Access to care is critical for treating arthritis and other chronic rheumatic conditions. That’s why choosing the best Medicare plan fit is such an important decision. Use these tips from the Arthritis Foundation’s Nick Turkas, MS, to help your patients make their best choice for insurance coverage.
WASHINGTON (Reuters)—U.S. President Joe Biden and his fellow Democrats promised voters sweeping drug price reform in their signature social spending bill but agreed to move ahead with a far less ambitious proposal after facing opposition in Congress. The plan could still fail as hurdles remain to approving the broader spending package, known as “Build Back…
Rheumatology leaders are encouraged by continued implementation of E/M coding changes, telehealth flexibilities and rheumatology-specific MIPS Value Pathway, but have concerns regarding conversion factor reductions and the CMS EHR interoperability and digital quality measures proposal.
In case you missed it, on Nov. 20, the Centers for Medicare & Medicaid Services (CMS), a department within the U.S. Department of Health and Human Services, announced that it will overhaul the payment system for Medicare Part B (i.e., infusion) drugs on Jan. 1, 2021. The plan is called the Most Favored Nation (MFN)…
(Reuters Health)—Most Medicare Advantage plans are not offering chronically ill enrollees supplemental benefits to address social needs, which were added to the government health program in 2018 in an effort to improve health outcomes and achieve cost savings, a U.S. study suggests.1 Researchers examined publicly available data on benefits and plan design for Medicare Advantage…
Take the challenge. Scenario 1—A: The nurse practitioner may act as the supervising physician if it’s within the scope of practice for the NP and should be coded as follows: CPT: 96413, 96415, J1745 x 30, J1200 x 1 Diagnosis ICD:10: M05.79 Scenario 2—A: To qualify as an incident-to service, the PA can provide the…
Scenario 1: Direct Billing A 70-year-old female patient with rheumatoid arthritis in multiple joints and positive rheumatoid factor returns to the practice for her fourth infusion of infliximab with the nurse practitioner (NP). She reports no fevers, cough, dyspnea or concurrent illness. She rates the severity of her joint pain at 6 on a 10-point…
(Reuters Health)—U.S. insurers and providers spent more than $800 billion in 2017 on administration, or nearly $2,500 per person—more than four times the per-capita administrative costs in Canada’s single-payer system, a new study finds. Over one-third of all healthcare costs in the U.S. were due to insurance company overhead and provider time spent on billing,…
NEW YORK, Dec 17 (Reuters)—CVS Health Corp. and its Omnicare unit were sued on Tuesday by the U.S. government, which accused them of fraudulently billing Medicare and Medicaid for hundreds of thousands of drugs without valid prescriptions. The U.S. Department of Justice joined two whistleblower lawsuits accusing Omnicare of failing to obtain new prescriptions from…
Legislation introduced in both houses of Congress would set a minimum Medicare reimbursement of $98 for DXA bone density scans.