Medical Billing Blog

"The American Medical Association (AMA) is appalled by news from the Centers for Medicare and Medicaid Services (CMS) today that more than 50 percent of eligible professionals will face penalties under the Meaningful Use program in 2015, a number that is even worse than we anticipated.

The Obama administration on Tuesday reported a big increase in new customers signing up for health insurance in Florida, Texas and other states using the federal insurance marketplace.

Secretary of Health and Human Services Sylvia Mathews Burwell said on Sunday 100,000 people submitted new applications for Obamacare in the first days of the second open enrollment period.

The Obama administration has opened a new health-insurance portal to small businesses in five states after a yearlong delay of the Affordable Care Act’s online marketplace for small-employer health plans.

Fall is enrollment season for many people who get insurance through their workplace. Premium increases for 2015 plans are expected to be modest on average, but the shift toward higher out-of-pocket costs overall for consumers will continue as employers try to keep a lid on their costs and incorporate health law changes.

Following widespread discontent with the meaningful use program and EHR policies, the American Medical Association (AMA) has released a list of eight priorities to improve quality and usability during EHR adoption.

According to study by the Kaiser Family Foundation analyzing ACA Benchmark premiums in the largest cities from 15 states and the District of Columbia, there will be a mixture of premium increases and premium decreases for the benchmark Silver plans in 2015. While many of the Silver plans sold on the Exchanges in 2014 will charge higher premiums in 2015, the new plans being sold on these Exchanges will have prices below (in some cases well below) the prices for the returning plans.

On August 22 the Centers for Medicare and Medicaid Services (CMS) announced that it would instruct Medicare Administrative Contractors (MACs) to hold three acknowledgement testing weeks for providers to prepare for the switch to ICD-10.

The Medicare National Correct Coding Initiative (NCCI) published Procedure to Procedure edits
that seek to prevent unbundling of services and overpayment. The requirements state that if one code defines a subset of work of another code, the codes should not be reported separately, which would be considered double billing. The notice states that modifier -59 defines a “Distinct Procedural Service” which represents a service that is separate and distinct from another service with which it would usually be considered to be bundled.

CMS Principal Deputy Administrator Andy Slavitt testified before the House Energy and Commerce Committee about a new report issued by the General Accounting Office (GAO) on CMS’ management of the healthcare.gov website.