Christopher P. Dean

Christopher P. Dean


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Physician Payment: CMS Seeks Suggestions for SGR, PQRS, Meaningful Use and VBM Replacement

CMS would like your help in developing the replacement to the Sustainable Growth Rate adjustment (SGR). But you need to act quickly because CMS' cutoff date for your suggestions is October 31, 2015....more

10/16/2015 - CHIP CMS Meaningful Use Medicare Medicare Access and CHIP Reauthorization (MACRA) MIPS Notice and Comment Physician Payments PQRS Request For Information Sustainable Growth Rate (SGR) Value-Based Payments

Key Ingredients of CMS' Proposed Comprehensive Care for Joint Replacement Model

On July 14, 2015, CMS released a proposed rule regarding a new, alternative payment model: the Comprehensive Care for Joint Replacement (CCJR) program. Modeled in large part on the Bundled Payments for Care Improvement (BPCI)...more

8/3/2015 - Alternative Payment Models (APM) BPCI Bundled Payments CCJR CMS Hospitals Medicare

It's Time to Bill Medicare: Do You Know Where Your Physicians Are?

The Department of Health and Human Services Office of Inspector General (OIG) recently reported that Medicare contractors overpaid physicians $33.4 million in incorrectly coded physician services between January 2010 and...more

6/29/2015 - Healthcare Medicare OIG Physician Medicare Reimbursements Physicians

MIPS: Moving Physician Payments Beyond the Sustainable Growth Rate?

Medicare continues to transition its primary physician payment methodology from a traditional fee-for-service model into a quality and value-based model. Recently, the Medicare Access and CHIP Reauthorization Act of 2015...more

5/29/2015 - CHIP CMS Medicare Medicare Access and CHIP Reauthorization (MACRA) Merit-Based Point System MIPS Physician SGR Formula Physicians Sustainable Growth Rate (SGR)

Medigap Deductible Discount Proposal Approved by OIG

The Office of Inspector General (OIG) recently issued Advisory Opinion 15-03 and concluded that a licensed provider (the Requestor) of Medicare Supplemental Health Insurance (Medigap) would not be sanctioned under the civil...more

4/1/2015 - Anti-Kickback Statute CMP Law Hospitals Medicare Medicare Part A Medigap OIG

Veterans Access, Choice, and Accountability Act May Result in More Patients for Medicare Providers

The President signed the Veterans Access, Choice, and Accountability Act of 2014 [PDF] on August 7, 2014 (the “Act”). Ordinarily, the Department of Veterans Affairs (VA) provides medical care to veterans at Veterans Health...more

8/25/2014 - Department of Veterans Affairs Healthcare Medicare Veterans Veterans Administration VEVRAA

Jury Verdict Against Millennium Provides Insight on Definition of Remuneration

Ameritox won the latest volley of an ongoing legal battle with Millennium when a federal jury in Florida awarded it $14.75 million on June 16, 2014. Ameritox persuaded the jury that Millennium’s free point of care test (POCT)...more

7/9/2014 - Anti-Kickback Statute Kickbacks Medicaid Medicare Remuneration Stark Law

CMS Proposes Enhanced Role for Non-Physician Practitioners in Rural Health Clinics

Recognizing the difficulty many rural health clinics (RHCs) face when recruiting health care practitioners, CMS recently proposed to change its interpretation of the Rural Health Clinic Services Act and allow RHCs to contract...more

11/7/2013 - CMS Healthcare Independent Contractors Medicare Rural Health Care Providers

OIG Not Asleep at the Switch: Reviews Polysomnography Services from 2011

The OIG recently released its review of polysomnography services (sleep studies) provided in both hospital-based outpatient settings and non-hospital settings. Medicare pays for sleep studies to diagnose obstructive sleep...more

10/28/2013 - Medical Research Medicare OIG

CMS Expands MSP Recovery Portal

Earlier in 2013 the President signed into law the Strengthening Medicare and Repaying Taxpayers Act of 2012 (the “Smart Act”) requiring CMS to establish a web portal for beneficiaries, their attorneys, and authorized...more

10/4/2013 - CMS Medicare Medicare Secondary Payer Act

Complex Chronic Care Management Reimbursement for 2015 Included in Proposed 2014 Physician Fee Schedule

The proposed 2014 Medicare Physician Fee Schedule [PDF] included reimbursement for case management to be made available in 2015 for physicians who treat patients with two or more complex conditions. The proposed rule would...more

7/25/2013 - CMS Electronic Medical Records Healthcare Home Health Care Medicare Physician Medicare Reimbursements Physician Payments Physicians

DME Face-to-Face Encounter Final Rule Effective October 1, 2013

The 2013 Final Physician Fee Schedule included final regulations for the durable medical equipment (DME) face-to-face encounter requirement for Medicare and Medicaid beneficiaries....more

7/12/2013 - Durable Medical Equipment Health Care Providers Healthcare Medicaid Medicare Physicians

Changes to Medicare Secondary Payer Conditional Payment Rules

Health care providers routinely treat Medicare beneficiaries who are injured from an accident or an employment injury. If another payment source like a personal injury no fault policy, workers’ compensation insurance policy,...more

1/24/2013 - Medicare Medicare Secondary Payer Act

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