Category: Medical Billing

Learn About OPPS Changes in July Update

Learn About OPPS Changes in July Update

Please be mindful that several coding and billing alterations pertaining to outpatient claims have been backdated to either April or January. Numerous modifications to Medicare’s Outpatient Prospective Payment System (OPPS) in the July update closely mirror those in the Medicare Physician Fee Schedule Database (MPFSDB) update for the same quarter. These include the introduction of […]
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Updates Clarify Medicare Split/Shared Billing

Updates Clarify Medicare Split/Shared Billing

Know the facts for ensuring proper payment of these claims in 2022. New policy for split/shared evaluation and management (E/M) visits (including critical care services and prolonged services) was finalized in the calendar year (CY) 2022 Medicare Physician Fee Schedule (MPFS) final rule. Knowing the new guidelines for billing split/shared visits performed in the facility […]
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CMS Releases No Surprises Act State Enforcement Letters

CMS Releases No Surprises Act State Enforcement Letters

During a National Stakeholder Call on January 18, 2022, Ellen Montz—Deputy Administrator and Director of the Center for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare and Medicaid Services (CMS)—announced that CMS had begun publishing state-specific letters (the “Enforcement Letters”) detailing anticipated Federal and state responsibilities with respect to enforcement of the […]
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California lawmakers introduce bill to mandate vaccinations in workplaces

California lawmakers introduce bill to mandate vaccinations in workplaces

The bill comes in the wake of a U.S. Supreme Court decision blocking President Biden’s nationwide vaccine mandate for large employers. A group of California lawmakers, led by District 15 Assemblymember Buffy Wicks, have introduced a bill proposing that all businesses in the state mandate COVID-19 vaccinations for their employees. Assembly Bill 1993 would require […]
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Telehealth, EHR Use Increases False Claims Act Violations, Fraud

Telehealth, EHR Use Increases False Claims Act Violations, Fraud

As more providers leverage telehealth services and EHR systems, the federal government has seen increased False Claims Act violations and healthcare fraud. Healthcare digitization, including increased use of telehealth and EHR has led to a higher volume of healthcare fraud and False Claims Act (FCA) cases, according to lawyers from Hogan Lovells. The False Claims […]
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