http://www.mtbc.com/medical-billing-legal-corner.aspx Medical Billing Company. MTBC offers 4 % medical billing solutions, 4 ¢ medical transcription and a free EMR software. http://www.mtbc.com/images/web_logo_new.jpg http://www.mtbc.com http://www.mtbc.com/E-Prescribing_PartV.aspx Many providers have asked for information regarding the application process for participating in E-Prescribing. In fact, there is not a formal, onetime application. However, a provider (or practice, as the case may be) will not be entitled to a bonus unless he or she consistently represents – in the context of claim submission - that a qualified E-Prescribing system is being utilized during encounters with Medicare patients. http://www.mtbc.com/E-Prescribing_PartIV.aspx As previously discussed, there are three main requirements for earning a Medicare E-Prescribing bonus. During the prior blog we considered the first requirement, i.e., the use of a “qualified” E-prescribing system. Today, we will address the second of the three requirements. http://www.mtbc.com/E-Prescribing_PartIII.aspx There are three primary requirements for earning a Medicare E-Prescribing bonus. Today, we will address the first of the three requirements, which is the consistent usage of a “qualified” E-Prescribing system. http://www.mtbc.com/E-Prescribing_PartII.aspx One of the primary reasons for the current swell in interest in E-Prescribing is Medicare’s 2009 bonus. http://www.mtbc.com/E-Prescribing_Part1.aspx With increasing frequency, healthcare providers are giving serious consideration to the adoption and implementation of an E-Prescribing system. Some of the most often cited reasons include the following: enhancing quality of care, increasing practice efficiency, reducing medical malpractice liability (and premiums) and qualifying for governmental and commercial payor incentives. http://www.mtbc.com/Survey-says.aspx A peer-reviewed article published today indicates that physicians who adopt and actively utilize electronic medical records (also known as "electronic heath records", "EMR" or "EHR") are almost 50% less likely to have a history of a paid medical malpractice claim. http://www.mtbc.com/e-prescribing_announcement.aspx The CMS bonus deadline for implementing electronic prescribing technology is quickly approaching. Is your practice prepared to meet the looming deadline? http://www.mtbc.com/Earning-Add_III.aspx Our last two blogs considered the nature of USCIS’ civil surgeon program and the process of applying to become a civil surgeon. Today, we will conclude our consideration of the civil surgeon program by discussing the responsibilities of a civil surgeon. http://www.mtbc.com/Earning-Add_II.aspx During our most recent blog, we considered the general nature of USCIS’ civil surgeon program. Today, we will discuss the process of applying to become a civil surgeon. http://www.mtbc.com/Seeking-New-Revenue.aspx As governmental and commercial insurance reimbursements continue to decline, physicians are increasingly seeking out new revenue streams. http://www.mtbc.com/Jury-Awards.aspx In a remarkable development,a New Jersey jury has just awarded a deaf patient $400,000 for her doctor?s failure to provide an American Sign Language (?ASL?) interpreter. http://www.mtbc.com/Harvard-wants-genome.aspx Harvard University's Personal Genome Project]]> is seeking volunteers willing to "share their genome sequence and other personal information with the scientific community and the general public." http://www.mtbc.com/president-signs-online.aspx Last week, we explored the details of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008]]>, which was passed by the House of Representatives on September 23, 2008 and approved by the Senate on September 30, 2008. Yesterday, the President signed ]]>this bill into law. http://www.mtbc.com/anthem-bcbs.aspx As regular readers of this blog]]> may recall, last year, Medicare implemented its Physician Quality Reporting Initiative,which is also known as PQRI. Doctors who satisfied the quality of care and reporting requirements under PQRI received bonuses equal to 1.5% of their 2007 reimbursements. http://www.mtbc.com/lawmakers-regulate.aspx Earlier this week, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008]]> was presented to the President for his signature. http://www.mtbc.com/medicare-stop-paying.aspx Beginning tomorrow, Medicare will no longer provide reimbursement for certain newly added "never event." In particular, Medicare will refuse to provide reimbursement for the following conditions: http://www.mtbc.com/President_signs.aspx Earlier today, the President signed the Identity Theft Enforcement and