User login
Thyroid Cancer Record
Thyroid cancer diagnoses are expected to set a new record this year, according to the Thyroid Cancer Survivors' Association. The number of newly diagnosed cases is expected to reach a new record of 30,180, which is 17% higher than last year and nearly 50% higher than 4 years ago, the association said, citing information from the Department of Health and Human Services and the American Cancer Society. Association board chair Gary Bloom of Olney, Md., urged doctors to contribute to early detection of thyroid cancer, one of the few cancers that is increasing in incidence. “Done properly, a neck check can be as simple as touching the neck and watching the patient swallow. This can be done very quickly and won't cause any delays for the medical office, but those few minutes could make all the difference in the world when it comes to thyroid cancer.”
Multiple Imaging Pay Cut
Endocrinologists will soon begin feeling the effects of a new Medicare reimbursement policy affecting multiple imaging procedures, according to the Endocrine Society. The policy reduces the payment for the “technical component” of a service when performed on a contiguous body part on the same day and in the same patient. That would include such procedures as dual-energy x-ray absorptiometry scanning or ultrasound on the thyroid, according to the society. Medicare is also capping rates for imaging services that are performed in a physician's office at the same amount as the rates paid to hospital outpatient departments. The portion of the Medicare payment that goes for professional services will not be affected. The provisions are expected to save $3 billion over 5 years, according to the Congressional Budget Office.
ICD-10 Fraud Concerns
The Blue Cross and Blue Shield Association and the Medical Group Management Association are among those objecting to the planned implementation of ICD-10, the newest version of the comprehensive list of diagnostic billing codes used by health care providers. A bill currently being considered in the House would require payers to switch from the current ICD-9 codes to ICD-10 by Oct. 1, 2009. Blue Cross/Blue Shield argues in a statement that the deadline should be pushed back to 2012 “because much has to be done before a switch to ICD-10 can be started … and providers need time to automate their offices and be trained.” The Blues are particularly concerned because the switch comes at the same time that Medicare is shrinking the number of its claims processors—many of which are Blues plans—from 50 to 15. At a press briefing, the association released a report by D. McCarty Thornton, former chief counsel to the HHS Inspector General, which found that forcing the switch to occur in 2009 “will not give the contractors who administer the Medicare fee-for-service claims process and payments systems sufficient time to upgrade their antifraud tools. Without additional time to switch to ICD-10, risks are high that improper and fraudulent Medicare claims will increase substantially.” The Federation of American Hospitals and several other groups disagree; they argue that the update is overdue.
J-1 Visas for Underserved Areas
J-1 visas remain the primary tool for recruiting physicians to work in underserved areas, according to a report by the Government Accountability Office. The GAO surveyed 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands regarding their waiver requests for fiscal years 2003–2005. States and federal agencies reported requesting more than 1,000 waivers in each of the 3 years, although the number requested varied by state: About one-fourth of states requested the maximum number of 30 visas, while slightly more than a quarter requested 10 or fewer. About 80% of states said the 30-waiver limit was adequate for their needs, the report noted. Nearly half of the states' waiver requests were for physicians to practice primary care exclusively, while about 41% were for specialists, such as anesthesiologists or cardiologists. An additional 7% were for psychiatrists, who have different waiver requirements. One state commented that most communities in the state need physicians trained in family medicine and that few physicians with J-1 visas have that training. Similarly, another state noted a lack of demand among its health care facilities for the types of medical specialties held by physicians seeking waivers, the report said.
Medicare Formulary Guidance
If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes for the rest of the year, according to guidance from the Centers for Medicare and Medicaid Services. Abby L. Block, director of the CMS Center for Beneficiary Choices, issued a memo to Part D sponsors in April outlining policies for formulary changes made after a beneficiary has signed on to a plan at the beginning of the plan year. In addition, Part D plans can change therapeutic categories and classes in a formulary only at the beginning of each plan year, except to account for new therapeutic uses or newly approved drugs. CMS also noted that after March 1, Part D drug plans are only allowed to make “maintenance changes” to their formulary, such as replacing a brand-name drug with a new generic drug. All proposed formulary changes, except for expansions, must be submitted to CMS for review and approval, according to the memo.
