Recently, the Centers for Medicare and Medicaid Services (CMS) discovered an error in the implementation of the 2019 Merit-Based Incentive Payment System (MIPS) payment adjustment. It incorrectly applies adjustments to payments for Medicare Part B drugs and other non-physician services billed by physicians. Adjustments to affected claims will occur in the near future. According to the…
Update & Changes to the OIG Work Plan
Early last fall, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its OIG Work Plan for fiscal year 2018–2019, which is a two-year framework for the audits, inspections, evaluations and investigative activities planned in support of its vision, mission, and strategic goals and objectives to maintain HHS program integrity….
Walgreens & Microsoft Partner to Develop Digital Healthcare Services
(Reuters)—Drugstore chain Walgreens Boots Alliance Inc and Microsoft Corp said on Tuesday they have entered a seven-year agreement to research and develop new methods of delivering healthcare services through digital devices. As a part of the deal, the companies will focus on virtually connecting people with Walgreens stores and provide services on therapeutic areas ranging…
Rheumatology Clinics Add Pharmacists to Care Teams, See Benefits
CHICAGO—Could the addition of a pharmacist to rheumatology care teams improve patient satisfaction, decrease staff burnout or reduce medication-related problems? Three panelists in Integrating Pharmacists into the Workforce, a session at the 2018 ACR/ARHP Annual Meeting, shared positive experiences with this interdisciplinary care model. Less Burnout, More Satisfaction Ten years ago, the Arthritis Treatment Center…
Reminder: How to Handle Part D Prior Authorization Requests
Note: Although originally posted in January 2018, the advice below remains valid. We see this issue recur each year. As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B,…
How Advances in Artificial Intelligence May Aid Rheumatology
From digital scribes to predictive pharmacology—as artificial intelligence advances, technology has a lot to offer medicine. What opportunities lie ahead for rheumatologists and their patients?
Common Issues That Lead to Claim Denials
In an already complicated reimbursement landscape, claims denials can potentially pose a serious issue to the financial revenue for rheumatology practices. Denials are not only highly prevalent in the healthcare environment, but also costly to appeal, which affects overall reimbursements. According to The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting…
Tips for Using Digital Health Tools
CHICAGO—Approximately 200,000 health apps are available through major app stores. Some offer real benefits, said Brennan Spiegel, MD, MSHS, director of health services research at Cedars-Sinai Health System, Los Angeles, Calif. But most, he told attendees at the 2018 ACR/ARHP Annual Meeting, are “rubbish.” “They do one or two things only—and generally not well,” he…
2019 Changes to E/M Documentation
As of Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) will implement several coding and documentation policies to provide immediate burden reduction to providers. The 2019 Medicare Physician Fee Schedule Final Rule (MPFS) released Nov. 1, 2018, by the CMS contained significant changes to the Medicare Part B coding and documentation policies…
Big Data Drives New Research
Big data can benefit rheumatology research. But according to experts at the 2018 ACR/ARHP Annual Meeting, the data must first be accessible, interoperable and shareable…
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