models, incident-to and pay parity in nurse practitioner reimbursement. Resources from this episode:AANP Reimbursement ResourcesReport a Reimbursement IssueAANP Advocacy Information2021 AANP Health Policy Conference Join AANP today! After the recording of this podcast, the Consolidated Appropriations Act of 2021 was signed into law which made some adjustments to the Medicare Physician Fee Schedule. CMS has provided updated guidance regarding the impact that these changes will have on the Medicare Physician Fee Schedule for 2021 and future years.
This is Part 2 of our discussion on the latest MACRA Rule for 2021. Leading experts from Sg2 discuss the issues that affect reimbursement for medical and clinical practices, including Advanced APMs and what they could mean for you. Guest speakers:Valinda Rutledge, MBA, MSNFellowSg2 Madeleine McDowell, MDPrincipal, IntelligenceSg2 Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice PresidentClinical ResourcesVizient Show Notes[00:44] Advanced Alternative Payment Models (aAPMs)—descriptions, developments[06:44] Outpatient Prospective Payment System (OPPS)—changes[08:16] Accountable Care Organizations (ACOs)—changes, options[11:19] Alternative Payment Model Performance Pathway (APP)—measures, options[12:22] Ramifications of elimination of Inpatient Only (IPO) list[14:06] Medicare Physician Fee Schedule—developments[15:44] Three themes from CMS continuing Links | Resources:Program handout from December 9, 2020 webcast: Click hereLink to December 9 webcast: Click hereCMS website on MACRA and QPP Click here Subscribe Today!Apple PodcastsSpotifyAndroidGoogle PodcastsStitcherRSS Feed
Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-coding-update Overview: This session will overview the new 2021 changes for outpatient E&M billing documentation requirements. Guest: Robert Baldor, MD, FAAFP Music Credit: Richard Onorato
Credits: 0.25 AMA PRA Category 1 Credits™ Claim CME/CE credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-coding-update Overview: This session will overview the new 2021 changes for outpatient E&M billing documentation requirements. Guest: Robert Baldor, MD, FAAFP Music Credit: Richard Onorato
Welcome to the latest advocacy edition of the AUA’s Inside Tract Podcast. This week’s podcast includes information on urology-specific funding requests in government research programs, an upcoming webinar on the Medicare Physician Fee Schedule, addressing disparities within the Veterans Health Administration, and a push to make telehealth changes permanent and much more.
Adam Johnson and Nicole Rich host a panel of vascular surgeons representing the Society for Vascular Surgery (SVS) Policy and Advocacy Council, Government Relations Committee (GRC), and the Political Action Committee. (PAC). They discuss how they became involved and specifically their work regarding the United States Centers for Medicare & Medicaid Services (CMS) Payment Reforms that will go into effect in January 2021. The updated physician fee schedule will substantially alter the Evaluation and Management (E/M) Codes that physicians use to bill for office-based services provided to Medicare patients. Our panelists detail how these changes will decrease reimbursement for surgical procedures, impact the field of vascular surgery, and the importance of surgeon involvement in the advocacy process. Panel Members Dr. Megan Tracci (@MeganTracci) is an associate professor of surgery at the University of Virginia (UVA) Health in Charlottesville, VA, and the chair of the SVS government relations committee (GRC). Dr. Matthew Sideman (@UTHSAvascular) is an associate professor of surgery at UT Health San Antonio in San Antonio, TX, and is the chair of the SVS Policy and Advocacy Council, as well as the SVS Representative to the RVS Update Committee (RUC). Dr. Peter Connolly (@phcvascular) is an associate professor of surgery at Weill Cornell Medical College in New York City, NY, and co-chair of the SVS Political Action Committee (PAC). Dr. Mark Mattos is a self-employed vascular surgeon, the program director for the vascular surgery fellowship at Michigan Vascular Center in Flint, MI, and co-chair of the SVS Political Action Committee (PAC). Learn more about Payment Reform: SVS Town Hall: Financial Implications of Impending Payment Reform SVS 2021 Medicare Physician Fee Schedule One-Pager SVS Advocacy Resources for Members Surgical Care Coalition Vascular Specialist: Advocating for our Members CMS Newsroom Factsheet: Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2021 Get involved in Policy and Advocacy through the SVS: Voter Voice: Contact Congress via the SVS SVS Virtual Coding & Reimbursement Workshop SVS Vascular Surgery Trainee Advocacy Travel Scholarship SVS Councils & Committees This episode is the first of our series working with the SVS political organizations. Future topics may include coronavirus response legislation, student debt, prior authorization, and red tape reduction. What other topics would you like to hear about? Let us know more about you and what you think of our podcast through our listener survey or AudibleBleeding@vascularsociety.org.
Welcome to latest Advocacy episode of the AUA’s Inside Tract Podcast. This week’s update includes information on final rule takeaways from the 2021 Medicare Physician Fee Schedule, Congressional outreach efforts and much more. In our top story, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited final rule for the 2021 Medicare Physician Fee Schedule on December 1.
