by L. Neal Freeman, MD, MBA, FACS The Medicare requirements for supervision of surgeons-in-training were not met, according to allegations filed against the University of Pittsburgh Medical Center. There were also claims of excessive reporting related to spinal decompression. A settlement of over $2.5 million dollars was agreed upon. See the full report here: https://www.justice.gov/usao-wdpa/pr/false-claims-act-violation-upmc-resolved-25-million

by L. Neal Freeman, MD, MBA, FACS In the proposed rule from the Centers for Medicare and Medicaid Services for 2017, CMS continues its long-standing interest in use of the -25 modifier.  Many procedures are often reported with this modifier, meaning that the provider is paid for both the office visit and the procedure.  CMS suspects [...]