Medicaid Auditors Gone Rogue

The case continues even after two suicides. When does an audit go beyond the reasonable and become persecution? An act of tyranny by claim denial and extrapolation? Vernon Partners LLC…

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CMS Adjusts Medicare RAC Documentation Limits

In an effort to reduce administrative burdens on hospitals and other providers, CMS has reduced the minimum medical record requests from Medicare Recovery Auditors — formerly known as Recovery Audit…

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Benefits of Medicaid EHR incentive program

Meaningful use expert Jim Tate has written that the Medicaid EHR incentive program reminds him of "zero entry" swimming pools: very easy to get into, with almost no barriers. Given…

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Registration open for electronic health records incentives

On Jan. 3, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) opened the registration for the Medicare and Medicaid electronic health record (EHR) incentive programs. It was started in Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee, and Texas and broad participation is invited from eligible professionals and eligible hospitals who wish to participate.

In February, the registration will open in California, Missouri, and North Dakota and in other states during the spring and summer of 2011.

“With the start of registration, these landmark programs get underway, and patients, providers, and the nation can begin to enjoy the benefits of widespread adoption of electronic health records,” CMS Administrator Donald Berwick, MD was quoted as saying in the news release. “CMS has many resources available to help providers register and participate, and we look forward to working with eligible professionals and eligible hospitals to facilitate the process, beginning on January 3rd and going forward.”

“It’s time to get connected,” said David Blumenthal, MD, MPP, National Coordinator for Health Information Technology. “ONC and CMS have worked together over many months to prepare for the startup on January 3rd. ONC’s Certified HIT Product List includes more than 130 certified EHR systems or modules and is updated frequently. ONC also has hands-on assistance available across the country through 62 Regional Extension Centers. We look forward to continuing to work with CMS to assist eligible providers in 2011 and future years.”

The news release said that interested providers can acquaint themselves with the programs’ requirements by visiting CMS’ Official Web Site for the Medicare and Medicaid EHR Incentive Programs.

Eligible providers seeking to participate in the Medicaid programs must initiate registration at CMS’...

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Payer Update: UHC Sticks With Consult Codes

Check with Medicaid plans, insurer warns. You can breathe a sigh of relief — one major payer will stick with 99241-99255. UnitedHealthcare (UHC) commercial plans will make no change in payment for consultation codes (99241-99255) at this time, according to a UHC e-mail alert. “Physicians may continue to submit claims for these services, and will be reimbursed according to United-Healthcare payment policies”. Beware: One Medicaid [...] Related articles:

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Medicare’s Consult Rule Trickle Down Effect

And what it means for pediatric practices. A report from AMA in Chicago. Although CPT clarifies the transfer of care definition, the fix came too late for Medicare, meaning your private payers may follow suit. Continued Errors Result in E/M Boon The Office of Inspector General found a high error rate on consultation codes. Different opinions on when [...] Related articles:

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