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Author: ICS Staff

Mandatory Payment Reductions in the Medicare Fee-for-Service (FFS Program) –

Mandatory Payment Reductions in the Medicare Fee-for-Service (FFS Program) –

In general, Medicare FFS claims with dates-of-service or dates-of-discharge on or after April 1, 2013, will incur a 2 percent reduction in Medicare payment. Claims for durable medical equipment (DME), prosthetics, orthotics, and supplies, including claims under the DME Competitive Bidding Program, will be reduced by 2 percent based upon whether the date-of-service or the start date for rental equipment or multi-day supplies, is on or after April 1, 2013.

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Understanding ERISA Law: How to Appeal ERISA Claims

Understanding ERISA Law: How to Appeal ERISA Claims

A large number of questions I receive deal with appealing denied insurance claims and these denials cause most doctors headaches. When a claim has been denied because of medical necessity or because a service is not covered, an important step in the appeals process is to determine if the patient’s plan is a self-funded ERISA plan.

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End of Session Report

End of Session Report

We went into the 2nd year of the 97th General Assembly predicting a political minefield of Education, Pension, Medicaid & Healthcare reform while legislators simultaneously struggled with maintaining tenuous public favor while running in entirely new legislative districts. Although no agreement was reached on pension reform, the Legislature adjourned on time (May 31st) choosing to avoid even tougher votes in an overtime session (when a supermajority would be required for passage).

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