Avoid these missteps to slash your medical coding audit risk

Whether you are dealing with a commercial payer, Medicare, or Medicaid, there are certain types of improper claims that should be avoided if you want to reduce your risk of a medical coding audit. That bit of wisdom comes from an entity that ought to know: the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG).

The OIG has released a roadmap to help new physicians avoid medical billing fraud and abuse in the Medicare and Medicaid programs. But this advice also broadly applies to how you approach reimbursement from commercial payers, and can also serve as a helpful reminder for physicians with years of experience in practice.

My latest in AMA Wire. The whole shebang.

HHS should withdraw proposed family-planning gag rule

The AMA is urging Health and Human Services (HHS) Secretary Alex M. Azar II to withdraw a proposed rule that that would significantly revise the regulations governing the federal Title X family planning program.

“We are very concerned that the proposed changes, if implemented, would undermine patients’ access to high-quality medical care and information, dangerously interfere with the patient-physician relationship and conflict with physicians’ ethical obligations, exclude qualified providers and jeopardize public health,”  AMA CEO and Executive Vice President James L. Madara, MD, wrote in a letter to Azar.

My latest at AMA Wire. The whole shebang.

DOJ should block CVS-Aetna merger: Calif. insurance regulator

California Insurance Commissioner Dave Jones has concluded that the proposed merger of CVS and insurance giant Aetna would have major anticompetitive effects and should be blocked. Following a recent public hearing featuring testimony from many experts, including the AMA, Jones is formally asking the U.S. Department of Justice to sue to block the proposed merger.

My latest AMA Wire. The whole shebang.

The top 3 questions residents ask about buying a home

Buying a home is the single largest financial transaction most Americans engage in during their lifetimes, and the joy of signing on the dotted line is often mixed with confusion, dread and plain-old exhaustion with the process. The questions over the what, when, where and why of the matter take on even greater weight for medical residents, who face unusual financial circumstances that complicate an already overwhelming process.

My latest at AMA Wire. The whole shebang.

Anticompetitive CVS-Aetna merger should be blocked

The proposed merger of the pharmacy chain CVS and insurance company Aetna would harm competition, lead to higher drug spending and out-of-pocket spending, and should be blocked, AMA President Barbara L. McAneny, MD, said yesterday in testimony at a California Department of Insurance hearing.

“After very careful consideration over the past months, the AMA has come to the conclusion that this merger would likely substantially lessen competition in many health care markets, to the detriment of patients,” Dr. McAneny said at the hearing called for by California Insurance Commissioner Dave Jones. “The AMA is now convinced that the proposed CVS-Aetna merger should be blocked.”

My latest at AMA Wire. The whole shebang.

My stories from the 2018 AMA Annual Meeting

This was one of the busiest meetings of the American Medical Association’s policymaking body, the House of Delegates, that I can recall.  And I’ve been covering these meetings on and off since 2005. As a result, I had plenty to write about for AMA Wire. You can check out the articles below.

JAMA Network launches open-access journal

The inaugural issue of JAMA Network Open has been published, with articles exemplifying the breadth of areas that readers should come to expect to see covered in the new journal—oncology, physical medicine and rehabilitation, pediatrics and cardiology.

The open-access journal, announced last year, is the 13th journal in the JAMA Network and the third journal launched by the AMA in the last three years. JAMA Oncology was launched in 2015, followed by JAMA Cardiology in 2016.

My lede. The whole shebang.

Directory-related mishaps affect patients monthly, say doctors

More than half of physicians who responded to a recent survey (52 percent) noted they have a patient who encounters coverage issues because of inaccurate payer directories every single month.

The inaccuracies have prompted a regulatory response. The Centers for Medicare & Medicaid Services and state legislative bodies have issued regulations to ensure physician directory accuracy across the industry. Additionally, there is substantial variability among state rules.

My latest at AMA Wire. The whole shebang.

Charter calls for comprehensive efforts on physician burnout

A group of experts on doctor burnout from leading medical centers and organizations—including the AMA—has developed a charter on physician well-being that lays out the societal, organizational, interpersonal and individual commitments that must be honored to properly restore joy in medicine for an overburdened workforce.

Physician well-being is increasingly recognized as the fourth goal that joins the vaunted “triple aim” of improving care quality and patient experience while lowering health costs. Health systems have a strong reason to pay attention to the issue: their bottom lines. It has been estimated that burnout accounts for one-third of the cost of physician turnover, according to data cited in a JAMA Viewpoint describing the new charter.

The lede to my latest article in AMA Wire. The whole shebang.

The Other Party

There is no one else
In this whole wide world
Exactly like you
No one who talks or walks
Precisely the way you do
Not a one who snuggles or smooches
Snores or snorts
Identically as you do

Because deep inside each of us
Composing us all
Is a special code that coins
The curl of our hair
The color in our eyes
The depths of our belly buttons
And the lengths of our eyelashes
It draws out our laugh lines
And shapes the way we tremble in tears

No matter what else occurs
You will have a place on this planet
A time through which you travel
That is your very own

We are each
In short
Unique

But —
It turns out
There are two
Girls named Avery
Celebrating birthdays
At this park district facility today
And we are at the wrong Avery’s party

That explains why
You did not recognize her
And why she is
Several years younger than you

My bad.

So, finish up your cupcake
Grab our gift
From the table
Wish the wrong Avery
A happy birthday

And let’s head next door
To the other Avery party
Where you will find cake
And Goldfish crackers too

– 30 –

Surgeon general: Naloxone should be widely prescribed, carried

Nearly 80 percent of opioid-overdose deaths happen outside of a medical setting, meaning that—in addition to first responders—family members and friends are commonly the ones  to find a loved one who has overdosed. When they make that discovery, a quickly administered dose of naloxone can be lifesaving, yet too few Americans know about the opioid-overdose antidote, how to get it or how to use it.

Read the whole shebang.