Dark Clouds Over Sunshine Act

Once again the Obama administration has been tripped up in launching a healthcare-related online system.  This time the problem concerns the Physician Payments Sunshine Act—the act that is supposed to enable the public to see whether a physician has a financial relationship with a drug or device manufacturer.  …

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Bundling Gains Momentum, Even as New Study Raises Questions

Health care cost bundling—the aggregating of all the costs of an episode of medical care into a single bill—seems to be here to stay. After all, it’s the way most all other billing is done. When your car is serviced, you don’t get a separate bill from each mechanic and vendor of parts and fluids. And …

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Brace Yourself: The RACs Are Back

Yesterday the Centers for Medicare & Medicaid Services announced that it will restart the Recovery Audit Contractor (RAC) program this month, on a limited basis.  It’s been on hold since June. Under the controversial program private contractors audit hospitals and other Medicare providers for fraudulent …

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Most Recent Final Deadline for ICD-10 Implementation is October 1

It’s been a while since CMS set a new “final” deadline for implementation of ICD-10—the greatly expanded medical coding system. So last Thursday CMS issued a new final rule setting October 1, 2015, as the final date for implementation. This new final rule shouldn’t be confused with the April 30 …

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D.C. CIRCUIT SAYS CMS DOESN’T KNOW WHAT’S NEW

On Tuesday of last week the D.C. Circuit Court ruled that the Provider Review Reimbursement Board doesn’t know what’s new.  It reversed the PRRB’s decision, along with the District Court’s decision that upheld it.  In doing so, it threw up its hands (figuratively speaking), repeatedly complaining that it …

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CMS WANTS TO SHINE LIGHT ON CME PAYMENTS TO PHYSICIANS

Should drug and device manufacturers be required to report payments to physicians who speak at CME (continuing medical education) programs? It’s a question CMS has been wrestling with since the enactment of the Sunshine Act (sometimes called the Open Payments Program) as part of the Affordable Care Act.  The …

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