Jul 28, 2022 | Physician Fee Schedule
CY 2023 Proposed Physician Fee Schedule Rule: Includes new policies across multiple areas including telehealth, dental, audiology, behavioral, and substance. Continues BNA for 2021 E&M reforms with -3% to conversion factor and an additional offset of -1.4% for new proposed policies. Political pressure building on Congress with potential for some relief to 2023’s planned reductions. Click to read more.
Jul 22, 2022 | Managed Care Friday
60: The percent of doctors who said they’d retire if they could, according to one of our polls. The number is both alarming and unsurprising, but there may be hope, according to Paul Rudd’s character in Anchorman. “60% of the time, it works every time,” Rudd said about his potent cologne, which Ron Burgundy sternly replied in a way that only Will Ferrell can, “Well that just doesn’t make sense.” But Rudd’s stat isn’t so illogical if you think about it. In baseball, 60% gets you in the Hall of Fame, in high school it gets you a diploma and in healthcare it can get you “coverage” for novel...
Jul 19, 2022 | Medicare, Physician Fee Schedule
Pathology: Recent developments in pathology include increases in Medicare FFS spending, as well as modest policy impact on FFS reimbursement. Click to read more.
Jul 19, 2022 | Medicare, Physician Fee Schedule
Orthopedics, Hand Surgery & Podiatry: Recent developments in orthopedics, hand surgery and podiatry include steady Medicare FFS spending in recent years and mostly positive FFS reimbursement trends in the non-facility, facility, and ASC settings. Click to read more.
Jul 15, 2022 | Managed Care Friday
20: Percent of adults who have received a surprise bill for themselves or a family member this year, despite the No Surprises Act that went into effect at the beginning of the year. About 1 in 5 received a bill over $1,000, according to a Morning Consult survey. Those who received unexpected bills were most likely to get them for in-network lab work that was sent to an out-of-network lab. Unsurprisingly, 1 in 4 survey respondents indicated they have skipped or delayed healthcare services because they’re worried about these unexpected costs. Cataract Reversal: Aetna no longer requires prior...
Jul 12, 2022 | BRG Publications, Payers
Working Knowledge Of Payor Contracts: In a recent case study, BRG reviewed write-offs from commercial payor denials and found that claims that had been submitted using nationally accepted CPT coders were denied. Click to read more.
Jul 12, 2022 | BRG Publications
The BRG Healthcare Transactions and Strategy quarterly compliance bulletin compiles noteworthy developments in the healthcare sector related to compliance, program integrity, and enforcement activities. In the second quarter of 2022, we have taken note of: DOJ/HHS activity OIG Medicare Advantage Prior Authorization Report Three Comparative Billing Reports Two GAO reports OCR activity Approved and proposed additions to the RAC audit list Click to read more.
