Newsletters & E-Blasts
Hot off the Presses: PHE Renewed for Another 90 Days! Health and Human Services Secretary Xavier Becerra, announced that he has renewed the COVID-19 Public Health Emergency declaration....July 19, 2022
Cognitive Assessment: What’s in the Written Care Plan? Knowing how many palliative care programs regularly provide care and treatment for patients with dementia and other cognitive impairments, we wanted to make sure you were aware of this important service...June 23, 2022
Must your HIPAA policies cover audio-only telehealth? In March 2020, in response to the COVID-19 public health emergency (PHE), telehealth services became a new way to assist the healthcare industry’s response to the PHE...
June 21, 2022
Hot off the Presses: PHE Renewed for Another 90 Days! Health and Human Services Secretary Xavier Becerra, announced that he has renewed the COVID-19 Public Health Emergency declaration....April 14, 2022
Physician Assistants Benefit with Direct Pay Under New CMS Rule Prior to January 1, 2022, payment for Physician Assistants' services could only be made to the PA's employer...April 1, 2022
Hot off the Presses: PHE Renewed for Another 90 Days! Health and Human Services Secretary Xavier Becerra, announced that he has renewed the COVID-19 Public Health Emergency declaration....January 17, 2021
Therapy Payment Reduction - Effective January 1, 2022 As you are probably aware, the mandatory payment reduction for some physical and occupational therapy services is effective January 1, 2022....December 10, 2021
Hot off the Presses: PHE Renewed for Another 90 Days! Health and Human Services Secretary Xavier Becerra, announced that he has renewed the COVID-19 Public Health Emergency declaration....October 18, 2021
Acevedo Consulting's Response to Medicare's Proposed 2022 Medicare Physician Fee Schedule Rule By now I'm sure that you are aware the proposed 2022 Medicare Physician Fee Schedule rule is out for comment....September 2, 2021
Read this if you Order, Refer or Prescribe for Patients with Medicaid However, if you treat patients with Medicaid (even as self pay), they most likely expect Medicaid to pay for items and services you order for them...August 27, 2021
Hot off the presses: PHE renewed for another 90 days! Health and Human Services Secretary Xavier Becerra, announced that he has renewed the COVID-19 Public Health Emergency declaration...July 20, 2021
National Initiatives to Expand Telehealth If you read the CCHP’s email accessible in the link below, you’ll see that there are a few bills in the Congress that would have a positive impact on you being able to continue to provide services to your patients via telehealth...June 29, 2021
Modifiers JA and JB Required for IV Administration of SAD Listed Drugs There was an update to the Self-Administered Drug Exclusion List (SAD) effective April 5, 2021 that is important for providers to be aware of.....May 12, 2021
Hot off the presses: PHE renewed for another 90 days!  Health and Human Services Secretary Xavier Becerra, announced that he has renewed the COVID-19 Public Health Emergency declaration....April 19, 2021
Read this if you Order/Refer Anything for Patients with Medicaid  "But I don't accept Medicaid" you may say, however, if you have a patient that has Medicaid or a Medicaid Advantage Plan that would normally cover the ordered item....April 15, 2021
CMS Instructs all Medicare Administrative Contractors (MACs) to Hold Claims  The Senate passed legislation last week to extend the pause on CMS' 2% sequestration reduction through December 31, 2021.....March 31, 2021
Christmas in Medicare World: Trigger Point Injection Audits  NGS has announced a post payment audit for trigger point injections (CPT 20552 and 20553) for the states of New York, Connecticut, Massachusetts, Rhode Island, Vermont, Maine and New Hampshire.....January 5, 2021
Update: G2211 on Hold  As part of the COVID relief bill passed in Washington and signed over the weekend by the President, implementation of the complexity add-on code (G2211) has been suspended for 3 years....December 29, 2020
COVID Accelerated/Advance Payment Revised Repayment Terms  We would like to share some good news for providers who requested and received Medicare advanced payments...October 7, 2020
