The U.S Preventive Services Task Force and the CDC (Centers for Disease Control) have joined in a recent call for one-time hepatitis C screening among baby boomers. The task force recommends that those born between 1945 and 1965 be screened, while the CDC encourages individuals born between 1946 and 1965 be screened. Hepatitis C affects approximately 3.2 million Americans, 75% of which were born between 1945-1965; many are unaware they ...

The Centers for Medicare & Medicaid Services (CMS) announced on July 3, 2013 that Medicare will not support full coverage of advanced imaging tests and PET scans intended to diagnose dementia or neurodegenerative disease. The Medicare Evidence Development & Coverage Advisory Committee determined that there is a lack of evidence as to whether PET screenings improve patient outcomes, and therefore advanced imaging tests will not be entirely covered by Medicare. ...

Under the PPACA (Patient Protection & Affordable Care Act), the landmark health bill signed by President Obama in 2010, “large” employers – that is, employers with 50 employees or more – must provide health insurance for all of their full time employees. Employers must otherwise pay a $2000 penalty for each full-time employee who does not receive coverage. On Tuesday, July 2nd, the White House announced that it would delay ...

In 2009, the Medicare and Medicaid EHR (electronic health record) incentive program created an incentive structure that would reward physicians who adopted an EHR system, and penalize those who did not. Under this current program, physicians must meet “meaningful use requirements” and adopt an EHR system by July 2014 in order to avoid penalties in 2015. However, House Rep. Diane Black (R, Tenn.) recently introduced a bill that would offer more ...

We have been actively following PQRS developments with a watchful eye for the most efficient and effective way for Medicare providers to avoid the 2015 PQRS penalty. An option that may be a good solution for both group practices and individual providers is the CMS-calculated administrative claims reporting option. This option was presented by CMS in response to the cumbersome process that providers were faced with when attempting to report ...

CMS recently published an article on raising awareness of men’s health issues and preventive services – in light of June being Men’s Health Month. With the revamped Medicare policy on preventive services – for which the Affordable Care Act contains provisions that have allowed Medicare to cover many new preventive services at no charge to the patient – it is important that every medical provider know which services are covered, ...

So – here you are, recently graduated from Medical School, or considering a venture into private practice, or a transition from your current practice into a new environment. As exciting as this time is, you may also feel as though you are wandering through a maze of questions and murky decisions. Is private practice best, or would joining a group better suit your needs? Would becoming a hospital employee ease ...

Novitas (Medicare Administrative Contractor) has sought to provide additional clarification for those providers seeking participation in clinical trials and applications for Investigational Device Exemption (IDE), Humanitarian Use Device (HUD) and/or Post-Approval and 510K Extension Studies for Carotid Artery Stenting (CAS). The Medicare A/B Reference Manual, Chapter 7 (available here: https://www.novitas-solutions.com/refman/chapter-7.html) has been revised. While there are no substantive changes to the regulations surrounding clinical trial participation, Novitas has added a helpful ...

Medical providers are currently being bombarded with various incentive and penalty programs… from PQRS, to EMR incentives, the sequestration cuts, and e-Rx. Of all of these programs, e-prescribing is on the easier end for provider participation. If your practice is not currently e-prescribing, what are you waiting for? With the correct software (often free, or available at little expense), and the proper coding and billing of an eRX CPT, providers ...