In this week’s episode, Limo Cherian, Steve Pine, and Macy Flinchum discuss some of the key changes for Accountable Care Organizations (ACOs) in the recent Medicare Physician Fee Schedule proposed rule. In particular, the presenters discuss the implications and potential challenges for ACOs if the proposed changes to quality reporting and the metrics on which ACOs are scored are finalized for 2021.
Dr. Bruce Cohen, a neurologist at Akron Children's Hospital, gives an update related to the 2021 Medicare Physician Fee schedule. Show references: https://www.aan.com/policy-and-guidelines/advocacy/aan-advocacy-action-center/ Part 1: https://neurologyminute.libsyn.com/website/neurology-2021-medicare-physician-fee-schedule-part-1
Dr. Bruce Cohen, a neurologist at Akron Children's Hospital, gives an update related to the 2021 Medicare Physician Fee schedule. Show references: https://www.aan.com/policy-and-guidelines/advocacy/aan-advocacy-action-center/
In this edition of HealthBeat, we discuss Medicare Physician Fee Schedule for 2021, And Finally, a Story about Plant Based Diets and Hypertension. Want More Health and Technology Info - Follow Dr Eglow at - http://www.twitter.com/teglow Please Support HealthBeat Advertisers - http://www.audiblepodcast.com/healthbeat For information about adding Personalized Healthbeat Podcasts to your offices Web Site, to help you attract new patients, please Email us at healthbeat@chiropracticradio.com COTs HealthBeat is now available on Stitcher Radio - Surf to - http://app.stitcher.com/browse/feed/31530/details And remember to surf to our Show Notes, located at http://www.ChiropracticRadio.com My Podcast Alley feed! {pca-35ddbc0845765814071fb2d2e8501841}
Brandt Jewell and Taylor Cowart join Mark Reiboldt to discuss the latest news for site neutrality. Hospitals have historically benefited from the Outpatient Prospective Payment System (OPPS), the reimbursement mechanism for Hospital Outpatient Departments (HOPD) facility fees, in comparison to their private practice peers functioning under the Medicare Physician Fee Schedule. Contact Information Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. Please email us: feedback@cokergroup.com Connect with us on LinkedIn: Coker Group Company Page Follow us on Twitter: @cokergroup Follow us on Instagram: @cokergroup Like us on Facebook: @cokerconsulting Episode Synopsis The procedures performed in a freestanding clinic versus an HOPD received 75% less reimbursement. Hospitals were highly incentivized to acquire independent sites, switch the designation to HOPD and begin increasing their reimbursement for the same procedures. This strategy caused HOPD billings to effectively double over the last decade. Both Medicare and its beneficiaries were under pressure to find a solution. Between 2018 and 2020, the Centers for Medicare and Medicaid Services (CMS) updated the OPPS rate and proposed to phase in a 60 percent reduction over two years. They believe site neutral payments will give patients more options for their care. Alternatively, hospitals predicted a massive loss under the site neutral payments into the millions for many organizations. The American Hospital Association (“AHA”), the Association of American Medical Colleges (“AAMC”) and various other private groups took up arms against CMS, arguing that hospitals should receive additional reimbursement as it is inherently more expensive to run HOPDs based on the standards they are required to uphold. Extras Another Blow for Hospitals: The Ongoing Battle of Site Neutral Payments Bonus Episode: Three Key Objectives from the 2019 State of the Union Address Episode 21: Q&A Episode – December 2018
This week’s Advocacy Update includes news on the 2021 Medicare Physician Fee Schedule proposed rule, updates on virtual meetings with lawmakers, an update on state activity around surprise billing and much more.
In the Breakroom this week, McDermottPlus VP Sheila Madhani and Director Rachel Stauffer discuss their key takeaways from the 2021 Medicare Physician Fee Schedule proposed rule. A summary of the rule is available here https://www.mcdermottplus.com/insights/cms-releases-cy-2021-physician-fee-schedule-proposed-rule/ And please join McDermottPlus for a webinar on the 2021 Medicare Physician, Hospital Outpatient and Ambulatory Surgical Center Proposed Rules on August 18 https://www.mcdermottplus.com/insights/cy-2021-pfs-opps-asc-proposed-rules-webinar/
Welcome back for another urology advocacy edition of the AUA Inside Tract Podcast. In our top news this week, the AUA joined the Alliance of Specialty Medicine in sending a letter to the chairs of the Senate Finance Committee and House Ways and Means and Energy and Commerce Committees urging Congress to quickly address an unresolved need to provide positive updates to the Medicare Physician Fee Schedule conversion factor.
