Archive for 'Provider News'
Pediatric Billers: SCHIP Enrollment Just Got Easier For Your Patients
Posted on 12. Feb, 2009 by .
There’s been quite a bit of hoo-ha over the $32.8 billion State Children’s Health Insurance Program bill President Obama signed this week. What got less attention was a memo he sent to HHS lifting certain SCHIP restrictions from the Bush administration, reports The Wall Street Journal.
SCHIP is meant to be a stop-gap for poor children not eligible for Medicaid. Previously, children had to be 250% below the poverty line to qualify for SCHIP. At $50,000 for a family of four, that’s pretty poor in many places, WSJ notes.
Several states had sued the federal government over the Bush restrictions that Obama’s memo makes null and void, the paper adds.
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30% of EMR Buyers De-Install Later
Posted on 10. Feb, 2009 by .
Suggest this solution and save your practice $45,000 per doctor.
The price tag for an electronic medical records system runs about $50,000 per physician. Yet 30 percent of practices that install EMR drop it later, reports American Medical News.
The problem: Many practices go for deluxe, whiz-bang EMR systems, when ‘lightweight’ EMR might be a better choice … More …
Medicare’s E-Prescribing Program: What’s In It For You?
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More Insured Patients for Pediatric Practices
Posted on 05. Feb, 2009 by .
… and physician-owned hospitals escape Stark, this time.
On February 4th, President Obama signed $32.8 billion worth of health insurance for children into law, rebooting SCHIP–the State Children’s Health Insurance Program. The bill should cover 4.1 million additional children over the next 4½ years, reports Modern Healthcare.
Another winner: Physician-owned hospitals. An earlier House version of the bill had a provision from Rep. Pete Stark to ban such hospitals, which typically focus on one area such as orthopedics or women’s health.
Big Loser: Cigarette Companies. Funding for the SCHIP bill will come from a steep tobacco tax increase, about 60¢ per cigarette pack, reports The Wall Street Journal.
Heads up, peds practices: Higher pay is just a surgery code away.
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Show Us the Money for Primary Care
Posted on 05. Feb, 2009 by .
Almost everyone agrees that federal and private insurers should reimburse primary care doctors more for their E/M skills and preventive care work.
But where should that extra reimbursement come from? Let’s lower the reimbursement specialists receive so we can pay primary care docs more, said readers in a recent Wall Street Journal Health Blog survey.
The American College of Physicians begs to differ. Pay primary care doctors more, the group argues, AND continue to pay specialists at the same rate. If the health care system doesn’t take that approach, primary care reimbursement will get lost as all the specialties wrangle over cash … More …
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Doctors’ Medicare Data Stays Locked … For Now
Posted on 04. Feb, 2009 by .
Because physician practices submit claims to Medicare, the government has a lot of information to share about the individual doctors you code for. And that information should be used for a ratings system available to the public, argues a group called Consumers Checkbook. In 2007, a federal court agreed.
Hold up, said an appeals court this week. The appeals court sides with the feds, who want to keep individual providers’ Medicare data out of any public ratings system. Some doctors applaud the appeals court ruling, arguing that freely available individual Medicare data would compromise patient privacy and could easily be misinterpreted … More …
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Do-Over: Look Out for Another HHS Secretary Nominee
Posted on 03. Feb, 2009 by .
We coders and billers would certainly be in some hot water for an $146,000 ‘oversight.’
The man President Obama selected to run the Department of Health and Human Services, and by extension, CMS, is in hot water too. On February 3rd at noon, Tom Daschle withdrew himself from the confirmation process, and won’t be our HHS Secretary.
The Rubber Hits the Road: Daschle failed to report $255,000 as “income” for a car and driver service a donor provided to him for his personal use between 2005 and 2007. (I know, MOMS-OUT-THERE, where’s the guy to give us that kind of swag for our carpool duties?) As a result, Daschle owed the IRS $146,000 in back taxes … More from The Washington Post…
The person who runs HHS and CMS makes a big difference to your coding & billing job. Stay tuned to Coding News for the latest scoop that affects you.
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Good-Bye Fee-For-Service, Hello ‘Episodes of Care’
Posted on 03. Feb, 2009 by .
It’s not like we’re going to go back to capitation for physician services, but some very powerful people want to lead us to something like mini-capitation.
A new CMS demonstration project is testing lump sum payments, to be split between inpatient hospitals and doctors, for “episodes of care” involving certain procedures like coronary bypass, reports The Wall Street Journal.
President Obama’s nominee for HHS Secretary, Tom Daschle, supports this approach as a “middle road” between runaway costs for unnecessary procedures that fee-for-service might encourage and the problems of broader capitation, such as substandard care and cherry-picking patients.
More on CMS’s “episodes of care” demo project …
What every health care financial executive needs to know about coding.
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200,000 New HIT Jobs?
Posted on 02. Feb, 2009 by .
There’s a big boost for ‘back office’ health care jobs in an economic stimulus bill making its way through Congress.
Part of the bill would inject $20 billion into health information technology development, reports National Public Radio. That translates into 200,000 jobs at health care facilities for professionals who set up HIT systems and teach clinicians how to use them, estimates Dr. John Halamka, CIO at Harvard Medical School. More from NPR …
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NON-Routine Pregnancy Care
Posted on 30. Jan, 2009 by .
‘Fess up, coders. While the rest of the country was cooing over the California woman who birthed octuplets this week, we were thinking about the heroic coder behind the scenes handling the claims.
V codes aside, just how ‘multiple’ can a multiple gestation coding scenario get? ‘The Explainer’ from Slate Magazine has some anatomical answers.
“Don’t the babies get tangled up? No. Each baby is enclosed in its own amniotic sac, which keeps the various umbilical cords and limbs from getting intertwined. Picture a bucketful of water balloons … More …
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Medicare Eases Restrictions for ‘Off-Label’ Cancer Treatments
Posted on 29. Jan, 2009 by .
In a quiet move back in November, noticed mostly by folks who focus on oncology reimbursement, CMS changed Medicare policies for cancer treatments not approved by the Food & Drug Administration. Private insurers are expected to follow Medicare’s lead.
Now the clamor begins: Some applaud Medicare’s move, arguing that the slow FDA approval process has made it difficult for providers to obtain reimbursement for clinically-proven treatments. Others caution that big pharma funds much of the research endorsing ‘off label’ uses, and that the conflict of interest will drive up unnecessary treatments and health care costs, reports The Wall Street Journal.
Oncology Coders: Brenda Chidester shows you how to tackle drug waste and off-label use.
More on the ‘off label’ story from The New York Times …
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