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  • Coding HBO Therapy Is a Gas

    It may sound like something out of a sci-fi movie, but hyperbaric oxygen (HBO) therapy is real. It involves breathing pure oxygen in a pressurized room or tube, and it has long been used to treat decompression sickness from scuba diving. More recently, physicians have found it useful to treat other conditions. Medicare Coverage under […]... Read more »

  • New O2 Modifiers Effective April 2018

    There are new and changed modifiers to use if you are adjusting oxygen volume. The Centers for Medicare & Medicaid Services (CMS) updated an October Transmittal better defining how to report oxygen amounts below 1 liter per minute, which reduces the fee schedule monthly amount for stationary oxygen by 50 percent. CMS’ rules for  volume adjustment say if […]... Read more »

  • Adhere to Strict Sexual Harassment Policies in Your Hospital

    Sexual harassment isn’t just a Hollywood problem coming into the limelight. It’s in nearly every workplace, including hospitals and physician practices. To help ensure your healthcare organization avoids incidents of sexual harassment, it’s important to have strict policies in place and to make sure your employees understand what constitutes inappropriate conduct. What Is Sexual Harassment? […]... Read more »

  • G0475 Subject to CLIA Edits

    The HCPCS Level II code G0475 HIV antigen/antibody, combination assay, screening is effective for dates of service on or after April 13, 2015, and is subject to Clinical Laboratory Improvement Amendments (CLIA) edits, despite its omission in previous transmittals from the Centers for Medicare & Medicaid Services (CMS). For Medicare reimbursement, G0475 requires a facility to have either a […]... Read more »

  • Aetna Sues Business Associate Over HIV Breach

    Here’s a stark reminder of the responsibilities  – and risks – of being a business associate: Aetna is suing the company that mailed 12,000 envelopes last summer revealing the recipients had HIV for $20 million and more. Aetna hired claims administrator Kurtzman Carson Consultants (KCC) to send letters notifying Aetna members of a settlement the […]... Read more »

  • CMS releases its Measures Under Consideration List for 2018 pre-rulemaking

    By: Kate Goodrich, M.D., M.H.S., Director, Center for Clinical Standards & Quality, CMS Chief Medical Officer Medicare and other payers are rapidly moving toward a healthcare system that rewards high quality care while spending more wisely. Foundational to the success of these efforts is having quality measures that are meaningful to patients, consumers, and providers alike.  CMS recently announced the “Meaningful Measures” initiative to identify the most impactful areas for quality measurement and improvement and reflect core issues that are most vital to high quality care and better individual outcomes. Each year, CMS publishes a list of quality and cost measures... Read more »

  • CMS announces a new user-centered resource to help improve alignment: the CMS Measures Inventory Tool (CMIT)

    By Kate Goodrich, MD Director, CMS Center for Clinical Standards and Quality & CMS Chief Medical Officer CMS is actively working to move the needle on improving quality in healthcare without additional burden to those providers on the frontlines. CMS recently launched a new initiative, ‘Meaningful Measures,’ which will streamline current measure sets – so providers can focus on the measures that are most impactful – and will move from process measures to outcome measures where possible. A great deal of attention has also been focused on alignment of quality measures within CMS and with commercial payers, and we are committed to... Read more »

  • Administrator’s Blog: National Rural Health Day (November 16, 2017)

    November 16, 2017 By: Seema Verma, CMS Administrator @SeemaCMS  Today, CMS is celebrating National Rural Health Day by commemorating our partners who provide quality care to the nearly one in five Americans who reside in rural communities. CMS recognizes the unique challenges facing rural America, and we are taking action to improve access and quality for healthcare providers serving rural patients. This fall, I have been visiting communities throughout the country to learn more about issues critical to improving access to rural healthcare. I travelled to Kansas City and visited the headquarters of the National Rural Health Association to talk with key leadership... Read more »

  • CMS’s 2017 Medicare Fee-For-Service improper payment rate is below 10 percent for the first time since 2013  

     CMS Blog November 15, 2017 By Kimberly Brandt, Principal Deputy Administrator for Operations ( The Centers for Medicare & Medicaid Services (CMS) is committed to reducing improper payments in all of its programs, as evidenced by improper payment reduction efforts contained in the Fiscal Year 2018 President’s Budget. CMS’s new leadership is re-examining existing corrective actions and exploring new and innovative approaches to reducing improper payments, while minimizing burden for its partners. Due to the successes of actions we’ve put into place to reduce improper payments, the Medicare Fee-For-Service (FFS) improper payment rate decreased from 11.0 percent in 2016 to 9.5 percent in... Read more »

  • Thank You For Your Service

    CMS BLOG November 9, 2017 By:  Seema Verma, CMS Administrator Thank You for Your Service We’ve all heard the stories of bravery and sacrifice, or have personally experienced the inspiring dedication to service of our US Military veterans, but for me their heroism was made real on a visit to Normandy. Early in the morning on D-Day, June 6, 1944, Army Rangers climbed the cliffs of Point-du-Hoc to the west of Omaha Beach to destroy a battery of 155mm German cannons on top of the cliff. As I stood there, viewing these cliffs as a tourist, I couldn’t help but imagine the fear that must’ve... Read more »

  • Opioids: Share Your Story on how epidemic has impacted your practice

    Share Your StoryTake PartAppears on:: Prescription Drug Misuse, Overdose & DeathMedical Student Section (MSS) Community Service Opportunities Appears on category: Reversing the Opioid Epidemic... Read more »

  • HITRUST & AMA Cybersecurity Workshop

    HITRUST & AMA Cybersecurity WorkshopLearn About CybersecurityAppears on category: Cybersecurity... Read more »

  • Contracting With Peers, Plans, and Others

    Short description: View tools and resources designed to help your practice succeed when contracting with peers, plans and additional groups.Disable social sharing: Add category highlights: Hide short description: Audience: Physician... Read more »

  • Succeeding With Commercial Payers

    Short description: View tools and resources designed to help your practice succeed with commercial payers.Disable social sharing: Add category highlights: Hide short description: Related Content Override: Related Content for Physician interdependence and independent practices can coexistRelated Content for Moving to new payment models: What you need to knowAudience: Physician... Read more »

  • AMA Code of Medical Ethics

    The AMA Code of Medical Ethics guides physicians to meet the ethical challenges of medical practice.Medical StudentPatientsPhysicianResident/Fellow Patient & Physician Interactions Consent, Communication & Decision Making Patient-Physician Relationships Physicians & the Health of the Community Privacy, Confidentiality & Medical Records Treatments & Use of Technologies Caring for Patients at the End of Life Genetics & Reproductive Medicine Organ Procurement & Transplantation Research & Innovation Professional Relationships & Self-Regulation Financing & Delivery of Health Care Inter-professional... Read more »