In the latest ASCO in Action Podcast, ASCO CEO Dr. Clifford A. Hudis, discusses updates that will affect oncologists in the 2020 Medicare Physician Fee Schedule final rule, which outlines changes to Part B reimbursement policies and the Quality Payment Program. ASCO’s goal will always be “to ensure that oncologists can provide the right treatment, at the right time,” says Dr. Hudis, “and we aim to help CMS implement policies that advance that goal.” Take the ASCO Podcast Survey and help ASCO improve its podcast program: https://www.surveymonkey.com/r/ascopodcasts The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Welcome to the ASCO in Action Podcast, brought to you by the ASCO Podcast Network, a collection of 9 programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org. The ASCO in Action Podcast is ASCO’s podcast series that explores the policy and practice issues that impact oncologists, the entire cancer care delivery team, and the individuals we care for—people with cancer. I’m Dr. Clifford Hudis, CEO of ASCO and the host of the ASCO in Action podcast series. For this podcast, I wanted to provide a quick update on an important announcement from the Centers for Medicare & Medicaid Services, which of course we refer to as CMS on this podcast. In early November, the agency released its final rule for the 2020 Medicare Physician Fee Schedule—commonly referred as the “physician fee schedule”—and other changes to Medicare Part B reimbursement policies, including proposed updates to the Quality Payment Program. Just to review, the physician fee schedule is a complete listing of fees that Medicare uses to pay doctors or other providers and suppliers. It is also a comprehensive listing of maximum fees that is updated each year and used to reimburse providers on a fee-for-service basis. At ASCO, we always review this rule closely and assess its likely impact our members and, most importantly, our patients. The top takeaway from the rule is that CMS estimates a zero percent overall impact for the hematology/oncology and radiation oncology specialties in 2020. Though it’s important to note that the actual impact on individual physician practices will depend on the mix of services the practice provides, and practices in certain states may see a change due to the elimination of the 1.0 threshold previously applied to the geographic practice cost indices. CMS also finalized provisions to align Evaluation & Management (or E&M) coding with changes laid out by the CPT Editorial Panel for office/outpatient E&M visits. This is a welcomed update that comes after ASCO and other stakeholders expressed concerns that earlier CMS proposals to consolidate E&M codes would have diminished the resources available to care for Medicare beneficiaries with cancer. We appreciate the fact that CMS listened to our perspective and revised its plans to better serve people with cancer. The physician fee schedule rule also finalizes updates to the Quality Payment Program for 2020 and beyond. A key update to the Merit-Based Incentive Payment System (or MIPS)—one of the Quality Payment Program’s two tracks—is that all four MIPS performance categories will remain at their 2019 weights in 2020, but the performance threshold, which is the minimum total MIPS score needed to avoid a negative payment adjustment will increase to 45 points in 2020 (up from 30 points in 2019). CMS also finalized its plan to establish “MIPS Value Pathways” (or MVPs) beginning in 2021. CMS has described MVPs as a way to reduce the burden of participating in MIPS and for CMS to collect more meaningful performance data. The MVP framework would connect activities and measures from the four MIPS performance categories that are relevant to a patient population, a medical specialty, or a specific medical condition such as cancer. For years, ASCO has encouraged the use of high-quality oncology clinical pathways to help ensure patient access to high-quality, high-value cancer care. We are hopeful that this provision in the CMS final rule is a move in the right direction. We have also appreciated CMS’ recent efforts to reduce administrative burden for providers. MVPs, if implemented appropriately, may help improve the quality and accessibility of cancer care. We will continue to work closely with CMS as it implements this new provision. I hope this summary of the updates to the physician fee schedule for 2020 was helpful to our listeners. Our ultimate goal is always to ensure that oncologists can provide the right treatment, at the right time, and we aim to help CMS implement policies that advance that goal. To that end we will submit detailed comments on the final rule during the open comment period, to ensure CMS understands the needs of the oncology community, and the full impact this rule is likely to have. If you’d like more information on Medicare physician reimbursement in 2020, please visit the ASCO in Action website at asco.org/ascoaction. Until next time, thank you for listening to this ASCO in Action podcast and if you enjoyed what you heard today, don’t forget to give us a rating or review on Apple Podcasts or wherever you listen and while you are there, be sure to subscribe so you never miss an episode. The ASCO in Action Podcast is just one of ASCO’s many podcasts; you can find all of the shows at podcast.asco.org. If you like what you hear from the ASCO podcast, please let us know. Take our listener survey and help shape the future of the ASCO Podcast Network. Visit podcast.asco.org click on the Survey link. Once again, that's podcast.asco.org. The survey will just take a few minutes to complete and will help us get to know you better. Thank you so much for listening.
This is the latest advocacy edition of the AUA's Inside Tract podcast. In our top payment advocacy news, the AUA recently submitted its comment letter to CMS on the Medicare Physician Fee Schedule proposed rule for 2020. The AUA supports the proposed increase in the conversion factor for 2020, as well as the overall proposed increase of 1 percent in allowable charges for urology. Learn about this and much more on today's Advocacy Update.
