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N.H. committee votes to increase Medicaid copays
By Kathleen Ronayne
CONCORD, N.H. (AP) — Medical copayments will increase on Jan. 1 for people on the state's Medicaid expansion plan with incomes higher than twice the federal poverty line, which is roughly $12,000 for an individual.
Concurrent surgeries come under new scrutiny
In Minnesota, heart surgeons occasionally performed overlapping operations at hospitals roughly eight miles apart, leaving the second patient waiting under anesthesia for the doctor to arrive.
In Wisconsin, a medical school paid $840,000 this year to settle a lawsuit alleging that neurosurgeons illegally billed Medicare for simultaneous spine surgeries that were largely done by unsupervised medical residents.
Norwalk Hospital settles Medicare fraud claims
Norwalk Hospital is among 32 hospitals in 15 states that have agreed to pay the United States a total of more than $28 million to settle allegations that they submitted false Medicare claims for minimally-invasive procedures to treat spinal fractures that often are due to osteoporosis.
CMS says 10% ICD-10 claims rejected, but only a fraction due to coding issues
Susan Morse, Associate Editor
About 10 percent of claims filed under ICD-10 have been denied since the coding vocabulary became the norm on October 1, the Centers for Medicare and Medicaid Services said on Thursday, though only a small number of those denials were due to coding errors.
Of 4.6 million total claims submitted per day, 2 percent were rejected due to incomplete or invalid information, CMS said.
The Centers for Medicare & Medicaid Services (CMS) has extended the deadlines for physicians and group practices facing two different Medicare penalties in 2016 to request an informal review if they believe the government made a mistake.
The penalties, which whittle down reimbursement, are levied under Medicare's Physician Quality Reporting System (PQRS) and the Value Based Payment Modifier (VBM) program. The original deadline for an informal review of both penalties had been November 9. Now it is November 23.