Pain doc faces a maximum total penalty of life in prison
Pain Doctor Convicted of Over $100 Million Health Care Fraud Scheme
A federal jury in the Eastern District of Michigan convicted a Michigan doctor today for his role in masterminding and executing a complex scheme to defraud Medicare and other health insurance programs by administering medically unnecessary spinal injections in exchange for prescriptions of high...
www.justice.gov
Pain Doctor Convicted of Over $100 Million Health Care Fraud SchemeA federal jury in the Eastern District of Michigan convicted a Michigan doctor today for his rol...
Source: Student Doctor Network - September 28, 2021 Category: Universities & Medical Training Authors: mid|ine Tags: Pain Medicine Source Type: forums
Cutting ties from a group practice?
Hello everyone.
I was wondering if those who have made a transition from a group practice to their own solo practice might be able to help me with this transition. I will spare you the details about why I am leaving.
Current situation: I started working with a group practice about 2 months ago as a 1099. I am still "undergoing credentialing" with medicare and several other insurance companies. The group practice has kept me out of the loop regarding the credentialing process, however I...
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Source: Student Doctor Network - September 20, 2021 Category: Universities & Medical Training Authors: trixter888 Tags: Psychiatry Source Type: forums
Billing for casting supplies (Q403x)
Do any of you bill for casting supplies when applying a cast? Do insurers usually pay for it separately? The only solid info I've found is that Medicare will pay for it only if the cast is applied in an office setting (Source: Student Doctor Network)
Source: Student Doctor Network - September 20, 2021 Category: Universities & Medical Training Authors: king22 Tags: Podiatric Residents & Physicians Source Type: forums
medicare funding for GME nuances
If one matches for an IM prelim year medicare funds 3 years of GME. What happens if, after finishing the prelim year, one wants to pursue graduate research work for several years? I imagine that there is a time limit for which to use these allocated funds.
Another way to state this question is, do the 3 years of medicare funding have to be continuous? Can one take a "leave" and then come back for 2 years with the gov't funding still there?
I realize that all this may change, but...
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Source: Student Doctor Network - September 20, 2021 Category: Universities & Medical Training Authors: Square Pants Tags: General Residency Issues Source Type: forums
Real Reimbursement For Professional Component of 88305 Drops More Than 71% Over 30 Years
1992 88305 PC = $63 (equivalent to $131.86 today)
2021 88305 PC = $37.68
Real Reimbursement drop of 71% since 1992.
Basically means that you have to do almost quadruple the amount of work as a pathologist in 1992 to get the same income.
Even worse: current MPFS proposal is to cut to $35.94 in 2022
2022 Proposed MPFS: See impact to pathology, labs
Pathologists will see payment reductions for key services if CMS adopts changes released in the 2022 Medicare Physician Fee Schedule Proposed Rule.
va...
Source: Student Doctor Network - September 16, 2021 Category: Universities & Medical Training Authors: 2021Doctor Tags: Pathology Source Type: forums
New Medicare LCD for epidural treatment under proposal
FYI, limitations are being proposed for Epidural Injection as treatment option for chronic pain
This proposed LCD on Epidural Procedures for Pain Management services was announced on June 10, 2021. This nationwide policy contains many onerous changes that will detrimentally affect patient access to care. ASIPP is aware and already contacting congress members, but getting your patients to complain can also help.
Please see below for important points but one of the bigger points...
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Source: Student Doctor Network - September 15, 2021 Category: Universities & Medical Training Authors: -Sojourner- Tags: Pain Medicine Source Type: forums
Charity Care
Now that I'm done practicing medicine for a paycheck, I've been wondering how I can use some of my skills to benefit humanity.
My interest would be in straight charity care, seeing and treating eligible people without charging them a dime.
You'd have to find a way to limit the number of people you saw before everyone in the planet beat a path to your door. I think this would start by opting out of CMS and not seeing medicare and medicaid patients. I also wouldn't see commercially insured...
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Source: Student Doctor Network - September 14, 2021 Category: Universities & Medical Training Authors: Old_Mil Tags: Emergency Medicine Source Type: forums
When do you "break the global"
https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/globallsurgery-icn907166.pdf
You're on call. A new patient shows up your list - admitted septic overnight. Some sort of forefoot gangrene, meth injecting, diabetic, vasculopath, smoker train wreck. Or perhaps another DPM already took a crack at a partial amp or toe amp and the whole thing fell apart (and they don't have priviledges at your hospital or the patient was transfered to you...