Restitution Act]]>, which strengthens federal law regulating the inappropriate access and use of certain data. http://www.mtbc.com/HHS_to_Host.aspx As readers of this blog may recall, earlier this year, the U.S. Department of Health and Human Services, Office of the National Coordinator for Health Information Technology, asked the consulting group of Booz Allen Hamilton to perform an assessment and evaluation of United States? medical identity theft problem. http://www.mtbc.com/oklahoma.aspx While Oklahoma may be a world away from New Jersey, the headline I read during my recent visit to Oklahoma reminded me that agencies and practices in every state struggle with safeguarding confidential patient health information. http://www.mtbc.com/Broad-based.aspx Earlier today,Health IT Now!]]>, a coalition of more than 175 businesses, non-profit and patient groups, urged Congress to ?pass federal legislation that promotes the widespread adoption of health information technology in the remaining weeks before Congress adjourns.? http://www.mtbc.com/Legislators.aspx As we have discussed in prior blogs, state lawmakers throughout the country are debating increased restrictions on the pharmaceutical industry?s]]> ability to promote its pharmaceutical products to physicians. http://www.mtbc.com/payers_acknowledges.aspx New Jersey patients and providers recently enjoyed a victory in their long-running tug-of-war with payers concerning the reasonableness of out-of-network reimbursements. http://www.mtbc.com/New-California-Law.aspx Under a bill]]> recently approved by the Assembly and expected to be signed into law, California Healthcare providers could soon be subject to hefty fines and costly civil litigation if they fail to adopt and implement ?appropriate administrative, technical, and physical safeguards to protect the privacy of a patient?s medical information.? http://www.mtbc.com/Carolina-to-Publish.aspx Under a new North Carolina regulation]]>, details regarding North Carolina medical malpractice settlements will soon be posted online for patients to view. http://www.mtbc.com/e-prescribing2.aspx Regular readers of this blog]]> will recall our recent discussion concerning the new ?carrot? of a 2% bonus that is being offered to electronic prescribers by the Centers for Medicare and Medicaid Services (?CMS?). http://www.mtbc.com/hhs-proposed.aspx Yesterday?s blog discussed the background of HHS? proposed]]> rule, which would penalize institutions that discriminate against providers who refuse to refer patients to abortion providers. http://www.mtbc.com/hhs-acog.aspx In a controversial move, last Thursday, HHS proposed regulations that would prevent healthcare providers from being compelled to refer patients to abortion providers if doing so would violate the provider?s conscience. http://www.mtbc.com/EM.aspx Notwithstanding years of litigation and multi-million dollar settlements, many healthcare providers continue to experience inappropriate evaluation and management service (?E/M?) denials. http://www.mtbc.com/njcapsself.aspx Uninsured New Jersey patients will soon be seeing lower hospital charges. Earlier this week, New Jersey?s governor signed into law Assembly Bill 2609]]>,which caps the fees that hospitals can charge uninsured patients. http://www.mtbc.com/reimbursment_denials.aspx As we discussed]]> earlier this year, Medicare has created an ever expanding list of hospital-acquired conditions for which it no longer provides reimbursement. http://www.mtbc.com/e-prescrbing-DEA.aspx Physician societies, patient groups and federal and state agencies are rarely on the same page; so, on an occasion where they unanimously and enthusiastically support a common objective, things must move quickly, right? Not quite. http://www.mtbc.com/insurer.aspx According to news accounts, Blue Cross Blue Shield of Georgia (?BCBS of Georgia?) recently sent more than 200,000 benefits letters (e.g., EOBs) to incorrect recipients, causing widespread concern among BCBS of Georgia?s patients and forcing the insurer to quickly rollout a mitigation plan. http://www.mtbc.com/e-prescribing-bonus.aspx In recent blogs, we focused on Congress? carrot and stick approach to encourage e-prescribing. As we discussed, providers who implement e-prescribing could receive Medicare bonuses (above and beyond the Medicare fee schedule payments) equal to 2% of their annual Medicare collections. http://www.mtbc.com/e-prescribing.aspx While we have seen many news stories regarding H.R. 6331?s rollback of the scheduled 10.6% Medicare reimbursement cuts, there has been virtually no coverage regarding the bill?s groundbreaking provisions calling for Medicare