Inside Angle

From 3M Health Information Systems

Topic: Regulatory Compliance

Get 3M’s perspective on the latest updates from CMS and other important regulatory changes. Find expert advice to help you stay compliant.

CMS proposes to shake things up

August 20th, 2018 / By Rebecca Caux-Harry

By now, you’ve undoubtedly seen the CMS proposal to overhaul the E/M documentation and coding guidelines for new and established office visits, along with consolidated payments. There are articles and […]

The importance of medical necessity compliance: Recent actions by the U.S. Attorney’s Office and the OIG

July 16th, 2018 / By Barbara Aubry, RN

I’ve been talking about this for years. I still see folks who don’t think compliance with medical necessity polices is critical. Believe me, I understand human nature; noncompliance can be […]

What do Facebook and healthcare data have in common?

April 9th, 2018 / By Barbara Aubry, RN

If you listen, watch or stream news updates then you’ve likely heard about the Facebook data privacy scandal. During a recent early morning treadmill jaunt, I listened to a CNBC […]

Fallout from the opioid crisis or improper coding?

March 7th, 2018 / By Barbara Aubry, RN

I review OIG updates as they are released and I saw something last week that unfortunately, I did not find surprising. Per the OIG report: “Payments made to providers for […]

Mammograms and Modifier 52

February 12th, 2018 / By Barbara Aubry, RN

In late December 2017, I was asked by a colleague for my opinion on a customer’s inquiry about modifier 52 and its use in mammograms. CPT® modifier 52 represents a […]

CMS: Low Volume Appeals Settlement Initiative

January 17th, 2018 / By Barbara Aubry, RN

I attended the January 9, 2018 CMS Medicare Learning Network conference call covering the logistics of the settlement process offered by CMS for providers with pending appeals. This impacts: “The […]

Implications of the 2019 Medicare Advantage Part 1 Advance Notice

January 10th, 2018 / By Gretchen Mills

On December 27, 2017, CMS published Part 1 of this year’s Medicare Advantage (MA) Advance Notice highlighting proposed changes in MA payments for 2019. CMS requires comments on this Part […]

Lest we forget: Focus still on medical necessity

December 6th, 2017 / By Barbara Aubry, RN

Can you believe 2017 is coming to a close? Did this year fly by for everyone, or is it just me? Some pretty interesting ideas were put forth in 2017, […]

OIG: The cost of noncompliance? $66+ million to be recovered from hospitals

October 30th, 2017 / By Barbara Aubry, RN

In September 2017, Office of Inspector General (OIG) released a report titled “Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities.” […]

MIPS repeal? MedPAC urges scrapping MIPS in favor of tracking more meaningful outcomes

October 6th, 2017 / By L. Gordon Moore, MD

“The Medicare Payment Advisory Commission is pushing for the immediate repeal and replacement of a Medicare payment system that aims to improve the quality of patient care.” – Modern Healthcare […]

Confused about incident-to physician coding and billing compliance?

October 2nd, 2017 / By Barbara Aubry, RN

I recently attended a presentation hosted by my local HFMA chapter. It was an excellent discussion regarding the ins and outs of compliant coding and billing for incident-to services by […]

CMS: Updates to prohibition on billing dually eligible individuals enrolled in the QMB program

September 6th, 2017 / By Barbara Aubry, RN

Last fall, I wrote a blog on providers who continue to bill cost-sharing co-payments to “dually eligible” (Medicare/Medicaid) patients. This practice is not allowed; providers and suppliers are barred from […]