Thyroid Cancer Record
Thyroid cancer diagnoses are expected to set a new record this year, according to the Thyroid Cancer Survivors' Association. The number of newly diagnosed cases is expected to reach a new record of 30,180, which is 17% higher than last year and nearly 50% higher than 4 years ago, the association said, citing information from the Department of Health and Human Services and the American Cancer Society. Association board chair Gary Bloom of Olney, Md., urged doctors to contribute to early detection of thyroid cancer, one of the few cancers that is increasing in incidence. “Done properly, a neck check can be as simple as touching the neck and watching the patient swallow. This can be done very quickly and won't cause any delays for the medical office, but those few minutes could make all the difference in the world when it comes to thyroid cancer.”
Multiple Imaging Pay Cut
Endocrinologists will soon begin feeling the effects of a new Medicare reimbursement policy affecting multiple imaging procedures, according to the Endocrine Society. The policy reduces the payment for the “technical component” of a service when performed on a contiguous body part on the same day and in the same patient. That would include such procedures as dual-energy x-ray absorptiometry scanning or ultrasound on the thyroid, according to the society. Medicare is also capping rates for imaging services that are performed in a physician's office at the same amount as the rates paid to hospital outpatient departments. The portion of the Medicare payment that goes for professional services will not be affected. The provisions are expected to save $3 billion over 5 years, according to the Congressional Budget Office.
ICD-10 Fraud Concerns
The Blue Cross and Blue Shield Association and the Medical Group Management Association are among those objecting to the planned implementation of ICD-10, the newest version of the comprehensive list of diagnostic billing codes used by health care providers. A bill currently being considered in the House would require payers to switch from the current ICD-9 codes to ICD-10 by Oct. 1, 2009. Blue Cross/Blue Shield argues in a statement that the deadline should be pushed back to 2012 “because much has to be done before a switch to ICD-10 can be started … and providers need time to automate their offices and be trained.” The Blues are particularly concerned because the switch comes at the same time that Medicare is shrinking the number of its claims processors—many of which are Blues plans—from 50 to 15. At a press briefing, the association released a report by D. McCarty Thornton, former chief counsel to the HHS Inspector General, which found that forcing the switch to occur in 2009 “will not give the contractors who administer the Medicare fee-for-service claims process and payments systems sufficient time to upgrade their antifraud tools. Without additional time to switch to ICD-10, risks are high that improper and fraudulent Medicare claims will increase substantially.” The Federation of American Hospitals and several other groups disagree; they argue that the update is overdue.
J-1 Visas for Underserved Areas
J-1 visas remain the primary tool for recruiting physicians to work in underserved areas, according to a report by the Government Accountability Office. The GAO surveyed 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands regarding their waiver requests for fiscal years 2003–2005. States and federal agencies reported requesting more than 1,000 waivers in each of the 3 years, although the number requested varied by state: About one-fourth of states requested the maximum number of 30 visas, while slightly more than a quarter requested 10 or fewer. About 80% of states said the 30-waiver limit was adequate for their needs, the report noted. Nearly half of the states' waiver requests were for physicians to practice primary care exclusively, while about 41% were for specialists, such as anesthesiologists or cardiologists. An additional 7% were for psychiatrists, who have different waiver requirements. One state commented that most communities in the state need physicians trained in family medicine and that few physicians with J-1 visas have that training. Similarly, another state noted a lack of demand among its health care facilities for the types of medical specialties held by physicians seeking waivers, the report said.
Medicare Formulary Guidance
If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes for the rest of the year, according to guidance from the Centers for Medicare and Medicaid Services. Abby L. Block, director of the CMS Center for Beneficiary Choices, issued a memo to Part D sponsors in April outlining policies for formulary changes made after a beneficiary has signed on to a plan at the beginning of the plan year. In addition, Part D plans can change therapeutic categories and classes in a formulary only at the beginning of each plan year, except to account for new therapeutic uses or newly approved drugs. CMS also noted that after March 1, Part D drug plans are only allowed to make “maintenance changes” to their formulary, such as replacing a brand-name drug with a new generic drug. All proposed formulary changes, except for expansions, must be submitted to CMS for review and approval, according to the memo.
