The hospital lobby is alive and well in America. In North Carolina they have so far successfully opposed the full repeal of Certificate of Needs (CON) Laws despite the matter being brought before the state legislature almost every year. I am sure we are going to hear from them about the latest rule change that President Trump has made to medical billing.<\/p>\n
On Monday, The Daily Signal<\/a> posted an article about a move by the Trump administration to lower healthcare costs.<\/p>\n The article reports:<\/p>\n Currently, doctors can charge Medicare recipients twice for exams during same-day services. The exam fee is called an \u201cevaluation and management fee\u201d and can cost more than $235.<\/a><\/strong><\/p>\n For example, during a Medicare recipient\u2019s standard dermatology exam, the doctor can charge the recipient twice for an exam of a mole if the removal service is performed on the same day. This is a common form of Medicare double billing among health care providers.<\/strong><\/p>\n In a recent audit by the Department of Health and Human Services, the Office of the Inspector General found that 42% of Medicare beneficiaries were double-billed<\/a> for intravitreal injections during eye exams, a recurring procedure. The same-day exam and procedure allowed the claims to bypass the system designed to prevent improper payments.<\/strong><\/p>\n California and Florida are the top two states, with roughly 10 million Medicare beneficiaries combined, to benefit from this rule change. It is expected to take effect in January, just after the midterm election.<\/strong><\/p>\n The proposed rule was announced in July and was open for public comment through mid-September. Now, the Centers for Medicare & Medicaid Services is evaluating the public comments and will soon announce the finalized rule.<\/strong><\/p>\n The American Hospital Association is obviously opposing this move.<\/p>\n The article notes:<\/p>\n The proposed rule was announced in July and was open for public comment through mid-September. Now, the Centers for Medicare & Medicaid Services is evaluating the public comments and will soon announce the finalized rule.<\/strong><\/p>\n The proposed rule suggested cutting the initial exam fee to 50% from 100% and keeping the final exam and procedure fee at the standard 100% charge. While the Trump administration has supported the rule change, Medicare providers and beneficiary associations have opposed the rule, claiming it would cause \u201cfragmented care and reduced access for patients.\u201d<\/strong><\/p>\n It’s time to consider the consumer as well as the provider. Keep in mind that the more money that flows through government agencies, the greater chance of corruption.<\/p>\n","protected":false},"excerpt":{"rendered":" The hospital lobby is alive and well in America. In North Carolina they have so far successfully opposed the full repeal of Certificate of Needs (CON) Laws despite the matter being brought before the state legislature almost every year. I … Continue reading