With special guest James Manz, MD, a consultant in spine and neurological surgery with the Mayo Clinic Health System in northwest Wisconsin. Co-hosted by Laurie Prescott, MSN, RN, CCDS, CCDS-O, CDIP, CRC, the CDI education director for ACDIS in Middleton, Massachusetts. To read a summary of the 2020 OPPS proposed rule and the Medicare Physician Fee Schedule proposed rule as discussed on In the News, go to: https://www.cms.gov/newsroom/fact-sheets/cy-2020-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center To take advantage of the early bird discount (and enter a drawing to win tickets to a brewery tour) to the upcoming ACDIS Symposium: Outpatient CDI conference in Austin, Texas on November 14-15, please visit: https://acdis.org/acdis-symposium
Subscribe through iTunes and Google Play. Welcome to this ASCO in Action podcast. This is ASCO's podcast series where we explore policy and practice issues that have an impact on oncologists, the entire cancer care delivery team, and most importantly, the individuals we care for-- people with cancer. My name is Clifford Hudis, and I'm the CEO of ASCO, as well as the host of the ASCO in Action podcast series. For today's podcast, I'm going to give our listeners a quick update on an important announcement from the Centers for Medicare and Medicaid Services. In an August podcast, I outlined the proposed Medicare Physician Fee Schedule and the Quality Payment Program Rule for 2019. This is commonly referred to as the Physician Fee Schedule. Today, I'm going to provide an update on where we are with this for next year. I have to say in passing, it's probably a good day for me not to have a guest, because I'm here with a terrible cold. So what is the 2019 Medicare Physician Fee Schedule? This is a fee schedule which consists of a complete listing of all of the fees that Medicare uses to pay doctors or other providers and suppliers. It's a comprehensive listing of the maximum fees. And it's updated each year and then used to provide reimbursement to physicians and other providers working on a fee-for-service basis. Now at ASCO, we, every year, review this rule very closely. And we try to determine and predict the impact that it will have on our members, and of course, on our patients. There are three provisions in particular that we want to highlight today. The first of these is related to care provided in calendar year 2019. And CMS estimates that there will be, overall, a 1% reimbursement cut for hematology and oncology, as well as radiation oncology specialties. It is important to note, however, that the actual impact on any individual physician or physician practice will depend on their mix of services-- that is, what it is they exactly provide and bill. Now the administration has publicly stated its aim to reduce the growing administrative burden that we've all been noting and complaining about for the last few years. And the second item we want to point out is there is some evidence of their sensitivity to this issue in the 2019 fee schedule. They intend to reduce the documentation required for evaluation and management services, frequently referred to as E/M. What CMS did is finalize provisions that consolidate E/M payments. And ASCO had expressed concerns about this previously, which the agency acknowledged, along with other stakeholders, by revising the proposal. And, if fully implemented, they believe that the impact will be delayed-- that is, it will not impact providers until 2021. But by that time, CMS plans to consolidate what has historically been Levels 2, 3, and 4 into a single billing level, and then to pay for Level 5 E/M services separately. So overall, this represents a simplification. And it fulfills one of their stated aims, again, of reducing some of the administrative burden that practitioners face. Finally, the third area that I want to highlight is a new rule starting in 2019 that refers to the amount of reimbursement you will receive for new Medicare Part B drugs. Currently, those drugs in Part B are reimbursed at wholesale acquisition cost plus 6%. They will, going forward, be reimbursed at wholesale acquisition cost plus 3%. It's critically important to emphasize that this relates only to those new drugs that are introduced into the supply chain this year. This new provision will also apply to drugs that have not yet reported an average sales price. But the point is it will not apply to drugs that have already been in use. So it only applies to new drugs, meaning that its reach is going to be relatively limited. However, what you can imagine going forward with each new year and new drugs being introduced is that the percentage over wholesale acquisition cost will translate into more and more absolute dollars. And therefore, this may be a growing concern for practices. I want to switch our attention and talk about the Quality Payment Program, or QPP. In the final rule, there is an update to QPP for 2019. The final 2019 payment adjustment for Merit-based Incentive Payment System, or MIPS, practices and providers will become plus or minus 7%. And it will have adjustments to maintain budget neutrality, as well as to reward exceptional performance. Other noteworthy changes will include an increase in the MIPS performance threshold from 15 points, which is where we were in 2018, up to 30 points for 2019. CMS also finalized two new optional opioid-related measures that MIPS providers can use to report on under the Promoting Interoperability category. These measures will give providers an opportunity to earn bonus points and therefore potentially boost their overall MIPS score. These are the two measures specifically. One allows for checking a prescription drug monitoring program, or PDMP, prior to submitting an electronic opioid prescription for any individual patient. And the second is an attempt to verify an existing opioid treatment agreement with the patient receiving the prescription. So I hope that this summary of the updates to the Physician Fee Schedule for 2019 is helpful to our listeners. Ultimately, our goal is to make sure that oncologists can provide the right treatment to the right patient at the right time. And we aim to help CMS implement policies that will advance that goal. ASCO will continue to work closely with the administration to ensure that CMS understands the needs of the oncology community and the full impact that the rule is likely to have. I would encourage you, if you need more information on the Medicare Physician Reimbursement Plan for 2019, to visit ASCO in Action's website. That's at ASCO.org/ASCOaction. And ASCOaction is written as one word. We have a link to the final rule there. And we also have a helpful, I think, webinar that explains the final rule schedule and QPP rule in greater detail. So hoping this is helpful. Until next time, I want to thank you all for listening to this ASCO in Action podcast and hope you don't catch my cold.
