Foggy Forecast for Sunshine Act

Richard N. Peterson, JD

During a National Provider Call sponsored by the Medicare Learning Network® in June, providers learned more about how the Centers for Medicare & Medicaid Services (CMS) plans to implement provisions of the Physician Payment Sunshine Act. But the presentations raised even more questions about how physicians can interact with what CMS is calling the “Open Payments Program” and what they will be required to do in the event of a dispute over the information.

AAOS Participating in ASC Quality Improvement Program

Howard Mevis

The AAOS is working with the Health Research and Educational Trust (HRET) of the American Hospital Association to undertake a special 1-year program designed to improve quality of care at ambulatory surgery centers (ASCs). The pilot program focuses on improving patient safety and reducing postoperative infections to zero. The Agency for Healthcare Research and Quality (AHRQ) is funding the program. “Participating in this program aligns with other AAOS patient safety programs.

Is Your Documentation Up to Par?

Mary LeGrand, RN, MA, CCS-P, CPC

It may be hard to imagine that payers really read the operative notes to make sure the documentation supports the work performed, but the reality is that when services reported don’t match the codes submitted, payers pay attention. A recent case filed in a United States District Court is just one example.

Four Steps to Improve Your Bottom Line

Howard Mevis

Sometimes, taking simple steps can result in big payoffs—particularly when it comes to the bottom line. The following tips can help improve cash flow, reduce expenses, and keep your practice Health Insurance Portability and Accountability Act (HIPAA)-compliant. Know what you’re owed. Patients’ out-of-pocket costs are increasing. Your staff should know each patient’s payment responsibilities before the patient checks in. Collect copayments at the time of service.

Recent Trends in State Medical Liability Reform

Wayne A. Johnson, MD

Currently, 31 states have legislation that places caps on noneconomic damages in medical liability lawsuits. Of these, six have caps on both economic and noneconomic damages. However, achieving tort reform on a state-by-state basis is both difficult and unpredictable. For example, although noneconomic damage caps have been upheld in 16 states, they have been overturned as unconstitutional in 12 states.

Using Life Insurance for Estate Planning

Erika Wieland

Wanting the people we love to be taken care of—even if we aren’t physically there to do so—is a natural emotion. But achieving that goal requires planning ahead and evaluating all aspects of the situation. Life insurance may be one way to provide the necessary funds. But this requires taking taxes into consideration so that our loved ones can benefit from every dollar of the life insurance plan.