What is health care provider fraud — and how can it be stopped?
What is health care provider fraud? It is intentionally fraudulent or wasteful practices conducted by health care providers, including physicians, rehab centers or labs. Examples include add-on lab tests, pass-through billing, predatory marketing practices or billing for services not rendered. It can be found in all health care claims data. Buried in health care claims are billing errors, pharmacy fraud and member issues. Nevertheless, provider fraud accounts for the highest amount of wasted dollars… (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - February 16, 2022 Category: Biotechnology Authors: SmartLight Analytics Source Type: news

ACR seeks summary judgment in No Surprises Act suit
The American College of Radiology (ACR) and two other associations are seekin...Read more on AuntMinnie.comRelated Reading: ACR sues to block No Surprises Act A surprising consequence of the No Surprises Act Regulatory and payment issues that will impact radiology in 2022 ACR mulls legal action over No Surprises Act implementation Understanding dispute resolution under 'surprise billing' rules (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - February 11, 2022 Category: Radiology Source Type: news

Home Births Became More Popular During the Pandemic. But Many Insurers Still Don ’t Cover Them
Tia DeShazor began to question whether she wanted to give birth in a hospital when she was about six months pregnant. It was winter 2021 and COVID-19 was still raging through New York City, where she lives. Pandemic restrictions prevented her husband from attending doctors’ appointments with her, and she wasn’t even allowed to video chat with him during her ultrasound. She felt ignored by her doctors, who assured her that her round ligament pain was normal, even though it was so severe that she had difficulty walking. And she knew about the disproportionate risks to Black women, like her, who give birth in U.S...
Source: TIME: Health - February 11, 2022 Category: Consumer Health News Authors: Tara Law Tags: Uncategorized COVID-19 healthscienceclimate Source Type: news

RF ablation safe and effective for thyroid tumors
Radiofrequency (RF) ablation is a safe and effective option for patients wit...Read more on AuntMinnie.comRelated Reading: Can cooled RF ablation relieve post-knee replacement pain? RF ablation relieves pain for bone cancer patients in 3 days E/M coding and billing for interventional radiology Is uterine artery embolization underused for postpartum bleeding? US features help define thyroid nodules in children (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - February 11, 2022 Category: Radiology Source Type: news

Long COVID Patients Are Waiting Months for Care, and the Problem May Only Get Worse
In March 2020, Laura Fitton, a 50-year-old entrepreneur in Massachusetts, had a high fever, sore throat, gastrointestinal issues, and loss of taste. But at the time, few of those symptoms were linked to COVID-19, so Fitton wasn’t eligible for a test. It took seven more months of persistent symptoms—including brain fog, swollen joints, fast heart rate, chills, and fatigue—for a doctor to order an antibody test. Although the test came back negative—perhaps because of how much time had passed since she had gotten sick—Fitton was relieved that a doctor was finally exploring the possibility of Long...
Source: TIME: Health - February 3, 2022 Category: Consumer Health News Authors: Jamie Ducharme Tags: Uncategorized Cover Story COVID-19 feature healthscienceclimate Magazine Source Type: news

Coding changes that will impact radiology practices in 2022
There are 249 new codes in the current procedural terminology (CPT) system tha...Read more on AuntMinnie.comRelated Reading: How will Medicare payment changes impact your radiology practice? A surprising consequence of the No Surprises Act Video from RSNA 2021: Regulatory changes for radiology in 2022 Understanding dispute resolution under 'surprise billing' rules ICD-10 coding changes your radiology practice should know (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - January 27, 2022 Category: Radiology Source Type: news

TMA Continues Fight for Fair Process in Federal Surprise Billing Law
The Texas Medical Association Monday reiterated its strong opposition to a part of a federal rule that unfairly favors health insurers when directing arbiters to resolve payment disputes between insurers and physicians under the No Surprises Act. A brief filed by TMA late Monday opposes the federal agencies ’ motion for summary judgment in TMA’s legal challenge to the federal rule. (Source: TMA News Room)
Source: TMA News Room - January 25, 2022 Category: Consumer Health News Source Type: news