Brandt Jewell and Alex Kirkland join Mark to discuss the final rule from CMS last month announcing changes to the physician fee schedule for 2019. Brandt and Alex provide their input on the changes that have been announced and what it means for physician practices. Contact Information Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes. Email us: feedback@cokergroup.com Connect with us on LinkedIn: Coker Group Company Page Follow us on Twitter: @cokergroup Follow us on Instagram: @cokergroup Episode Synopsis On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019. Key Points from the Final Rule One of the payment provisions announced involved streamlining evaluation and management payment and reducing clinician burden. Beginning in CY 2021, payment for E/M office/outpatient visits will be simplified and payment would vary primarily based on attributes that do not require separate, complex documentation. After consideration of concerns raised by commenters in response to the proposed rule, CMS is not finalizing aspects of the proposal that would have: Reduced payment when E/M office/outpatient visits are furnished on the same day as procedures; Established separate coding and payment for podiatric E/M visits; Standardized the allocation of practice expense RVUs for the codes that describe these services. Brandt and Alex will also be hosting a webinar on January 24, 2019 that will cover, in part, the potential ramifications for physicians and healthcare organizations. Learn more and sign-up for the live event today! Extras Final Policy on Payment and Quality Provision Changes to the Medicare Physician Fee Schedule for CY 2019 Follow Brandt on Twitter Connect with Brandt on LinkedIn Follow Alex on Twitter Connect with Alex on LinkedIn
The tragic events that shocked the nation’s collective conscience on an otherwise peaceful recent Saturday morning call to mind the intersection of physician burnout and post-traumatic stress syndrome.With physician burnout reported to be widespread and suicides among physicians escalating at an alarming rate, do disasters – both natural and manmade – disproportionately impact the profession? Or are there other conflicts endemic to healthcare that tear at the emotional and mental health of physicians, thus creating a sense of helplessness?Reporting on our lead story during this edition of Talk Ten Tuesdays will be Dr. Tracy Sanson, a practicing emergency physician, consultant, and educator on leadership development and medical education. A national and international speaker, Dr. Sanson also serves as a core faculty member for the American College of Emergency Physicians.Other segments to be featured on the broadcast include:CDI Report: What does the future of clinical documentation integrity (CDI) look like? Mel Tully, vice president of clinical services and education for the healthcare division of Nuance Communication, reports on the evolution of CDI as an integrated, interdisciplinary function impacting patient care.News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesday News Desk.Tuesday Focus: Julie Dooling, a director at the American Health Information Management Association (AHIMA), reports on health information management challenges and tips for hospitals and other healthcare organizations in the aftermath of a hurricane, specifically in light of the devastation recently brought by Hurricane Michael.RegWatch: Leading healthcare technology consultant Stanley Nachimson returns to the broadcast to report on the final rules for the Medicare Physician Fee Schedule and the Quality Payment Program (QPP) that were released by the Centers for Medicare & Medicaid Services (CMS) on Thursday. TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on an issue that recently caught her attention during her popular TalkBack segment.
Listening In (With Permission): Conversations About Today's Pressing Health Care Topics
Suzanne Delbanco calls Mai Pham, MD, Vice President of Provider Alignment Solutions at Anthem Inc., and former Chief Innovation Officer at CMMI, to discuss the Medicare Physician Fee Schedule. They explore the history of the fee schedule, its repercussions across the entire health care marketplace, and what Anthem plans to do - in the long haul- to diverge from the status-quo for the sake of improving health care quality and affordability. With all the recent news about CMS' proposed changes to the fee schedule, you won't want to miss this exciting discussion!
Talking denials and appeals, with special guests Timothy N. Brundage, MD, CCDS, medical director of the Brundage Group, and Brett Hoggard, MD, chief medical officer of Brundage Group. Co-hosted by Allen Frady, RN, BSN, CCDS, CCS, CDI Education Specialist for ACDIS. To view a slideshow of the FY 2019 Medicare Physician Fee Schedule proposed rule and the documentation and payment changes to E/M codes as detailed on "In the News," please click here.