Hot off the presses: PHE renewed again for another 90 days!  Health and Human Services Secretary Alex Azar announced that he had renewed the COVID-19 Public Health Emergency declaration. ...October 6, 2020
New!  Provider Reimbursement for Counseling Patients to Self-Isolate at Time of COVID-19 Testing  In an effort to further encourage physicians and non physician practitioners to counsel patients who are undergoing COVID-19 testing on what they should do while waiting for results (e.g., self-isolation, signs & symptoms to be on the alert for, etc.)...July 30, 2020 
PHE Renewed for Another 90 Days  Many of you have asked and wondered if the Public Health Emergency (PHE) order will expire today...July 24, 2020
Medicare Audits will Resume August 3rd Other than what the fraud contractors continued to do, “routine” Medicare audits hit a pause button during the COVID-19 public health emergency...July 21, 2020 
Capture payments for Uninsured COVID Patients, But Act Fast to Get a Slice In addition to the first two rounds of Provider Relief Fund allocations, there is additional funding to help reimburse providers who have cared for the uninsured with COVID-19... June 29, 2020
June 3rd Deadline for Round 2 of the $100B Provider Relief Fund When the 1st phase of Provider Relief Fund money went out in April, the amount received was based on 2019 Medicare reimbursement.   For some, Medicare is the major payer but for others, this is not the case... May 26, 2020
Medicare Coverage and Payment of Virtual Services CMS' video will provide you with answers to common questions about the expanded Medicare telehealth services benefit under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.
Health Insurance Providers Respond to Coronavirus (COVID-19) Many of you has asked if we know if a particular managed care plan or commercial insurance is covering telehealth, waiving patient co-pays, or even making emergency advance payments.  To help you find the answer for the plans most important to your practice/organization, you may want to take advantage of the AHIP’s (America’s Health Insurance Plans) website... May 6, 2020
Medicare to Implement Prior Authorization Process July 1, 2020 Medicare is implementing a prior authorization process for certain procedures performed in the outpatient hospital or ambulatory surgery center... April 29, 2020
Provider Relief Fund Dilemma:  Keep the Money or Send it Back Providers have been receiving unsolicited funds due to the CARES Act’s Provider Relief Fund. While at first this has brought the intended sigh of relief, once the recipients read the Terms and Conditions that they must attest to, in many cases that sigh has turned into hesitation as to whether they should keep the money... April 21, 2020
CARES Act Provider Relief Fund Explained Are You Suddenly Finding Extra Money Marked as “HHSPAYMENT” in Your Business Checking Account?... April 13, 2020
Medicare FFS Claims: 2% Payment Adjustment Suspended (Sequestration) Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act temporarily suspends the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration... April 10, 2020
Alert: Individual Posing as OCR Investigator Acevedo Consulting received information from the Office of Civil Rights (OCR) that an individual posing as an OCR Investigator has contacted HIPAA covered entities in an attempt to obtain protected health information (PHI)... April 6, 2020
Expansion of Medicare's Accelerated and Advance Payments Program In order to increase cash flow to providers of services and suppliers impacted by the 2019 Novel Coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) has expanded their current Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers.... March 30, 2020
MIPS Update CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19 ... March 30, 2020
Telehealth: An Update Due to the President's declaration of a State of Emergency, and as part of the Coronavirus Preparedness Act, there has been a revision for Medicare Patients that allows a Physician/ Non-Physician Practitioner to use his/her telephone if the phone allows the doctor and patient to see each other in real time (i.e. Skype for Business) for the provision of Telemedicine/Telehealth. ...March 17, 2020
Additional Code for Coronavirus Lab Tests Developed CMS has published new codes as well as billing and coverage guidelines for patients being tested or treated for the coronavirus... March 6, 2020

