Topic: Billing and Coding
Doctors may have heard a lot about MACRA, but not so much about new patient relationship categories and codes.
A doctor has agreed to pay $3 million to settle claims from improperly billing Medicaid and Medicare programs.
The OIG also found that beneficiaries spent $8.7 million in unnecessary deductibles and coinsurance from 2015-2017.
Anthem must provide testimony requested by federal prosecutors investigating the insurer's retrospective chart review.
CMS will appeal a September legal decision invalidating a 2014 rule with huge implications for insurers, including UnitedHealth.
Physician groups say they hope to work with CMS on a new E/M coding and payment structure to ensure doctors are fairly paid.
Doctors spoke, and CMS listened—delaying any changes to codes for Medicare patient visits until 2021.
Of the nearly $7 billion Medicare paid to inpatient rehab hospitals in 2013, $5.7 billion was deemed improper.
No one is making predictions about what CMS will do when it comes to a proposal to change E/M billing codes.
HealthCare Partners Holdings agreed to the settlement without admitting wrongdoing.