Few proposals from the Centers for Medicare and Medicaid Services (CMS) have generated such a plethora of opposition from concerned stakeholders as the agency’s recent proposed evaluation and management (E and M) reimbursement changes in the 2019 Medicare Physician Fee Schedule. The outrage has been intense over the plan to reimburse new patient visits at a single flat rate for codes 99202-99205 (99201 would be paid at a lower rate), while a corresponding, lower flat rate would apply to established patient visit codes 99212-99215. Code 99211 would also be paid a lower rate. The level 1 codes don’t get the flat rate, because they don’t require the presence of a physician. Making a final stand in opposition to the proposed changes during this edition of Monitor Mondays will Dr. Steven J. Meyerson, board-certified in internal medicine and geriatrics, and Holly Louie, past president of the Healthcare Business and Management Association. The broadcast rundown also will include: Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment. Monday Focus: Social Determinants of Health (SdoH) are coming into sharp focus, as Tropical Gordon impacted parts of the Central Gulf Coast this week. It brought with it memories of Hurricane Harvey and its impact that is still being experienced in Houston, especially among the poor, the unemployed, and the disenfranchised – those who are predisposed to SDoH. Reporting on the compliance issues surrounding SDoH will be nationally recognized topic authority Ellen Fink-Samnick. Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, reports on all the latest hot topics. Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron reports on another example of a potentially troublesome issue that could pose a risk to your facility. Monitor with us™
Questions are overflowing about the Centers for Medicare & Medicaid Services’ (CMS’s) proposed changes to evaluation and management (E&M) coding and reimbursement found inside the proposed 2019 Medicare Physician Fee Schedule. Returning this coming Tuesday for the next edition of Talk Ten Tuesdays will be Sally Streiber, president of Practical Coding Solutions, LLC. Sally is expected to answer some of those questions when she continues her two-part series reviewing the proposed changes. Sally will report on the “good” and the “bad” aspects of anticipated impacts. Other segments to be featured on the broadcast include: News Desk: Larry Field, DO, will anchor the Talk Ten Tuesdays News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors. CMS, Are You Listening? In the closing days before the public comment period ends (Sept. 10) for the proposed 2019 Medicare Physician Fee Schedule and E&M changes, nationally recognized coding authority Terry Fletcher will return to the broadcast to report on a number of specialties expected to be impacted if the proposed rule becomes effective Oct. 1. Tuesday Focus: Senior healthcare consultant Laurie Johnson with Revenue Cycle Solutions, LLC, will preview the upcoming Coordination and Maintenance meeting kicking off Tuesday, Sept. 11. CDI Report: ICD10monitor contributor Glenn Krauss, the clinical documentation improvement (CDI) manager at University Health Systems Las Vegas, will report on how providers too often approach CDI from a misguided and counterproductive direction, focusing too closely on reimbursement as the primary objective and endpoint of chart reviews. TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will report on a current issue that caught her attention during her popular TalkBack segment.
Backlash continues over the Centers for Medicare & Medicaid Services (CMS) proposed changes to evaluation and management (E&M) coding and reimbursement found inside the proposed 2019 Medicare Physician Fee Schedule. But it’s not all bad news. On this edition of Talk Ten Tuesdays, when Sally Streiber, president of Practical Coding Solutions, LLC, returns to the broadcast and launch part one of her two-part series reviewing the proposed changes. Sally will begin the first part of her series with the “ugly,” notably a 50 percent reduction of the less-expensive service when an E&M code and a procedure are billed on the same date of service. Sally will return on Aug. 28 with part two, reporting the good and the bad of other anticipated impacts. Other segments to be featured on the broadcast include: Talk Tuesdays News Desk: The NFL continues to make payouts for former players who have been diagnosed not only with chronic traumatic encephalopathy, but now Parkinson’s and amyotrophic lateral sclerosis (ALS), according to a recent news report by the Los Angeles Times. Senior healthcare consultant Laurie Johnson, an ICD10monitor contributor, reports on the clinical indicators of these two diagnoses in advance of the NFL season, which kicks off Sept. 6. Mental Health Report: Feeling the heat? With unseasonably hot weather plaguing most of the U.S., physicians are feeling another kind of burn; burnout. A recent study reports that 52 percent of physicians feel burned out regularly. Returns to report on this topic will be nationally renowned psychiatrist H. Steven Moffic, MD, the Talk Ten Tuesdays resident psychiatrist. TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on her personal role as a patient advocate for her ailing father. Joining the conversation will be Caitlin Donovan, director of outreach and public affairs for the National Patient Advocate Foundation. Talk Ten Tuesdays. More than just talk.™
