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…
HHS clarifies rules on charging patients for medical records
The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently provided clarification of its policy for how much a HIPAA covered enti…
College member selected for new CMS committee
The Advocacy Council of ACAAI continues to provide College members with pathways through the myriad of complex sections of the MACRA legislation. We have provi…
Important reminder about billing requirements for certain dual-eligibles
Balance billing is prohibited for Medicare beneficiaries enrolled in the Qualified Medicare Beneficiary (QMB) program. CMS has expressed concern that some phys…
Understanding Medically Unlikely Edits
Last week, CMS finally made public a number of Medically Unlikely Edits (MUEs) assigned to a series of CPT allergy codes. MUEs are claims edits used to limit t…
How to use the JW modifier
A new CMS rule becomes effective Jan. 1, 2017. Providers are required to use the JW modifier on claims to report the unused portion of drugs or biologicals fro…
Advocacy Council work results in code increases from 3 to 39%
The Centers for Medicare and Medicaid Services (CMS) released the 2017 Proposed Medicare Physician Fee Schedule on July 7, 2016. The following summary covers t…
New proposed methodology for Part B drugs
CMS recently released a proposed rule to change how it covers certain Medicare Part B drugs. (Medicare Part B drugs are generally those delivered in a health c…
Do you need a medical scribe?
In the hospital world, medical scribes are an everyday fact of life but they are quickly spreading into the ambulatory scene. Why is this occurring? Today&rsqu…
Taking Alternative Payment Models one step at a time
There’s been a lot of talk about quality payment programs – we’ve been publishing articles on it, and it’s been everywhere you look. We…
What are Accountable Health Communities?
Earlier this year, the Centers for Medicare and Medicaid Services (CMS) announced it would begin a five-year testing period of a new community-based health car…
Do you owe Medicare money?
Is it possible that you have, in the past six years, been overpaid by Medicare for your services? If the answer is “yes,” then read on.The final ru…
New modification to the “two midnight” rule
Currently, you cannot admit a Medicare patient to an intensive care unit for desensitization to a chemotherapeutic agent or antibiotic because you need to cert…
Skinny networks – Are they in your patient’s best interest?
The Advocacy Council of ACCAI (formerly JCAAI) knows that you are concerned about skinny (or narrow) provider networks. The Affordable Care Act (ACA) (“O…
Our experts have ICD-10 Answers
Who are our experts? The Advocacy Council of ACAAI utilizes the same team of experts who served you as the Joint Council of Allergy, Asthma and Immunology (JCA…
Now that the SGR is gone… part II
Last week we began a summary of additional parts of the SGR bill. The summary continues below.Between now and 2019, CMS has been directed to work with physicia…
Now that the SGR is gone… what’s next?
You may recall that the public couldn’t learn what was in “Obamacare” until the bill was passed. With the recent passing of the bill to do away with the Medica…
Sorting out modifier -59 changes
Modifier -59 is not only the most used modifier, but it’s also one of the most abused. Modifier -59 is used to indicate that a procedure or service was distinc…
