CMS proposes streamlining Medicare provider application

From Modern Healthcare:

The CMS on Friday suggested revising the Medicare enrollment application used by providers to make the standards clearer for enrolling clinicians.

The agency announced a slew of revisions to the form in an information collection notice, including reorganizing the form to create a more logical flow what questions are being asked.

The new form will include new specialty codes for physicians and non-physician practitioners to choose from, questions with “Yes/No” check boxes and will remove duplicate fields.

“This application collects information to ensure that only legitimate physicians, non-physician practitioners and other eligible professionals are enrolled in the Medicare program,” the agency said in a notice. “It is meant to be the first line defense to protect our beneficiaries from illegitimate providers and to protect the Medicare Trust Fund against fraud.”

The proposed application changes come just weeks after CMS announced it wanted to make it easier for physicians to enroll in Medicare and Medicaid through a pilot program that streamlines the screening process.

Many non-emergency medicine trained physicians in ER care

From MedicalXPress:

M. Kennedy Hall, M.D., from the University of Washington School of Medicine in Seattle, and colleagues performed a cross-sectional study of all clinicians receiving reimbursement for evaluation and management services to Medicare fee-for-service beneficiaries in the emergency department using the 2014 Medicare Public Use Files. Providers were classified as emergency physicians, non-emergency physicians, and advanced practice providers.

The researchers found that of the 58,641 unique emergency medicine clinicians, 61.1, 14.3, and 24.5 percent were classified as emergency physicians, non-emergency physicians, and advanced practice providers, respectively. Family practice and internal medicine predominated among non-emergency physicians categorized as emergency medicine clinicians (41.7 and 19.9 percent, respectively). Physician assistants and nurse practitioners (68.4 and 31.5 percent, respectively) predominated among advanced practice providers. Overall, 58,565 emergency medicine clinicians were mapped to 2,291 U.S. counties. The proportion of emergency physicians was higher in urban versus rural counties (63.9 versus 44.8 percent); 27.1 and 41.4 percent of counties, respectively, had no emergency medicine clinicians and no emergency physicians reimbursed by Medicare fee-for-service Part B.

CMS proposes to overhaul Medicare billing standards, pay for telehealth

From Modern Healthcare:

The CMS on Thursday proposed paying doctors for virtual visits and overhauling Medicare billing standards it has had in place since the 1990s.

In a lengthy proposed rule, the agency said it would pay doctors for their time when they reach out to beneficiaries via telephone or other telecommunications devices to decide whether an office visit or other service is needed. In addition, the CMS also proposed paying for the time it takes physicians to review a video or image sent by a patient seeking care or diagnosis for an ailment.