Thyroid Cancer Record
Thyroid cancer diagnoses are expected to set a new record this year, according to the Thyroid Cancer Survivors' Association. The number of newly diagnosed cases is expected to reach a new record of 30,180, which is 17% higher than last year and nearly 50% higher than 4 years ago, the association said, citing information from the Department of Health and Human Services and the American Cancer Society. Association board chair Gary Bloom of Olney, Md., urged doctors to contribute to early detection of thyroid cancer, one of the few cancers that is increasing in incidence. “Done properly, a neck check can be as simple as touching the neck and watching the patient swallow. This can be done very quickly and won't cause any delays for the medical office, but those few minutes could make all the difference in the world when it comes to thyroid cancer.”
Multiple Imaging Pay Cut
Endocrinologists will soon begin feeling the effects of a new Medicare reimbursement policy affecting multiple imaging procedures, according to the Endocrine Society. The policy reduces the payment for the “technical component” of a service when performed on a contiguous body part on the same day and in the same patient. That would include such procedures as dual-energy x-ray absorptiometry scanning or ultrasound on the thyroid, according to the society. Medicare is also capping rates for imaging services that are performed in a physician's office at the same amount as the rates paid to hospital outpatient departments. The portion of the Medicare payment that goes for professional services will not be affected. The provisions are expected to save $3 billion over 5 years, according to the Congressional Budget Office.
ICD-10 Fraud Concerns
The Blue Cross and Blue Shield Association and the Medical Group Management Association are among those objecting to the planned implementation of ICD-10, the newest version of the comprehensive list of diagnostic billing codes used by health care providers. A bill currently being considered in the House would require payers to switch from the current ICD-9 codes to ICD-10 by Oct. 1, 2009. Blue Cross/Blue Shield argues in a statement that the deadline should be pushed back to 2012 “because much has to be done before a switch to ICD-10 can be started … and providers need time to automate their offices and be trained.” The Blues are particularly concerned because the switch comes at the same time that Medicare is shrinking the number of its claims processors—many of which are Blues plans—from 50 to 15. At a press briefing, the association released a report by D. McCarty Thornton, former chief counsel to the HHS Inspector General, which found that forcing the switch to occur in 2009 “will not give the contractors who administer the Medicare fee-for-service claims process and payments systems sufficient time to upgrade their antifraud tools. Without additional time to switch to ICD-10, risks are high that improper and fraudulent Medicare claims will increase substantially.” The Federation of American Hospitals and several other groups disagree; they argue that the update is overdue.
J-1 Visas for Underserved Areas
J-1 visas remain the primary tool for recruiting physicians to work in underserved areas, according to a report by the Government Accountability Office. The GAO surveyed 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands regarding their waiver requests for fiscal years 2003–2005. States and federal agencies reported requesting more than 1,000 waivers in each of the 3 years, although the number requested varied by state: About one-fourth of states requested the maximum number of 30 visas, while slightly more than a quarter requested 10 or fewer. About 80% of states said the 30-waiver limit was adequate for their needs, the report noted. Nearly half of the states' waiver requests were for physicians to practice primary care exclusively, while about 41% were for specialists, such as anesthesiologists or cardiologists. An additional 7% were for psychiatrists, who have different waiver requirements. One state commented that most communities in the state need physicians trained in family medicine and that few physicians with J-1 visas have that training. Similarly, another state noted a lack of demand among its health care facilities for the types of medical specialties held by physicians seeking waivers, the report said.
Medicare Formulary Guidance
If officials at a Medicare Part D drug plan change the preferred or nonpreferred formulary drugs, remove dosage forms, or exchange therapeutic alternatives, they must allow beneficiaries currently taking the drug to be exempt from the changes for the rest of the year, according to guidance from the Centers for Medicare and Medicaid Services. Abby L. Block, director of the CMS Center for Beneficiary Choices, issued a memo to Part D sponsors in April outlining policies for formulary changes made after a beneficiary has signed on to a plan at the beginning of the plan year. In addition, Part D plans can change therapeutic categories and classes in a formulary only at the beginning of each plan year, except to account for new therapeutic uses or newly approved drugs. CMS also noted that after March 1, Part D drug plans are only allowed to make “maintenance changes” to their formulary, such as replacing a brand-name drug with a new generic drug. All proposed formulary changes, except for expansions, must be submitted to CMS for review and approval, according to the memo.