“Podiatrists should not be discriminated against any further. E&M (evaluation and management) requirements are the same as (those for) other providers, and we should be reimbursed justly,” one podiatrist recently wrote, expressing his opposition to the Centers for Medicare & Medicaid Services’ (CMS’s) proposed E&M reimbursement changes in the recently posted 2019 Medicare Physician Fee Schedule. “If Medicare is going to change E&Ms to only two codes, then all specialists should be changed,” another opined. “All I have to ask is what about optometrists? Why aren't you focused on them as well?” Reported by RACmonitor, the controversy centers on the proposal by CMS to reimburse new patient visits at a single flat rate for codes 99202-99205 (99201 would be paid at a lower rate), while a corresponding, lower flat rate would apply to established patient visit codes 99212-99215. Code 99211 would also be paid a lower rate. The level 1 codes don’t get the flat rate, because they don’t require the presence of a physician. Reporting on this developing story on this edition of Monitor Mondays will be Jeffrey D. Lehrman, DPM, diplomate of the American Board of Foot and Ankle Surgery. The broadcast rundown also will include: Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment. Monday Focus: The proposed E&M changes are expected to impact providers’ bottom lines. But by how much? Senior healthcare analyst Frank Cohen, director of business intelligence and analytics for DoctorsManagement, has done the math and shares his analysis. Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron reports on another example of a potentially troublesome issue that could pose a risk to your facility. False Claims Act Report: Nationally recognized whistleblower attorney Mary A. Inman, partner at Constantine Cannon’s London office, has an update on the $65 million settlement by Prime Healthcare to resolve allegations that its hospitals submitted false Medicare claims. Medicare Report: Monitor Mondays national correspondent J. Paul Spencer, a senior healthcare consultant for DoctorsManagement, continues to report on the vexing issue of Medicare compliance. Monitor with us™
The Centers for Medicare & Medicaid Services’ (CMS’s) proposed evaluation and management (E&M) code changes in the recently posted 2019 Medicare Physician Fee Schedule continue to generate controversy. The controversy centers around the proposal by CMS to reimburse new patient visits at a single flat rate for codes 99202-99205 (99201 would be paid at a lower rate), while a corresponding, lower flat rate would apply to established patient visit codes 99212-99215. Code 99211 would also be paid a lower rate. The level 1 codes don’t get the flat rate, because they don’t require the presence of a physician. Reporting this developing story during this edition of Monitor Mondays will be Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS) as well as president of coding and billing services and a partner at DoctorsManagement, LLC. The broadcast rundown also will include: Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment. Monday Focus: Lori O’Hara, the lead of the additional documentation request (ADR), appeals, and clinical review team for Ensign Services, a provider of skilled nursing and assisted living services, reports on the impact of the Inpatient Prospective Payment System (IPPS) final rule as it pertains to skilled nursing facilities. Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, reports on all the latest hot topics and present the Monitor Mondays Listener Survey. Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron reports on another example of a potentially troublesome issue that could pose a risk to your facility. IRF Report: One of the nation’s most respected authorities on Inpatient Rehabilitation Facility (IRF) provider issues, Angela Phillips, president and chief executive officer for Images & Associates, reports on IRF provisions that will be impacted by the IPPS final rule. Monitor with us™
In the latest ASCO in Action Podcast, ASCO CEO Dr. Clifford A. Hudis discusses the recently released Medicare Physician Fee Schedule (MPFS) proposed rule. The MPFS is a complete listing of all fees Medicare uses to reimburse doctors and other providers and suppliers under a fee-for-service payment system.
There is a lot of buzz out in the industry about ICD-11, especially since the World Health Organization (WHO) released the new code set in June as first reported by ICD10monitor and Talk Ten Tuesday. Nevertheless, ICD-11 is a trending topic—a topic we will explore during this edition of Talk Ten Tuesdays. That’s when nationally recognized coding authority Rhonda Buckholtz will report on the need to make sure all of the coding options have been refined in ICD-10-CM in order to make coding more productive in ICD-11. Other segments to be featured on the broadcast include: Tuesday Focus: 2019 ICD-10-CM Official Guidelines: The FY2019 Official Guidelines have been released as reported by ICD10monitor. Gloryanne Bryant, past president of the California Health Information Association, reports on the new changes. E and M Coding Update: Given the potential impact of major E and M changes in the 2019 Medicare Physician Fee Schedule proposed rule, Deborah Grider, senior healthcare consultant for Karen Zupko and Associates, reports on reaction to the E and M overhaul being proposed by the Centers for Medicare and Medicaid Services (CMS). News Desk: Larry Field, DO, anchors the Talk TenTuesday News Desk with the very latest healthcare news. Field is the treasurer of the American College of Physician Advisors. RegWatch: Leading healthcare technology consultant Stanley Nachimson returns with his popular segment, RegWatch, through which he reports on the latest regulatory changes coming out of Washington, D.C. Talk Ten Tuesdays. More than just talk.™
The Medicare Physician Fee Schedule/resource-based relative value scale (MPFS/RBRVS) regulations were formally published in the Federal Register on July 27, 2018. The Outpatient Prospective Payment System/Ambulatory Payment Classifications (OPPS/APCs) was released two days prior. Both were reported by RACmonitor. Although you can expect the final changes to published in early November, for a contemporary analysis listen to Duane Abbey during this edition of Monitor Mondays. Duane Abbey is president of Abbey and Abbey Consulting, Inc., and is RACmonitor contributing editor and a frequent panelist on Monitor Mondays. The broadcast rundown also will include: Monday Focus: Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS) as well as president of coding and billing services and a partner at DoctorsManagement, LLC, reports on the reaction to the proposed overhaul of the E&M guidelines by CMS. Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron reports on another example of a potentially troublesome issue that could pose a risk to your facility. Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment. Dr. Hirsch will also present the Monitor Mondays Listener Survey. Monitor with us™
