The federal government has been active in seeking out fraud and abuse in the Medicare and Medicaid programs. Urology practices should ensure that they are in compliance with all applicable federal and state regulations in the event of an audit. Practices are encouraged to develop and implement a compliance plan followed by an internal baseline audit.
Urology practices can maximize office efficiency and productivity by implementing shared medical appointments and drop-in group medical appointments. The goal of these appointments is to free up more time for the practicing physician. Administrative staff should ensure that documentation is accurate and specific in order to receive appropriate reimbursement.
The new ICD-10 coding system will allow for greater specificity in characterizing medical conditions by expanding the current ICD-9 compendium of 13,000 diagnosis codes to over 68,000 codes. This is expected to improve the ability to measure healthcare services, process claims, conduct public health surveillance, and identify fraud and abuse. Urology practices should be proactive in preparing for ICD-10 implementation.
Medicare Part D is a voluntary program established to provide access to outpatient prescription drug coverage. Private insurers administer prescription drug benefits under the auspices of the Centers for Medicare and Medicaid Services (CMS). Urology practices can help their Medicare patients by familiarizing themselves with Part D plans, benefit designs, and formularies in their respective service areas.
The Multiple Procedure Payment Reduction (MPPR), designed by the Centers for Medicare and Medicaid Services (CMS) to lower Medicare costs and improve efficiency by modifying payments for overlapping consecutive services, has been expanded in 2012. The reductions apply to both the technical and professional components of imaging services conducted by physicians.
Understanding Medicare Incentives and Payment Adjustments for e-Prescribing, PQRS, and Meaningful Use
The Centers for Medicare & Medicaid Services (CMS) supports a number of initiatives designed improve quality, reduce medical errors, and promote cost efficiency in the healthcare system. Urology practices should be aware of changes in the incentive structures for these initiatives, which include electronic prescribing, the Physician Quality Re porting System (PQRS), and electronic health record (EHR) meaningful use guidelines.
A number of nonpharmacologic approaches to the prevention of prostate cancer are being studied, with mixed results. Findings from one study indicated that long-term vitamin E use was associated with an increased risk of developing prostate cancer, while results from another study found that vigorous exercise slowed the progression of prostate cancer. Researchers suggested that exercise may have favorable effects on gene expression in these patients.
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