bonuses for providers who adopt and regularly utilize electronic prescribing. Therefore, let?s take a few minutes to discuss some of the basics. http://www.mtbc.com/congress_stops.aspx By a veto-proof, bipartisan majority, Congress has just passed H.R. 6331, which will rollback the 10.6% Medicare reimbursement cuts that were scheduled to become effective today and provide an incentive to physicians who adopt and utilize electronic prescribing technology. http://www.mtbc.com/significant_health_law.aspx On June 30th, we witnessed the latest chapter in the Medicare cuts saga, as President Bush issued a 10-day stay of the impending 10% reimbursement cuts. http://www.mtbc.com/doctors_vs_payers.aspx Finally, physicians are fighting back. Earlier this week, the American Medical Association released its 2008 National Health Insurer Report Card. http://www.mtbc.com/cms-offers.aspx Your primary care practice could earn up to $290,000, over a five year period, if you adopt and actively use an EMR in coordination with the new Medicare Demonstration Project, which is designed to measure and showcase the quality care improvements that can result from the widespread use of interoperable EMRs/EHRs. http://www.mtbc.com/physician_brace.aspx Medicare reimbursements for healthcare providers will be cut by an average of 10.6% on July 1st and Congress may not be capable of rolling back these planned reductions in time to beat the deadline. http://www.mtbc.com/oig-streamlines.aspx OIG created SDP in 1998 to encourage providers to voluntarily disclose Medicare billing fraud and abuse. It provides such encouragement by creating a framework for reporting fraud and abuse, coupled with reduced penalties for reporting providers, i.e., typically resolving self-disclosures at a multiple of the amount of the benefit conferred, as opposed to a multiple of per-claim statutory amounts. http://www.mtbc.com/medicare_reimburse.aspx Unless congress is able to intervene, Medicare physician reimbursements will be reduced by 10.6 percent on July 1st.  Thereafter, reimbursements will be slashed another 5 percent as of January 1, 2009. http://www.mtbc.com/florida_moves.aspx The Florida House of Representatives? Healthcare Council recently voted unanimously to recommend the approval of landmark legislation that would require healthcare providers to provide each uninsured patient with a good faith estimate of charges for non-emergency treatment. http://www.mtbc.com/cms-proposes.aspx My August 13, 2007 blog discussed CMS? then-groundbreaking move to deny reimbursement for seven hospital-acquired conditions including pressure ulcers, hospital falls, certain catheter-associated infections, air embolism as a result of surgery, leaving an object in during surgery, providing incompatible blood or blood products and mediastinitis following coronary bypass surgery. http://www.mtbc.com/ca-regulators.aspx As I explained in my April 1st blog, California regulators have proposed new rules that would allow payers to continue to underpay non-participating providers, while penalizing the providers who seek customary and reasonable reimbursement. http://www.mtbc.com/terminator.aspx Earlier this week, California Governor Arnold Schwarzenegger's administration followed the lead of a handful of other states by moving to ban certain balance billing practices. http://www.mtbc.com/lost-laptop.aspx New Jersey Blue Cross Blue Shield (BCBSNJ) recently made news as word of one lost employee laptop spread like wildfire through the health care community and press, adding BCBS to a long list of payers and physicians who have been forced to disclose the loss of computer hardware containing patients' personal information. http://www.mtbc.com/medical-malpractice-claims.aspx A growing chorus of health care industry experts, physicians' groups, politicians and medical malpractice insurance carriers are urging doctors to adopt new technologies to reduce the likelihood and costs associated with medical malpractice. Most of this focus has been on electronic prescribing, medical practice management software and electronic medical records. http://www.mtbc.com/revised-I-9-form.aspx The U.S. Citizenship and Immigration Service's (USCIS) Form I-9, which every U.S. employer must complete in conjunction with the hiring process, has just been revised. Failure to utilize and properly complete the Form I-9 can result in a fine of $1,000 per infraction; therefore, it is important for every employer to be aware of and comply with these I-9 changes. http://www.mtbc.com/medical-authorizes.aspx It is increasingly common for physicians to charge their patients a fee for missed appointments. For