College member selected for new CMS committee
Read the full articleThe Advocacy Council of ACAAI continues to provide College members with pathways through the myriad of complex sections of the… The Advocacy Council of ACAAI continues to provide College members with pathways through the myriad of complex sections of the MACRA legislation. We have provided…
Important reminder about billing requirements for certain dual-eligibles
Read the full articleBalance billing is prohibited for Medicare beneficiaries enrolled in the Qualified Medicare Beneficiary (QMB) program. CMS has expressed concern that… Balance billing is prohibited for Medicare beneficiaries enrolled in the Qualified Medicare Beneficiary (QMB) program. CMS has expressed concern that some physicians are still billing…
How to use the JW modifier
Read the full articleA new CMS rule becomes effective Jan. 1, 2017. Providers are required to use the JW modifier on claims to… A new CMS rule becomes effective Jan. 1, 2017. Providers are required to use the JW modifier on claims to report the unused portion of…
New proposed methodology for Part B drugs
Read the full articleCMS recently released a proposed rule to change how it covers certain Medicare Part B drugs. (Medicare Part B drugs… CMS recently released a proposed rule to change how it covers certain Medicare Part B drugs. (Medicare Part B drugs are generally those delivered in…
Don’t say goodbye to ICD-9 just yet
Read the full articleYou might not want to call it “dual coding,” but there will be a need to maintain coding capability for… You might not want to call it “dual coding,” but there will be a need to maintain coding capability for both ICD-9 and ICD-10. As…
The HCPlan is moving forward
Read the full articleEarlier this year, the Secretary of Health and Human Services (HHS) announced the Health Care Payment Learning and Action Network… Earlier this year, the Secretary of Health and Human Services (HHS) announced the Health Care Payment Learning and Action Network (HCPlan) had been formed to…
New modification to the “two midnight” rule
Read the full articleCurrently, you cannot admit a Medicare patient to an intensive care unit for desensitization to a chemotherapeutic agent or antibiotic… Currently, you cannot admit a Medicare patient to an intensive care unit for desensitization to a chemotherapeutic agent or antibiotic because you need to certify…
Update on USP (US Pharmacopeia)
Read the full articleThe Advocacy Council of ACAAI has received several phone calls in response to a recent article about the allergy exemption… The Advocacy Council of ACAAI has received several phone calls in response to a recent article about the allergy exemption to the USP compounding regulations.…
White House moves to fix key consumer complaints about the Affordable Care Act
Read the full articleSince the Affordable Care Act (ACA) became effective, the main complaints patients have had have been inaccurate provider directories and… Since the Affordable Care Act (ACA) became effective, the main complaints patients have had have been inaccurate provider directories and higher than expected out-of-pocket costs…
Mismatch - Meaningful Use vs PECOS data
Read the full articleTo make sure you receive your incentive payment and report your compliance with Meaningful Use (MU) requirements, you must have… To make sure you receive your incentive payment and report your compliance with Meaningful Use (MU) requirements, you must have a national provider identifier (NPI)…
We need greater accuracy for physician work components
Read the full articleThe Government Accountability Office (GAO) issued a report urging the Centers for Medicare and Medicaid services (CMS) to improve the… The Government Accountability Office (GAO) issued a report urging the Centers for Medicare and Medicaid services (CMS) to improve the process for determining the value…
Our take on the proposed PFS
Read the full articleReviewing the proposed Physician Fee Schedule – part 1 Every July, Medicare (CMS) issues a proposed Physician Fee Schedule (PFS)… Reviewing the proposed Physician Fee Schedule – part 1Every July, Medicare (CMS) issues a proposed Physician Fee Schedule (PFS) for the upcoming year. It includes…
Mark your calendar for Nov. 9!
Read the full articleThe Advocacy Council (formerly JCAAI) wants to make you aware of the following announcements from CMS with an important upcoming… The Advocacy Council (formerly JCAAI) wants to make you aware of the following announcements from CMS with an important upcoming deadline – Nov. 9, 2015.…
What you need to know about the final rule on Stage 3 of Meaningful Use
Read the full articleThe Centers for Medicare and Medicaid Services (CMS), recently released its final rule with comment period implementing Stage 3 of… The Centers for Medicare and Medicaid Services (CMS), recently released its final rule with comment period implementing Stage 3 of Meaningful Use. The release came…
Reviewing the proposed physician fee schedule
Read the full articleReviewing the proposed Physician Fee Schedule – part 1 Every July, Medicare (CMS) issues a proposed Physician Fee Schedule (PFS)… Reviewing the proposed Physician Fee Schedule – part 1Every July, Medicare (CMS) issues a proposed Physician Fee Schedule (PFS) for the upcoming year. It includes…
Skinny networks - Are they in your patient's best interest?
Read the full articleThe Advocacy Council of ACCAI (formerly JCAAI) knows that you are concerned about skinny (or narrow) provider networks. The Affordable… The Advocacy Council of ACCAI (formerly JCAAI) knows that you are concerned about skinny (or narrow) provider networks. The Affordable Care Act (ACA) (“Obamacare”) created…
More physicians need to review CMS data!
Read the full articleMedicare (CMS) recently published 2014 data detailing payments to physicians (and other providers) by drug and medical device manufacturers. This… Medicare (CMS) recently published 2014 data detailing payments to physicians (and other providers) by drug and medical device manufacturers. This data includes payments made to…
Check your CMS QRUR report today!
Read the full articleCMS has created a Quality and Resource Use Report (QRUR) for physicians that compares how much you and/or your practice… CMS has created a Quality and Resource Use Report (QRUR) for physicians that compares how much you and/or your practice have been paid by Medicare…
Don’t ignore audit alerts!
Read the full articleOne of the Advocacy Council’s consultants recently attended a Medicare (CMS) presentation on Meaningful Use (MU) of electronic health record… One of the Advocacy Council’s consultants recently attended a Medicare (CMS) presentation on Meaningful Use (MU) of electronic health record (EHR) audits. What are the…
Quality & resource use reports - The physician feedback program
Read the full articleFederal legislation has mandated that physicians who provide high-quality, low-cost care be rewarded with up to a four percent bonus… Federal legislation has mandated that physicians who provide high-quality, low-cost care be rewarded with up to a four percent bonus on their Medicare reimbursement while…
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