Emergency Physicians Support House Bill to Address Surprise Billing
As the surprise billing debate continues, emergency physicians have begun lining up behind one bipartisan House bill. READ MORE
Anthem Extends Post-Payment Review Policy to Medicare Advantage Claims
Just weeks after Anthem announced then retracted a new post-payment review policy for emergency department level 5 services for its commercial plans in some states, the payer has now announced that the policy will be implemented for Medicare Advantage plans in most states where Anthem conducts business. READ MORE
Anthem to Implement Post-Pay Reviews for ED Level 5 Claims in Some States; Indiana Currently Excluded
Anthem Blue Cross and Blue Shield recently announced a new policy of post payment reviews of professional ER claims billed with level 5 E/M codes. The new policy is being implemented to “ensure documentation meets or exceeds the components necessary to support its billing,” according to Anthem, and will begin August 1. Indiana and a few other states currently are excluded. READ MORE
Breaking Down the Growth in Emergency Department Visits
A trio of recent studies pulls back the curtain on the growing number of emergency department visits in the United States, revealing how presenting symptoms, geographical location, and insurance coverage (or the lack thereof) influence usage. READ MORE
Facility-Based Measurement for MIPS: What You Need to Know
Facility-based physicians and other eligible clinicians whose practice takes place primarily in a hospital setting have a new way to meet reporting requirements for MIPS for the 2019 performance year. READ MORE
MedPAC to Recommend National Coding Guidelines for Emergency Departments
The Medicare Payment Advisory Commission may soon be recommending national guidelines for coding emergency department visits after the group discussed options for slowing the growth of emergency department spending during their March meeting. The recommendation would task the Department of Health and Human Services with addressing the shift toward high intensity service levels by 2022. READ MORE
Exploring CMS’s Emergency Triage, Treat, and Transport Payment Model
A new payment model by the Center for Medicare and Medicaid Innovation (CMMI) hopes to reduce low-acuity hospital visits by allowing ambulance care teams to provide care and transportation based on a patient’s health needs rather than rigid Medicare guidelines. READ MORE
ACEP’s New Geriatric Emergency Department Accreditation Program Takes Off in First Year
Elderly patients with chronic conditions are increasingly ending up in emergency departments around the country. ACEP meets the challenge with their new Geriatric Emergency Department Accreditation Program. READ MORE
New Requirements for Indiana’s Prescription Drug Monitoring Program, INSPECT, Begin January 1
By Jan. 1, 2019, all Indiana healthcare providers who hold a controlled substance registration (CSR) must register with INSPECT, the state’s prescription drug monitoring program, and practitioners in hospital emergency departments and pain management clinics must begin querying INSPECT when prescribing opioids or benzodiazepines based on legislation passed during the 2018 General Assembly. READ MORE
2019 Medicare Physician Fee Schedule: What Emergency Physicians Should Know
The Centers for Medicare and Medicaid Services recently published the final rule of the Medicare Physician Fee Schedule for 2019, including several policy changes relevant to emergency physicians. READ MORE
