Washington -- High error rates on claims for certain hospital services has led the Medicare contractor covering Florida to propose withholding payment for certain cardiology and orthopedic procedures until the payer has had the chance to review physician documentation.

The Medicare contractor First Coast Service Options has targeted 11 cardiology and four orthopedic surgeries for prepayment review. First Coast singled out procedures that were determined to have high error rates during postpayment audits. For instance, a sample of claims for permanent cardiac pacemaker implantation procedures did not meet Medicare national coverage decision criteria during a recent comprehensive error rate audit.

ASIPP is offering three different courses in one warm, wonderful, and scenic location! Join us on February 24 at the beautiful Hilton Pointe Squaw Peak Resort in Phoenix, AZ.

The course choices are: Comprehensive Review Course and Cadaver Workshop with basic, intermediate, and ABIPP preparation (advanced) levels; Coding, Compliance and Practice Management Comprehensive Review Course (Feb 24-25) Competency Examination - (Feb 26); and Controlled Substance Management Comprehensive Review Course - (Feb 24-25) Competency Examination - (Feb 26)

Take this opportunity to not only break away from the cold but also earn CMEs. Consider comimg early or staying over. Bring your family and stay and play! Registration and Room Rate Discounts are available through February 2.

Brochure and Registration for Review Course and Cadaver Workshop

Coding, Complinace, and Practice Management brochure and registration

Controlled Substance Management brochure and registration

Scenario: How do we explain conflicting screening guidelines?

The U.S. Preventive Services Screening Task Force, specialty societies and disease advocacy groups promulgate guidelines for prevention of illness and disease. Sometimes screening recommendations from different groups -- for the same condition -- are not in sync.

Reply:

Consider two patient questions. The first patient is a 46-year-old woman coming to see you for a routine visit. Last year she had a mammogram. She has no family history of breast cancer. Based upon the U.S. Preventive Services Screening Task Force, you recommend waiting until she turns 50 before starting yearly mammograms.

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Experience the same great discussion, powerpoint presentation, and printable materials as the webinar attendees did all on your own time.

Coding is critical to your practice and there are new changes you need to know about. Once you purchase, you can watch it anytime, anywhere, as often as you want.

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At least one survey indicates that physicians' personal embrace of tablet computers is translating into a professional embrace -- one that could put small offices at the forefront in the latest wave of health information technology.

A survey by the market research firm NPD Group found that 76% of small to medium-sized physician and dental practices said they plan to buy tablets in the next 12 months and spend an average of $6,800. The findings were part of a survey of 500 businesses with fewer than 1,000 employees across all industry sectors.

The provisions of the national health system reform law are only part of the puzzle. Exactly how those provisions are implemented will affect whether reform is considered a success. American Medical News has investigated some lesser-known aspects of reform that might surprise those who think they know how it will roll out.

Health reform after 2014: Not-so-universal coverage
Roughly 30 million people are expected to gain health coverage under the reform law's provisions, but that would still leave about 20 million uninsured, whether by choice or by circumstance.

Physician employment has grown by 32 percent over the past 10 years. Hospitals today are employing roughly 212,000 physicians - or 20 percent of the practicing physician workforce - according to the AHA Hospital Statistics 2012 Edition.

Employment varies by region, with 56 percent of New England physicians reportedly employed or under contract compared to 29 percent in the West South Central Region. This variation is largely due to state corporate practice of medicine laws, such as those in Texas and California, which prohibit the employment of physicians.

CMS has corrected the 2012 ASC payment rates published in November by the agency, according to an ASCA report.

The corrections fix technical errors in how the costs of certain procedures were determined. The payment rates for some procedures have changed significantly, with a comparison from ASCA available here. Most of the corrections have little effect on 2012 rates, according to the report.

SAN DIEGO, January 17, 2012 -- The destruction of quality in the American medical system will not result from one isolated event. Neither the 'Affordable Care Act', its restricted pay to physicians, nor even rationed care will immediately tip the scales toward a subpar medical system. Rather, the turn for the worse will take effect as several pieces of the Obamacare puzzle are set into motion over the next few years.

One piece of this puzzle likely to work against the success of Obamacare will be the creation of local managed care 'medical homes' called 'Accountable Care Organizations' or ACOs. These little fifedoms controlled by local medical community powerbrokers will pit physician against physician, with only hospital administrators and local medical society 'leaders' profiting above the fray.

Data breach experts are issuing a warning to small practices -- don't be the vulnerable target that data thieves assume you are.

Kroll Fraud Solution's Top Cyber Security Trends for 2012 reported that small practices are more susceptible to security vulnerabilities because they are "the path of least resistance." Many rely on outdated technology. Basic security protections, such as proper use of encryption, often are overlooked as practices focus on meeting regulatory requirements, such as those related to meaningful use.

The Medicare Payment Advisory Commission (MedPAC) on Thursday recommended that Congress increase hospital inpatient and outpatient care payments by 1% in fiscal year (FY) 2013.

The panel voted 16-1 to approve earlier draft recommendations for the coming fiscal year. In addition, MedPAC voted 14-2 to recommend reducing payments for evaluation and management visits in hospital outpatient departments to the rate of free-standing physicians' offices across three years.

"Over time, Medicare needs to move toward paying the same amount for the same service regardless of the provider type," said MedPAC Chair Glenn Hackbarth. Hackbarth noted that the recommendations are not intended to discourage hospital-physician alignment.

WASHINGTON -- The Affordable Care Act's Medicaid expansion is "coercive" and "transforms the basic nature" of the insurance program for the poor, according to a brief filed with the Supreme Court by 26 states.

Requiring states to lower the eligibility requirements for Medicaid and to ensure that all Medicaid plans meet certain minimum requirements is an overreach of the federal government's power, the states argued in the brief filed Tuesday.

WASHINGTON - A Miami-area resident pleaded guilty today in U.S. District Court in Miami for her role in a Medicare fraud scheme that resulted in the submission of more than $200 million in fraudulent claims to Medicare, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).

Sandra Jimenez, 38, admitted to participating in a fraud scheme that was orchestrated by the owners and operators of American Therapeutic Corporation (ATC); its management company, Medlink Professional Management Group Inc.; and the American Sleep Institute (ASI). ATC, Medlink and ASI were all Florida corporations headquartered in Miami. ATC operated purported partial hospitalization programs (PHPs) - a form of intensive treatment for severe mental illness - in seven different locations throughout South Florida and Orlando. ASI purported to provide diagnostic sleep disorder testing.

Jimenez pleaded guilty to one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States and to pay and receive illegal health care kickbacks. Jimenez was charged in an indictment unsealed on Feb. 15, 2011, in the Southern District of Florida.

FSIPP Annual Meeting Dates May 18-20, 2012

The Florida Society of Interventional Pain Physicians has set the date for their next annual meeting for May 18-20, 2012 at the Gaylord Palms, Orlando, FL.

Read more about the meeting and other activities going on in the state of Florida in their newsletter. Click HERE to read latest issue.

For a complete look at the May meeting schedule and CME information, click HERE

CASIPP Annual Meeting Dates Nov. 9-11, 2012

The California Society of Interventional Pain Physicians Annual Meeting of the will be Nov. 9 -11, 2012 at the Pelican Hill Resort in Newport Beach, CA.

Go to www.casipp.com for more information.

Visit the ASIPP Web site to find available positions for IPM physicians.