Back in February, as reported by ICD10monitor, the American Hospital Association (AHA) changed coding rules, allowing case managers and social workers to assign Z codes—one of 88 assignable ICD-10 codes to report on claims for homelessness, low income, stressful work environment, low literacy, divorce, personal history of abuse, and many more. But not all healthcare professionals—including a number of physicians—are getting the message. To help clear up the confusion, Ellen Fink-Samnick, a nationally recognized expert on social determinants of health (SDoH), will report our lead story. Other segments to be featured on the broadcast include: Talk Ten Tuesday News Desk: Timothy Powell, a nationally recognized expert on regulatory matters including the False Claims Act, ZPIC audits, and the OIG, will return to report on the latest healthcare news. E&M Coding Update: Given the scale and potential impact of major E&M changes in the 2019 Medicare Physician Fee Schedule proposed rule, Grant Huang, director of content for DoctorsManagement, will report on the major overhaul being proposed by the Centers for Medicare & Medicaid Services (CMS). Tuesday Focus: Malnutrition: Severe protein calorie malnutrition is under high scrutiny from CMS, U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), and commercial insurers. Megan Cortazzo, MD, medical director of clinical documentation improvement and health information management at University of Pittsburg Medical Center, will report on why it is happening and how to ensure hospitals and providers get compensated for the services they are providing. Talk Ten Tuesdays. More than just talk.™
Are seasoned coding professionals competent or trained well enough to interpret clinical terms and concepts from the medical record? Although they have been doing so for decades, the question continues to remain contentious. Reporting our lead story during this edition of Talk Ten Tuesdays will be Debra Beisel Denton, who works at Maricopa Integrated Health System as the health information management (HIM) system coding educator. Other segments to be featured on the broadcast include: News Desk: Dennis Jones, the patient financial services administrator at Nyack Hospital in Nyack, N.Y., will anchor the Talk Ten Tuesdays News Desk. Tuesday Focus: Shannon DeConda, a nationally recognized evaluation and management (E&M) coding authority, reports on the 2019 proposed Medicare Physician Fee Schedule released Thursday by the Centers for Medicare & Medicaid Services (CMS). DeConda is founder of the National Alliance of Medical Auditing Specialists (NAMAS). RegWatch: Leading healthcare technology consultant Stanley Nachimson returns with his popular segment, RegWatch, through which he reports on the latest regulatory changes coming out of Washington, D.C. TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., reports on a current issue that caught her attention during her popular TalkBack segment. Talk Ten Tuesdays. More than just talk.™
Listening In (With Permission): Conversations About Today's Pressing Health Care Topics
Are we really transitioning away from fee-for-service? Suzanne calls Bob Berenson, MD, Institute Fellow at the Urban Institute, to discuss the Medicare Physician Fee Schedule, why it's flawed and why it's so important we fix it as we move to pay providers based on value.
For the first episode of 2014, we are excited to bring you a conversation with widely-known Richard Lindstrom. We talk about the "seminal" changes he has witnessed in regard to the technology of cataract surgery, the increased expectations of patients in regard to outcome, integrated eyecare delivery, the Medicare Physician Fee Schedule, the $500 cataract surgery barrier and more! Dr Richard L Lindstrom, founder and attending surgeon of Minnesota Eye Consultants and Adjunct Professor Emeritus at the University of Minnesota Department of Ophthalmology, is a board-certified ophthalmologist and internationally recognized leader in corneal, cataract, refractive and laser surgery. He has been at the forefront of ophthalmology's evolutionary changes throughout his career, as a recognized researcher, teacher, inventor, writer, lecturer and highly acclaimed physician and surgeon.
Host: Jack Lewin, MD Guest: Chris Kaiser What payment cuts does the 2010 Medicare Physician Fee Schedule include for cardiology? How will these lower reimbursements affect cardiology practices and impact patients' access to care? Chris Kaiser, editor of Cardiovascular Business, joins host Dr. Jack Lewin to discuss ways cardiology practices can try to adapt to payment cuts by increasing practice efficiency. How can cardiologists optimize use of health information technology to help their practices thrive and encourage better outcomes, despite these payment cuts? What economic challenges will cardiology practices continue to face? Tune in to hear more.
Host: Jack Lewin, MD Guest: Chris Kaiser What payment cuts does the 2010 Medicare Physician Fee Schedule include for cardiology? How will these lower reimbursements affect cardiology practices and impact patients' access to care? Chris Kaiser, editor of Cardiovascular Business, joins host Dr. Jack Lewin to discuss ways cardiology practices can try to adapt to payment cuts by increasing practice efficiency. How can cardiologists optimize use of health information technology to help their practices thrive and encourage better outcomes, despite these payment cuts? What economic challenges will cardiology practices continue to face? Tune in to hear more.
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