Private healthcare providers cannot sue state Medicaid agencies over low reimbursement rates, the U.S. Supreme Court decided Tuesday in a 5-4 decision (PDF), reversing a lower court’s ruling. Providers had argued in a case, Armstrong v. Exceptional Child Center Inc., that suing over low rates is sometimes the only way to enforce federal payment requirements. Otherwise, low rates could lead to fewer providers […]

The bill introduced Thursday to replace Medicare’s sustainable growth-rate formula for physician pay would also significantly alter federal policy on health information technology. Lawmakers avoided making any changes to the timeline for requiring the industry to switch to ICD-10 diagnostic and procedure codes. Last year’s temporary “doc fix” included a stealthily added delay of the conversion.But the legislation’s merit-based incentive payment […]

Congress needs to enact legislation that will permanently repeal the flawed Sustainable Growth Rate (SGR) formula before the March 31, 2015 deadline. Medicare Part B providers of all types, including doctors of chiropractic, will face devastating cuts to the payment rates if action is not taken. These payment cuts will also impact patients by threatening their ability […]

The Council on Chiropractic Guidelines and Practice Parameters has updated their guideline so it can be placed on the National Guidelines Clearinghouse site. This is very important for our profession to ensure that stakeholders that don’t have our best interest at heart are not using bogus guidelines to restrict care/access, and to ultimately help providers […]

New EHR Attestation Deadline for Medicare Eligible Professionals: March 20, 2015. Eligible professionals now have until 11:59 pm ET on March 20, 2015, to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year. CMS extended the deadline to allow providers extra time to submit their meaningful use data. CMS continues […]

By Joseph Conn  | March 4, 2015 Modern Healthcare The American Medical Association and 99 other state medical, medical specialty and professional associations are asking CMS acting Administrator Andrew Slavitt to have the agency improve transition plans for the Oct. 1 conversion to ICD-10 diagnostic and procedural codes.“By itself, the implementation of ICD-10 is a massive undertaking,” the AMA and […]

CMS recently published an update regarding the time frame for responding to pre-payment review Additional Documentation Requests (ADRs). Effective April 1, 2015, when a provider receives a pre-payment review ADR from a Medicare Administrative Contractor (MAC) or Zone Program Integrity Contractor (ZPIC), the provider will now have 45 calendar days to respond and supply the requested […]