Why It ’s Still So Complicated to Get Free Home Covid Tests
This week, nearly two full years into the on-going pandemic, the Biden Administration told Americans that they would, at long last, be given access to free, rapid COVID-19 tests — a key tool in containing the spread of the virus. The government’s plan was two-fold. First, on Jan. 15, federal agencies implemented new rules requiring private health insurers to cover at-home tests. And second, on Jan. 18, the feds launched a new website to deliver free rapid antigen tests directly to Americans’ homes. [time-brightcove not-tgx=”true”] The effort was a major step in the right direction, public heal...
Source: TIME: Health - January 21, 2022 Category: Consumer Health News Authors: Abigail Abrams Tags: Uncategorized Source Type: news

Private Labs in South Africa Voluntarily Agree to Lower Prices for COVID-19 PCR Tests following Investigation by Country ’s Competition Commission
In an out-of-court settlement, two commercial clinical laboratory companies also agreed to reduce their prices for rapid antigen tests as well How clinical laboratory companies were pricing their COVID-19 tests caught the attention of government authorities in South Africa. Government agencies in that country are establishing what they view as fair clinical laboratory pricing for […] The post Private Labs in South Africa Voluntarily Agree to Lower Prices for COVID-19 PCR Tests following Investigation by Country’s Competition Commission appeared first on Dark Daily. (Source: Dark Daily)
Source: Dark Daily - January 21, 2022 Category: Laboratory Medicine Authors: Jillia Schlingman Tags: Coding, Billing, and Collections Compliance, Legal, and Malpractice International Laboratory News Laboratory Pathology Laboratory Sales and Marketing Laboratory Testing Ampath anatomic pathology BinaxNOW COVID-19 Antigen Self Test center Source Type: news

How will Medicare payment changes impact your radiology practice?
Now that the final Medicare conversion factor for 2022 of $34.6062 has bee...Read more on AuntMinnie.comRelated Reading: A surprising consequence of the No Surprises Act Video from RSNA 2021: Regulatory changes for radiology in 2022 Understanding dispute resolution under 'surprise billing' rules ICD-10 coding changes your radiology practice should know ICD-10 coding changes that will impact radiologists in 2022 (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - January 20, 2022 Category: Radiology Source Type: news

CMS: Agency Information Collection Activities; Proposals, Submissions, and Approvals
Notice from the Centers for Medicare and Medicaid and Medicaid Services (CMS) seeking comment on the following information collections: 1) Medicaid Program; Eligibility Changes under the Affordable Care Act of 2010; 2) Children's Health Insurance Program Managed Care and Supporting Regulations; 3) Requirements Related to Surprise Billing; Part II; and 4) Student Health Insurance Coverage. Comments are due by March 7, 2022. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 5, 2022 Category: Rural Health Source Type: news

ACR sues to block No Surprises Act
The American College of Radiology (ACR) and other physician groups have file...Read more on AuntMinnie.comRelated Reading: A surprising consequence of the No Surprises Act Regulatory and payment issues that will impact radiology in 2022 ACR mulls legal action over No Surprises Act implementation U.S. government issues final rule on 'no surprises' billing Study suggests No Surprises Act simply veils insurance coverage gaps (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - December 23, 2021 Category: Radiology Source Type: news

A surprising consequence of the No Surprises Act
The federal No Surprises Act was designed to protect patients from receivin...Read more on AuntMinnie.comRelated Reading: Video from RSNA 2021: Regulatory changes for radiology in 2022 Understanding dispute resolution under 'surprise billing' rules ICD-10 coding changes your radiology practice should know ICD-10 coding changes that will impact radiologists in 2022 More pandemic relief is available from the HHS Provider Relief Fund (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - December 22, 2021 Category: Radiology Source Type: news

Ascension Wisconsin converting all of its hospitals and clinics to Epic Systems
Ascension Wisconsin launched an Epic Systems electronic health records and billing platform at its legacy Columbia St. Mary ’s hospitals and clinics this fall and is preparing a rollout by fall 2022 for hospitals and clinics in the Fox Valley. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - December 16, 2021 Category: Pharmaceuticals Authors: Rich Kirchen Source Type: news

Doctors and Hospitals Make Late Bid to Change Surprise Billing Ban
A lawsuit says the Biden administration ’s faulty interpretation of the law will harm medical providers. (Source: NYT)
Source: NYT - December 9, 2021 Category: American Health Authors: Margot Sanger-Katz Tags: Hospitals Health Insurance and Managed Care Suits and Litigation (Civil) Law and Legislation Arbitration, Conciliation and Mediation United States Politics and Government Prices (Fares, Fees and Rates) Regulation and Deregulation of Industry Source Type: news