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3 Min Read

Disastrous Medicaid claims software hit with class action suit

The disastrous implementation of North Carolina's new Medicaid claims software, which physicians in the state say caused more than one-half billion dollars in unpaid or delayed medical claims, is being challenged in a class action lawsuit.

Judicial Advocacy
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2 Min Read

Revamp underway for Medicare enrollment system

Bringing the Medicare physician enrollment process up to speed in the digital world may take some time, but recent significant steps in the right direction should reduce the hassles many physicians have experienced with the online process.

Medicare & Medicaid
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2 Min Read

CMS adds quality measures to Medicare's physician search site

CMS announced last week that quality measures will be added to its Physician Compare website, a move coming just days before Monday's scheduled town hall meeting to get public input on the website.

Payment & Delivery Models
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2 Min Read

Overriding doctor's orders-Case takes up hospital observation

A federal court case is shining light on the growing problem of inappropriately classifying hospital patients as “observation status” in an effort to cut down Medicare costs.

Judicial Advocacy
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3 Min Read

CMS promises end-to-end ICD-10 testing this summer

CMS announced it would conduct end-to-end testing of ICD-10 with a sample group of physicians this summer in response to a letter from the AMA urging further consideration of the code set.

Claims Processing
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2 Min Read

Medicare ACOs saved $380 million in first year, CMS reports

Preliminary results for the first year of Medicare's two ACO programs indicate that the new model for care delivery and payment can be an effective way to rein in health care costs while improving quality.

Payment & Delivery Models
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3 Min Read

Frightening cost estimates for ICD-10 should make regulators listen

An AMA study released last week estimated dramatically high costs for practices to implement the mandated ICD-10 code set. As a physician, the study results were very frightening. 

Claims Processing
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2 Min Read

Judge orders arbitration period for Medicare Advantage terminations

Thousands of physicians dropped from UnitedHealthcare's Medicare Advantage network without cause have been granted 30 days to challenge their termination, thanks to a recent federal court ruling.

Judicial Advocacy
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2 Min Read

Medical associations urge HHS to address Medicare appeals backlog

Following a January notice from the U.S. Department of Health and Human Services (HHS) that Medicare appeals could be delayed for more than two years, the AMA and nearly 100 other organizations called on the Office of Medicare Hearings and Appeals (OMHA) to remedy the appeals backlog. 

Medicare & Medicaid