Frustrated with “fail first” MCO policies? The Advocacy Council steps in.
In recent years, managed care organizations (MCO) have increased the use of “fail first” policies, commonly called “step therapy,” as a…
Update on eClinicalWorks and Meaningful Use incentive payments
Last week we let you know that on May 31, the U.S. Department of Justice announced a massive settlement with eClinicalWorks (eCW), one of the nation’s la…
eClinicalWork Settles with Department of Justice for $155 million
On May 31, 2017 the U.S. Department of Justice announced a massive settlement with eClinicalWorks (eCW), one of the nation’s largest EHR vendors whose pr…
National Government Services’ Medical Review of CPT 99214
The Advocacy Council received notice that the National Government Services’ (NGS) Medical Review department will be focusing on CPT 99214 in Connecticut,…
CMS takes action to stabilize ACA insurance market
It has often been said that when it comes to health insurance, what’s good for the insurance company may not be good for the physician or patients. That …
Advocacy Council participates in AMA workshop on alternative payment models
On March 20, the Advocacy Council participated in the AMA-sponsored Workshop on Alternative Payment Models (APM).The Advocacy Council’s APM sub-committee…
The “skinny” on narrow networks…
The Advocacy Council continues to hear from practicing allergists about limited (also called narrow or “skinny”) managed care networks. These are p…
Coalition to reform prior authorization requirements
The Advocacy Council recognizes the huge burden prior authorization’s put on allergy practices; one article states as much as 20 hours per week is attrib…
ACA and MACRA – they are not one and the same!
With the recent changes in Congress and the executive branch, it’s a challenge to keep track of the changes to health care reform. If you are confused ab…
Allergy & immunology and ICD-11
The International Classification of Diseases (ICD) by the World Health Organization (WHO) has been in use since 1900. Since it is only slightly more than a yea…
Why MACRA is probably a good thing for allergists
By now you’ve probably heard more than you care to about the Medicare Access and CHIP Reauthorization Act (MACRA), which became effective on Jan. 1. But …
MACRA recommendations that support the practicing allergist
As 2017 approaches, it’s time for you to begin preparing for the Medicare Access and CHIP Reauthorization Act (MACRA). While the final rule was already i…
CMS finds frequent errors in Medicare Advantage plans’ provider directories
Do you participate in one or more Medicare Advantage (MA) plans? If so, we suggest you check your plan’s provider directory to make sure your listi…
Medical research and drug approval legislation making its way through Congress
Bipartisan legislation that seeks to expand our nation’s ability to undertake more research into the causes and cures for disease and, where possible, br…
2017 Medicare Physician Fee Schedule
The Centers for Medicare and Medicaid Services (CMS) has released the Medicare rates for 2017 as well as a fact sheet summarizing the policy and payment change…
Medicare background checks/fingerprinting
As part of the Affordable Care Act, Congress authorized background checks, including fingerprinting, for so-called “high risk” providers seeking to…
Providing high-quality cost-conscious medication therapy – Part III
This article will conclude the series on providing high-quality cost-conscious medication therapy. Sharing this information with your patients could make a dif…
Providing high-value, cost-conscious medication therapy (Part II)
This is the second of a three-part series intended to help you ensure your patients receive the medications you prescribe. And how you can make sure they are t…
Providing high-value, cost-conscious medication therapy (Part I)
This is the first of three Advocacy Insider articles designed to improve your medication prescribing. The goal is to increase your patients’ compliance w…
ICD-10 Changes and Medicare Revalidation
Reminder! ICD-10 changes effective Oct. 1The one-year anniversary of ICD-10 is approaching and with it comes some important changes. When ICD-10 became ef…