example, approximately 31% of MTBC?s clients routinely charge a missed appointment fee. Most of these providers charge approximately $25, while others charge as little as $15 or as much as $100 per missed appointment. http://www.mtbc.com/data-mining-of-provider.aspx In a decision that could have broad implications for physicians and patients alike, the United States District Court for the District of Columbia has recently ordered the Centers for Medicaid and Medicare Services ("CMS") to disclose claim information regarding hundreds of thousands of patient encounters. http://www.mtbc.com/medicare-deny-claims.aspx Newly adopted Medicare regulations make it clear that Medicare intends to stop reimbursing hospitals for expenses associated with "hospital-acquired conditions". http://www.mtbc.com/reimburse-non-participating-providers.aspxx Last week, the New Jersey Department of Banking and Insurance ("NJ DOBI") entered an order requiring Aetna to pay a fine of $9,457,500 for violating New Jersey's HMO regulations regarding reimbursement for services rendered by non-participating providers. http://www.mtbc.com/compliance-update-medical-industry.aspx Regulators are increasingly focusing on the propriety of certain relationships and interactions between health care providers and the pharmaceutical industry. Since this issue is on the minds of many providers, I am including below an article I recently wrote for Florida Medical Business Journal, the region's leading medical business publication. http://www.mtbc.com/why-utilize-eras-and-efts.aspx A provider recently asked me whether she should register to receive Electronic Funds Transfer ("EFT") and Electronic Remittance Advice ("ERA") for her Medicare Part B claims. I answered "yes" and also encouraged her to consider registering for EFT and ERA with regard to any other payers with whom she participates. Since so many providers have asked me this question, I am providing a quick summary of the reasons I believe every provider should consider EFTs and ERAs. http://www.mtbc.com/legal-medicine.aspx I am including below excerpts from an article I recently had published in Florida Medical Business Journal, Florida's leading medical business journal. I apologize in advance to those who practice outside of Florida; however, most of the principles discussed in this article are applicable to doctors practicing in any state with the United States. http://www.mtbc.com/needy-patients-as-costs-soar.aspx Major medical technology advances over the last two decades have significantly improved the quality of care received by hospital patients. However, the use of technology has also resulted in increased costs and many of the underinsured or uninsured 'working/retired poor' have been priced out of the market. http://www.mtbc.com/enforceable-non-compete-agreements.aspx I am including below an article I recently had published in Florida Medical Business Journal, Florida's leading medical business journal. I apologize in advance to those who practice outside of Florida. Nevertheless, the principles of Florida law are very similar to those in most of states; therefore, I encourage non-Florida employers and employees to read this article. http://www.mtbc.com/how-to-earn-your-pqri-bonus.aspx My last two blogs addressed the 'what', 'when' and 'why' aspects of PQRI (if you haven't yet read them, you may want to do so prior to reading today's blog). Today's blog focuses on the issue of how a health care provider can obtain a PQRI bonus. http://www.mtbc.com/time-to-get-ready-for-pqri.aspx As of July 1, 2007, providers must begin reporting information regarding certain quality measures (I'll describe this in greater detail tomorrow). While the official kickoff for reporting activities is still months away, NOW is the time to make certain that you will be ready. http://www.mtbc.com/medicare-pqri-deadline-approaches.aspx As we approach the July 1, 2007 deadline, health care providers are increasingly asking about the details associated with Medicare's Physician Quality Reporting Initiative ("PQRI"). My next few blogs will address some of the questions I have been asked by providers. http://www.mtbc.com/cms-relaxes-npi-deadline.aspx The Centers for Medicare & Medicaid Services (CMS) has just announced that it is relaxing the enforcement of its May 23, 2007 deadline concerning the mandatory use of the National Provider Identifier ("NPI") in conjunction with all standard transactions. http://www.mtbc.com/oig-certifies-hawaiis-false-claims-act.aspx The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) has just announced that it has reviewed and approved of Hawaii's version of a False Claims Act.