New York State Goes Paperless for Health Commerce System Accounts

The New York State Senate passed the Internet System for Tracking Over-Prescribing (“I-STOP”) Act in order to curb abuse and diversion of prescription drugs.  The program requires prescribers to review the patient’s recent history of controlled substance prescriptions, which offers providers more information to exercise professional judgment in treating patients.  Starting on August 27, 2013, any New York State (NYS) licensed prescriber who holds a valid DEA registration must consult New York’s online Prescription Monitoring Program (PMP) Registry prior to prescribing Schedule II, III or IV

OIG Work Plan To Be Released in January 2014!!

The Office of the Inspector General has just announced that its annual Work Plan will not be released in the Fall!  The Work Plan is usually released in early October.  But now, the OIG says the "Work Plan will next appear in January 2014. This change from the usual October release will better align with priorities OIG has set for the coming year, a time of continuing fiscal challenges."

Is ICD-10 really needed in the US?

Key industry players, such as the AMA and MGMA, have questioned whether we really need ICD-10-CM in this country.  They seem to think there will be no benefit to clinicians with the upcoming change in the diagnosis coding system.  I think they’re wrong.  The current system hasn’t been overhauled since 1979.  It’s been updated every year but it can’t move forward to work in the electronic environment and it can’t capture information about current day medical practice.  It’s pretty hard to describe cutting edge medicine with a 34 year old system. 

Medicare and Inpatient Consultations

CMS made a major blooper in their announcement about a new set of claims edits designed to keep providers from reporting new patient evaluation and management (E/M) services more frequently than allowed. But the good news is that they have fixed the edits and you should not run into any problems with them as long as you are following correct E/M coding guidelines. On May 3 CMS issued Transmittal 1231, which explained the new edits. The Transmittal listed the codes that CMS considered to be new patient services.

New OIG Self-Disclosure Form Online Follows Updated Protocol

Today, the OIG launched an online submission process for the Self-Disclosure Protocol ("SDP").  The SDP is a mechanism for providers to voluntarily disclose evidence of potential fraud to the OIG and have the opportunity to avoid the costs and disruptions associated with a government-directed investigation and civil or administrative litigation.  This new online form comes just a few months after the OIG issued an updated SDP on April 17, 2013.  In the updated SDP, the OIG reviews the benefits of disclosure:

AHIMA ICD-10 and Computer Assisted Coding Summit – Our Takeaways

We just got back from the AHIMA ICD-10 and Computer Assisted Coding Summit, and wanted to share our experience.
In the sessions, during social time, and while interacting with attendees, we heard deep and intelligent conversations about the readiness assessment process, education approaches, and implementation strategies. We are pleased that the “wait and see” attitude so prominent last year seems to have shifted to “let’s get this done!”

Navigating the Diabetes Self-Management Training (DSMT) Reimbursement Maze (Webinar Replay)

View a replay of the the Navigating the Diabetes Self-Management Training (DSMT) Reimbursement Maze webinar. This replay will give you an overview of Diabetes Self-Management Training (DSMT) Coding and Coverage. Review practices for overcoming reimbursement obstacles faced by pharmacies, solo practices and other providers, along with ways to Improve Profitability of AADE programs.


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