Common Fund Doctrine
In a written opinion just released, the Illinois Supreme Court has ruled that attorneys who recover money for injured parties may not deduct legal fees from health care providers.
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Knee Pain
Patellofemoral pain syndrome (PFPS), also called “Runner’s Knee,”, describes the symptom complex of knee discomfort, swelling or crepitus that results from excessive or imbalanced forces acting on the joint. PFPS can be traumatically induced but more commonly results from muscular imbalance and cumulative overload. It is the most common cause of knee pain in the general population, affecting an estimated 25% of adults. (1,5,23) Many PFPS patients are young and athletic. (32) Data suggests the condition may affect nearly 10% of young athletes. (2)
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Temporomandibular Joint Problems
TJD describes a complex group of muscular and articular disorders affecting the TMJ, leading to pain, dysfunction and sometimes degeneration.
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Medicare Announces Part B Deductible for 2021
Recent legislation signed by President Trump significantly dampened the 2021 Medicare Part B premium increase that would have occurred, given the estimated growth in Medicare spending next year. The standard monthly premium for Medicare Part B enrollees will be $148.50 in 2021, an increase of $3.90 from $144.60 in 2020. CMS also announced that the annual deductible for Medicare Part B beneficiaries is increasing.
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Medical Necessity Requirements
On December 23, 2015, the Centers for Medicare and Medicaid Services (CMS) released a new instructional video describing their policies and procedures for establishing the medical necessity of chiropractic care.1 The video was released on the heels of a new study released by the Office of Inspector General (OIG), “CMS Should use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services”2, which revealed extrapolated data suggesting fraud and abuse in chiropractic Medicare utilization.
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Work Comp Update 2011
Today (September 1, 2011) many parts of the new Workers’ Compensation Act take effect and the ICS wants to ensure you know what changes occur, and what steps you need to take. Already our office has received phone calls from doctors with stories of employers claiming chiropractic ineligibility. So first, I would print out an updated Workers’ Compensation Handbook to distribute to your patients and for your own records:
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Increasing Value
The Illinois Chiropractic Society understands the current challenges for our doctors and their practices. The number of changes that have happened and are coming in the next year are simply daunting: BCBS/Orthonet, NGS taking over Medicare in Illinois, HIPAA Omnibus Rule changes, Insurance Marketplace new offerings, other Affordable Care Act implementations, EHR deadlines, license renewals, CME deadline, and sweeping changes to diagnosis codes (ICD-10). However, we will continue to make sure that our members are kept up-to-date regarding all of these coming changes.
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A Simple Check that Can Save Thousands (and Prevent Sanctions)
Federal law gives authority to the Office of Inspector General (OIG) to impose Civil Monetary Penalties to practices that hire an employee/contractor who has been excluded from Medicare (or other federal programs). If the employee/contractor is involved in any part of service to the Medicare (or other federal program) patient, it can create a penalty liability as much as $10,000 PER service rendered.
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