Tag Archive for ‘physician reimbursement’
The 2018 inpatient-only list
Provides an update on the Medicare inpatient-only list—which refers to procedures identified by CMS as typically provided in the inpatient setting and therefore not paid under OPPS—is provided.
Regulatory burden reduction
This column provides an overview of efforts to reduce regulatory burdens on surgeons, looks at the regulations that are most onerous for surgeons, and describes ACS recommendation for reducing or eliminating these encumbrances.
The 2018 Medicare physician fee schedule: An overview of provisions that will affect surgical practices
This article summarizes provisions in the 2018 Medicare physician fee schedule final rule that are relevant to general surgery and its related specialties.
Medicare participation: Know your options
The three options for surgeons who participate in Medicare Part B are summarized, as are the steps for achieving participating in this program.
The New Medicare Card Project
The steps providers can take to prepare for the Centers for Medicare and Medicaid Services New Medicare Card Project are outlined.
2016 ACS Governors Survey: Issues affecting surgical practice
Surgeons’ views on health policy and advocacy-related issues and their potential effect on general surgery practice, based on the findings of the 2016 ACS Governors Survey, are summarized.
Postoperative data reporting for global services
The Centers for Medicare & Medicaid Services is collecting claims-based data on postoperative visits provided in the 10- and 90-day global period.
2016 ACS Governors Survey: MACRA: Are surgeons ready?
Surgeons’ views of the payment reforms implemented through MACRA, based on the findings of the 2016 ACS Governors Survey, are summarized.
Reporting global codes data in 2017
This column describes the Centers for Medicare & Medicaid Services’ efforts to collect global surgical codes data from practitioners in nine states..
The 2017 Medicare physician fee schedule: An overview of provisions that will affect surgical practice
This article summarizes provisions in the 2017 Medicare physician fee schedule final rule that are relevant to general surgery and its related specialties.
Modifier 25 under fire: Are you using it correctly?
Suggestions for avoiding overuse or misuse of modifier 25 to reduce the risk of an audit and repayment demand by payors are detailed in this month’s column.
Preparing for MACRA implementation
This column describes the reimbursement systems that will replace the sustainable growth rate formula and offers recommendations on how surgeons can prepare for the transition.
Provisions in the 2016 Medicare physician fee schedule that will affect surgical practice: An overview
This article summarizes the Medicare physician fee schedule provisions that will affect reimbursement for surgeons in 2016.
AMA HOD Annual Meeting sparks adoption of new policies
This report summarizes the topics addressed by the College’s delegation at the American Medical Association’s House of Delegates meeting in June.
Changes on the horizon for global services payment
The averted CMS policy that would have transitioned 10- and 90-day global payment codes to 0-day codes is summarized in this article, as is the legislation that will revise global payments in the coming years and the ACS’ advocacy-related role concerning these issues.
Physician Payments Sunshine Act data scheduled for release
The Physician Payments Sunshine Act, also known as Open Payments, is addressed in this month’s column, along with the registration process, types of data included in the system, the review and dispute process, and recommendations from the College.
What does the ACA mean for residents and their future practice?
Major provisions in the Affordable Care Act are described, including insurance exchanges, employer-based coverage, and quality improvement efforts with an emphasis on what they mean for residents and their future as health care providers.
The SGR repeal: How bad politics ruined sound policy
This article provides details on the Protecting Access to Medicare Act, which delays physician payment cuts resulting from the sustainable growth rate (SGR) formula and describes the politicking that prevented the passage of alternative legislation—the SGR Repeal Act—which offered a long-term solution to the Medicare physician payment problems.
Gundersen Health System studies effect of modifier 22 on reimbursement for complex operations
This article summarizes the findings of a study conducted at the Gundersen Health System, La Crosse, WI, designed to examine the use of modifier 22, its impact on reimbursement for complex surgical procedures, and the time to payment for surgeons. The authors found that use of modifier 22 resulted in payment increases for all procedures studied, but, for some operations, the time to recover charges rose as well.
Legislated mints on the pillow
Altering pay based on subjective surveys will increase costs to the medical system with no evidence that these surveys will improve the quality of care. “For government to legislate exactly what factors lead to that immeasurable connection [between patient and physician] taints the relationship with impersonal checkboxes, while adding costs to an already expensive and complex medical system with no evidence that it will increase value in American health care,” the author writes.
