Category: Medical Billing

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Tread Carefully in Medicare Billing

Thanks to new provisions that went into effect for the 2022 calendar year, CMS is no longer necessarily considering “nefarious intent” when determining whether a provider or supplier should be excluded from the Medicare program. The Physician Fee Schedule for the 2022 calendar year is in full effect. The proposals, which were issued in July […]
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Hospitals Saw Substantial Underbilling for Medicare Telestroke Services

One-third of hospitals across the country offered telestroke services, but less than 40 percent submitted Medicare telestroke claims in the year before the COVID-19 pandemic. Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial underbilling from hospitals with […]
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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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Telehealth Update: New Bill Could Provide Much Needed Certainty to Providers and Patients

On Monday, February 7, 2022, U.S. Senators Catherine Cortez Masto, D-Nevada, and Todd Young, R-Indiana, introduced the Telehealth Extension and Evaluation Act, which if passed, would extend several of the telehealth waivers for two years after the end of the federal public health emergency (PHE).  See our previous coverage of telehealth during the COVID-19 pandemic. […]
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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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New Senate Bill Aims to Extend Medicare Telehealth Waivers By 2 Years

The bill proposes extending Medicare reimbursement for a range of telehealth services, including substance abuse treatment, for two years after the public health emergency has ended. A new piece of bipartisan legislation has been introduced in the US Senate that aims to extend access to telehealth for Medicare beneficiaries after the COVID-19 pandemic has ended. […]
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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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