Author: Mario P. Fucinari DC, CPCO, CPPM, CIC

Medicare Requiring Modifier GP on Physical Therapy Services

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jan 17, 2018 | Insurance, Medicare and Medicaid, zall | 0 |

On January 1, 2018, the Centers for Medicare and Medicaid Services (CMS) released MLN Matters Number: MM10176. In this notice, CMS identified certain services subject to the therapy cap. The revision became effective on January 1, 2018. Due to this revision, some providers have begun to receive claim rejections because they are not using the appropriate modifier.

CMS Finalizes Quality Payment Program Rule for Year 2018

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Nov 8, 2017 | Insurance, Medicare and Medicaid, zall | 0 |

On November 2nd, the Centers for Medicare & Medicaid Services (CMS) issued the final rule with comment for the second year of the Quality Payment Program (calendar year 2018), as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), as well as an interim final rule with comment.

CMS Reveals New Medicare Card Design

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Sep 20, 2017 | Insurance, Medicare and Medicaid, zall | 0 |

The Centers for Medicare & Medicaid Services (CMS) has released images of the newly designed Medicare card. The new Medicare card contains a unique, randomly-assigned number that replaces the current Social Security-based number.

Locum Tenens and Practice Coverage

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jul 27, 2017 | Practice Management, zall | 0 |

The demands of practice can often be daunting. We know we should take care of ourselves and take a break once in a while. Getting away is not always practical. Overhead is still present, the staff doesn’t always keep to our schedule because of family obligations, and of course, the patients seemingly want us on call 24/7. We can hire another doctor to practice in the office with us, but it is hard to find someone that the patients love who practices in the same style as we do. Then, of course, we have government and insurance regulations. Certification for another doctor for Medicare, PPO restrictions and credentialing can be tedious, especially when we just want them to fill in on a temporary basis.

CMS Eases Eligibility Threshold Again on MIPS Participation

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jun 22, 2017 | Insurance, Medicare and Medicaid, zall | 0 |

The Centers for Medicare and Medicaid Services (CMS) announced today that they intend to further raise the threshold for participation in its Merit-Based Incentive Payment System (MIPS). In its much-anticipated proposed 2018 rule for the Quality Payment Program (QPP), CMSproposed to increase the threshold to exclude MIPS-eligible clinicians or groups with $90,000 or less in Part B-allowed Medicare charges or 200 or fewer Part B Medicare beneficiaries.

Medicare Announces New Cards to Be Issued

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | May 1, 2017 | Insurance, Medicare and Medicaid, zall | 0 |

Identity theft has become a major problem in the United States. As a prevention measure, the Centers for Medicare & Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft and safeguard taxpayer dollars.

Strategic Health Solutions Audits Chiropractic Medicare Records

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Mar 1, 2017 | Compliance, Medicare and Medicaid, zall | 0 |

Strategic Health Solutions, a contractor working for Medicare, is auditing chiropractic records throughout the United States. Many doctors in multiple states, most recently Illinois, have received requests to send in records in response to a Medicare audit conducted by Strategic HealthSolutions. This round of audits is a Centers for Medicare and Medicaid Services (CMS) initiative to request, receive and review medical records through its Medicare Contractors, including Strategic Health Solutions.