Mutual Matters

Medicare Update - Appropriate Use Criteria 

Posted by Hoyt Torras, MPA, MHA on Jan 19, 2018 12:05:00 PM

This summary is based primarily on the Medicare Physician Fee Schedule CY2018, Final Rule – Published in the Federal Register November 15, 2017.

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Topics: Billing and Reimbursement

Billing Under Another Provider's Number Can Land Physicians in Hot Water

Posted by Emma Cecil on Nov 7, 2017 11:29:00 AM

An Oklahoma physician agreed on August 28, 2017 to pay the government $580,000 to resolve allegations that he violated the False Claims Act by submitting claims to the Medicare program for services he did not provide or supervise. According to the government, the physician allowed a company that employed him and in which he had an ownership interest, to use his national provider identification (NPI) numbers to bill Medicare for physical therapy evaluation and management services that he did not provide or supervise. The government further alleged that after he separated from the company and deactivated his NPIs associated with the company, he reactivated those NPIs so that the company could use them to bill Medicare for services he neither performed nor supervised.

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Topics: Billing and Reimbursement

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Sharing Insight on Mutual Matters

Here we share some basic insights on matters that are important to physicians, hospitals and healthcare professionals.

Topics include:

  • MACRA
  • Legislative updates that affect healthcare professionals
  • Patient safety guidance
  • Practice and hospital management advice
  • and more. 

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