Practice Management
CityMD will pay a $6.6 million settlement over a variety of charges related to treating Medicare patients at its 96 urgent care centers. The U.S. Department of Justice claims the company billed Medicare for services by physicians who did not actually provide them, and charged for more complex procedures than were actually performed or that were unsupported by the documentation provided. By doing so, CityMD received higher reimbursements than it would have if it billed …
Read More
Lower reimbursements, regulatory challenges, and increased competition are among the factors moving Ascension to reduce its “footprint,” according to a new article in Modern Healthcare. CEO Anthony Tersigni told employees that the company would be restructured from its current model as a hospital system “to one that’s focused on outpatient care and telemedicine.” Ascension saw revenues drop 27% last year compared with 2016 (though nonoperating income increased by $1.31 billion). It’s noteworthy that inpatient and …
Read MoreQ. I understand that there will be reductions for x-ray reimbursements from Medicare in 2017. Is this true? A. To give imaging providers an additional incentive to adopt more advanced x-ray technology, Medicare will reduce reimbursement, beginning in 2017, for the technical component (and the technical component of the global fee) in claims submitted for x-rays performed with analog equipment. The cuts will continue in future years for those using computed radiography equipment (Table 1). …
Read More
A community hospital in California says Blue Cross and Blue Shield of Georgia is punishing it for being out-of-network by paying patients directly for emergency services received at the hospital, rather than reimbursing the hospital. Martin Luther King Jr. Community Hospital is taking the matter to court, charging that the Georgia BCBS plan is trying to pressure the hospital, unfairly, to accept its contract rates. The suit further claims that by paying patients directly, the …
Read More