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Oct 02, 2018

Disclosure Requirements in Non-Emergent Cases – NJ

The Out-of-Network Consumer Protection Transparency Cost Containment and Accountability Act was adopted in June 2018 and went into effect last month.  It has gotten significant attention regarding emergent or urgent services rendered to patients, and the inability of out-of-network providers and facilities to balance bill the patient. » Read More

Jul 19, 2018

CMS Proposes Overhaul of Billing Rules and Pays for Telehealth

On July 12, 2018, The Centers for Medicare & Medicaid Services (CMS) proposed a major overhaul of the way doctors have billed Medicare for patient visits for two decades. Some of the key provisions in the lengthy proposed rule include:

  • simplifying the billing process to require less documentation that must be submitted by collapsing four separate levels of documentation requirements into one;
  • allowing physicians to use their medical decision making or time spent with the patient to designate the level of patient care needed in lieu of using the traditional evaluation and management codes;
  • paying physicians for certain telemedicine services; and
  • continuing the site-neutral policy that pays off-campus facilities 40% of the outpatient rates for the services they provide to encourage “fairer competition between hospitals and physician practices by promoting greater payment alignment between outpatient care settings.”

If you have any questions concerning the proposed regulations, please contact me at sjarvaweiss@nmmlaw.comRead More

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