Physician Compensation and Reimbursement
Polsinelli Podcast - Health Care Payment Changes: From Service to Value
Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more
On October 26, 2018, CMS published Transmittal 839 (Change Request 10789) in the Medicare Program Integrity Manual (Pub. 100-08, Chapter 4/4.5 – 4/4.5.5). This Transmittal is meant to convey instructions to Medicare...more
Health care bankruptcy filings more than tripled in 2017 as compared to 2016 with no end in sight to the financial struggles facing owners and operators in the sector. According to Bloomberg, health care bankruptcies have...more
Last week, home health agencies welcomed the Centers for Medicare & Medicaid Services' (CMS) decision to drop a controversial proposed payment model and leave largely unchanged the current payment system. Responding to...more
Recently, we have noticed an alarming increase within the Spilman footprint of revocations by the Centers for Medicare & Medicaid Services ("CMS") of physicians' Medicare billing privileges. In particular, CMS has been...more
On July 7, 2014, the Centers for Medicare & Medicaid Services ("CMS") published proposed changes to the Medicare Home Health Prospective Payment System ("HH PPS") for calendar year 2015 ("Proposed Rule"). The Proposed Rule...more
MedPAC Recommends Short- and Long-Term ACO Changes – In a comment letter sent to CMS Administrator Marilyn Tavenner on June 16, 2014, the Medicare Payment Advisory Commission (MedPAC) outlined certain challenges associated...more
The OIG recently released a report summarizing the details of its study regarding compliance with the requirement that physicians (or certain practitioners working with them) who certify beneficiaries as eligible for Medicare...more
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