Month: June 2021

New Provider Relief Fund Rules Give More Time to Use, Report Money

New Provider Relief Fund Rules Give More Time to Use, Report Money

HHS recently updated Provider Relief Fund reporting requirements, extending the period of availability of funds and reporting periods. The update to the Post-Payment Notice of Reporting Requirements states that clinicians now have a period of availability of funds based on the date they received the payment, rather than the original deadline of June 30, 2021. […]
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CMS Updates Medicare Part B Drug Prices

CMS Updates Medicare Part B Drug Prices

Retroactive code pricing updates may require claims lookback. The Centers for Medicare & Medicaid Services (CMS) has posted a retroactive update to the April Average Sales Price (ASP) pricing file for three Medicare Part B drugs. Also now available are the July ASP and Not Otherwise Classified (NOC) pricing files and the ASP NDC HCPCS […]
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Emergency physicians call United healthcare’s ED denial Policy ‘Dangerous’

Emergency physicians call United healthcare’s ED denial Policy ‘Dangerous’

The American College of Emergency Physicians said that it “firmly believes that the new policy is in direct violation of the federal Prudent Layperson Standard.” Calling it a “dangerous decision” and a “scare tactic,” the American College of Emergency Physicians (ACEP) is condemning UnitedHealthcare’s recent announcement to retroactively deny emergency care claims. “ACEP firmly believes […]
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CMS Increases Medicare Payments for At-Home COVID-19 Vaccinations

CMS Increases Medicare Payments for At-Home COVID-19 Vaccinations

  CMS will increase Medicare payments by $35 per dose to administer at-home COVID-19 vaccines in an effort to increase the vaccination rate among beneficiaries. Medicare payments will increase by $35 per dose for providers who administer at-home COVID-19 vaccinations for Medicare beneficiaries, CMS announced today. In alignment with President Biden’s goal of ensuring vaccine […]
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CMS Releases PCS Codes Final Rule

Medical/Legal Impact of 2021 E&M Changes

Without detailed documentation, providers may face an uphill battle in defending themselves from quality audits and even malpractice issues. Up until 2021, at least for the prior two decades, coders and clinicians relied upon the established Evaluation and Management (E&M) guidelines to determine which E&M code was appropriate for each specific encounter. The 1995 guidelines […]
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Biden Requests $133.7B for HHS Budget, Other Health Spending Plans

Biden Requests $133.7B for HHS Budget, Other Health Spending Plans

  President Joe Biden has requested an increase in the HHS budget next year to strengthen public health infrastructure and crisis-related needs, among other top health spending proposals. The president’s budget for fiscal year (FY) 2022—Biden’s first since taking office—requests a total of $6 trillion. Of that, the president requested $133.7 billion for the HHS […]
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Physician Compensation Plateaus Despite Pandemic Losses

Physician Compensation Plateaus Despite Pandemic Losses

Despite a fiscally challenging year for the healthcare industry, physician compensation for most specialties has remained the same or has slightly increased, a new report from the Medical Group Management Association (MGMA) reveals. However, most specialties showed an overall decrease in productivity in 2020. The report utilized data from 185,000 providers spanning over 6,700 organizations, […]
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