CMS Chief Could Take Over at HHS After Price Resignation

By | 2017, Coding and Auditing, Practice Operations, Regulatory Compliance
CMS Chief Could Take Over at HHS After Price Resignation By Grant Huang Director of Content at DoctorsManagement The sudden resignation of Tom Price, the former Georgia Congressman, from his post as HHS Secretary creates more uncertainty over how the agency will approach crucial initiatives, such as enforcing the politically divisive Affordable Care Act (ACA)...
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Why the Hierarchical Condition Category (HHC) Model Matters

By | 2017, Coding and Auditing, Practice Operations, Regulatory Compliance
Why the Hierarchical Condition Category (HHC) Model Matters By Grant Huang Director of Content at DoctorsManagement For many providers and administrators, Hierarchical Condition Categories (HCCs) are still something of a mystery, a concept that seems to do most of its work in the background. But now, as the healthcare industry accelerates towards alternative payment models,...
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Medicare Therapy Coverage Doesn’t Hinge on Patient ‘Improvement’

By | 2017, Coding and Auditing, Regulatory Compliance
Medicare Therapy Coverage Doesn’t Hinge on Patient ‘Improvement' By Sean M. Weiss Partner, Vice President and Chief Compliance Officer of DoctorsManagement We at DoctorsManagement have been aware of Medicare payers improperly applying the government’s “improvement standard” far too broadly, using it to deny physical and occupational therapy services in particular. This is wrong, and we...
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Supreme Court Ruling Weakens Whistleblower Suits

By | 2017, Coding and Auditing, Regulatory Compliance
Supreme Court Ruling Weakens Whistleblower Suits By Sean M. Weiss Partner, Vice President and Chief Compliance Officer at DoctorsManagement A recent Supreme Court ruling will reduce the success rate of whistleblower lawsuits made against healthcare payers and providers under the False Claims Act (FCA), though it also reaffirms the most consequential aspect of the FCA:...
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As Cuts Loom, Should You Switch to Digital Radiography?

By | 2017, Coding and Auditing, Regulatory Compliance
As Cuts Loom, Should You Switch to Digital Radiography? By Andy Oterson National Account Manager at Henry Schein Medical. Last year, Congress passed the Consolidated Appropriations Act, which includes reductions in reimbursements for imaging performed with analog X-ray and computed radiology systems, beginning in 2017 and beyond. Medicare will begin to reduce payments by 20% on analog...
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