The Time to Submit 2019 MIPS Data is Now! The Performance Year 2019 Submission Window is Open... February 11, 2020

Medicare Billing Requirements for Therapy After conducting several audits, the Office of Inspector General (OIG) determined that payments for physical therapy services did not comply with Medicare billing requirements... February 11, 2020

The MIPS 2019 Data Submission Period is Now Open  MIPS Eligible Clinicians Can Start Submitting Data for 2019 through March 31, 2020... January 7, 2020

Coding for Sinuva™ Claims Whether or not NGS is your Medicare contractor, we thought you might find these coding instructions helpful when using the Sinuva implant... October 24, 2019

Iowa Otolaryngologist Agrees To Pay $1,000,000 To Resolve Medicaid False Claims Allegations Many of you make a point to use a checklist or other tool to help ensure the medical necessity of the doctors’ sinus surgeries... October 25, 2019

60-Day Overpayment Rule & Incident-To Errors Article Featuring Jean Acevedo of Acevedo Consulting Jean Acevedo was recently interviewed by the Report on Medicare Compliance. This interview followed a webinar on Medicare’s 60-Day Overpayment Rule where she presented alongside Attorney Lester Perling for the Health Care Compliance Association... October 16, 2019

New Florida Law Regarding Opioid Prescribing Effective July 1, 2019 As of July 1, 2019, all Florida physicians and nonphysician practitioners who prescribe any opioids are required to inform the patient of any alternative treatments available... July 22, 2019

Volume 3, Issue 4 - December 2018 Evaluation & Management Services Changes for 2019; "2019" The Year of Restoring the Doctor-Patient Relationship Through Telehealth and Virtual Services; Get Out Your Checkbook if a Business Associate Agreement is Not in Place!
Volume 3, Issue 3 - September 2018 Security Risk Assessment: What is it and Why is it Important?; Palliative Care Does Not Have To Be a Loss Leader
Volume 3, Issue 2 - July 2018  Ignorance Is Not Bliss in Health Care; "Incident to" Billing and Nonphysician Practitioners
Volume 3 Issue 1 - March 2018 Meeting Medicare Advantage Requirements; Target, Probe and Educate: The End of Insanity; New Medicare Cards: What You Need to Know; Firm News
Volume 2 Issue 4 - December 2017 Are the 1995 and 1997 Evaluation and Management Documentation Guidelines on Their Way Out?; Fraud, Waste & Abuse Training; Surviving Prepayment Review; ACI Welcomes New Consultants
Volume 2 Issue 3 - September 2017 Security Risk Assessment: What is it and Why is it Important?; Surgical Assists: What Documentation is Required?; ICD-10 Changes: What will this mean for you?; MIPS Participation Reminder
Volume 2 Issue 2 - June 2017 Telehealth: Possible Changes on the Horizon; That Infamous E&M Code: 99214; Changes to United Healthcare Policy
Volume 2 Issue 1 -March 2017 Practice agrees to $4,488,000 to settle False Claims Allegations; Anti-discrimination Litigation Under Section 1557 Of The ACA
Volume 1 Issue 4 -December 2016 Medicare in 2017: What’s New and Different; It’s Important to Ensure Your Medicare Enrollment Information is Accurate; The Importance of Documenting the Medical Necessity of Services; Is your organization in compliance with Section 1557 of the Affordable Care Act?
Volume 1 Issue 3 - September 2016 CMS Introduces the Merit-Based Incentive Payment System; Responding to an Audit; Does Your Organization Run Exclusion Checks?;  2017 ICD-10 Changes Released; The Office of Civil Rights  Issued A New Rule On Discrimination 

Volume 1 Issue 2 - June 2016 Office of Civil Rights Update; CMS' Value Based Modifier: Payments Based on Quality vs. Cost; New Medicare Revalidation Tool

Volume 1 Issue 1 - March 2016 What the Value-based Payment Modifier Means for Your Practice; Modifier 25: Have You Received a Comparative Billing Report (CBR)?; HIPAA HITECH Audits; Meaningful Use Attestation Error Fixed; Widespread Probe Notification for CPT 99214; The Medicare EHR Incentive Program Hardship Application Deadline Extended