AOA Practice Management Update

The Centers for Medicare and Medicaid Services (CMS) has announced four new categories of hardship exemptions that may have prevented physicians from successfully e-prescribing in 2011 and potentially incurring a 1% penalty on their Medicare Part B allowed charges during 2012.

Effective for dates of service on or after Jan. 1, 2011, Medicare provides coverage of an Annual Wellness Visit (AWV) for a beneficiary who is no longer within 12 months after the effective date of his or her first Medicare Part B coverage and who has not received either an IPPE or an AWV within the past 12 months.

The Centers for Medicare and Medicaid Services (CMS) released a final rule on its Medicaid RAC audit program that is effective Jan. 1, 2012. The RAC program recovered some $670 million in overpayments under the Obama administration and is aiming to save $2.1 billion over five years. The AOA is seeing increased activity in Medicaid audits of osteopathic physicians.

The Office of the Inspector General (OIG) published their Semi-Annual Report to Congress. Included in this report are two specific areas that we are closely monitoring: review of outpatient therapy services; and activities of the Health Care Fraud Prevention and Enforcement Action Team (HEAT).

ICD-10 will be discussed at several venues during OMED 2011 in Orlando. Find out when and where you can get all the latest information if you're attending the AOA's annual conference.

The Centers for Disease Control and Prevention recommends a yearly flu vaccination as the first and most important step in protecting against flu viruses. Remind your patients that annual vaccination is recommended for optimal protection.

The Agency for Healthcare Research and Quality has developed a new toolkit to help small- and medium-sized practices analyze workflow and redesign before, during, and after implementing health information technology

In 2009, an investigation by then-New York State Attorney General Andrew Cuomo uncovered conflicts of interest in one system that health insurers used to calculate reimbursement for patients who received care from providers outside their plan’s network.

Medicare is asking physicians to continue to resubmit routine enrollment changes while revalidation efforts are under way. Providers should continue to submit routine changes — address updates, reassignments, additions to practices, changes in authorized officials, information updates, etc. — as they always have.