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Source: Student Doctor Network - September 14, 2021 Category: Universities & Medical Training Authors: heybrother Tags: Podiatric Residents & Physicians Source Type: forums
Radiologist assistants?
Under new legislation, Medicare would cover radiology assistants’ services in all settings
www.radiologybusiness.com
Perhaps I’m misunderstanding what radiologist assistants do, but this sure sounds like opening up the midlevel can of worms for DR. (Source: Student Doctor Network)
Source: Student Doctor Network - September 12, 2021 Category: Universities & Medical Training Authors: Steve_Zissou Tags: Radiology Source Type: forums
Derms do Rad Onc
Here are the recent office notes from a dermatologist.
He's doing all the rad onc billing, as a derm (and getting paid too I presume). Billing for weekly 77427. Billing a daily sim (77280) and G6001. Literally doing IGRT for simple skin cancer. Only in America.
This is a Medicare patient. When a Medicare patient gets billed for radiation therapy treatment, does CMS have the bandwidth/subtlety to know that it's derm doing the billing and not rad onc? The majority of radiation fractions...
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Source: Student Doctor Network - September 11, 2021 Category: Universities & Medical Training Authors: TheWallnerus Tags: Radiation Oncology Source Type: forums
CMS Comment time
About that time again. Time to submit comments to CMS to help avoid reimbursement cuts. I believe telehealth and some other issues are also still on the table. Please take a couple minutes to submit. You do not have to be an APA member, and it literally takes like 2 minutes with the template that APA provides, but feel free to personalize it for more impact.
ACT TODAY: Tell the Biden Administration (CMS) to Protect Access to Psychological Services!
Safeguard Psychological and Behavioral Services Send a Note to the Biden Administration (CMS) Now!Deadline to Comment: Septemb...
Source: Student Doctor Network - September 5, 2021 Category: Universities & Medical Training Authors: WisNeuro Tags: Psychology [Psy.D. / Ph.D.] Source Type: forums
What are the best study materials to learn more about healthcare industry/problems in medicine/etc.
Does anyone have any recommendations for condensed study guides or short books (i.e. please do not link general websites with thousands of links) for interviews to prepare for healthcare industry/biggest problems in medicine/life of a physician/Medicare/Medicaid/ACA/healthcare policy? I have already read The Healthcare Handbook by Askin. Thank you. (Source: Student Doctor Network)
Source: Student Doctor Network - July 27, 2021 Category: Universities & Medical Training Authors: apismnfla1003 Tags: Pre-Medical (MD) Source Type: forums
buy and bill
Now that I have started my own practice I am faced with tough financial questions that I did not have to deal with before. One such question is viscosupplementation injections. For medicare patients where I would have to buy and bill for the medication, the j-code reimbursements are significantly lower than the actual cost of the medication.
Is there any specific discount programs or GPOs to get better pricing at least on par with medicare reimbursement or ideally lower than the medicare...
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Source: Student Doctor Network - July 26, 2021 Category: Universities & Medical Training Authors: metadr Tags: Pain Medicine Source Type: forums
Work RVU
Has anyone seen an increase in work RVUs for Medicare patients? The new E/M payment took effect January 2021 but I’m not seeing a change in my wRVUs despite 70% Medicare panel. (Source: Student Doctor Network)
Source: Student Doctor Network - July 18, 2021 Category: Universities & Medical Training Authors: desertdocs Tags: Family Medicine Source Type: forums
It's that time of year folks. CMS released it's proposed fee schedule for 2022
CMS gives us a real good one here.
Calendar Year (CY) 2022 Medicare Physician Fee Schedule Proposed Rule | CMS
On July 13, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, on or after January 1, 2022.
www.cms.gov
Looks like we get a lovely 3.75% decrease. Do you think my malpractice carrier will decrease my premium...
Source: Student Doctor Network - July 15, 2021 Category: Universities & Medical Training Authors: king22 Tags: Podiatric Residents & Physicians Source Type: forums
