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2019 Medicare Physician Fee Schedule Final Rule Changes & Analysis

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued their final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (MPFS) beginning on January 1, 2019.


UnitedHealthcare to Institute Site of Care Reviews for Certain Advanced Outpatient Imaging Procedures

Beginning with dates of service on or after Jan. 1, 2019, UnitedHealthcare, aiming to minimize out-of-pocket costs for its members, will review the site of care during their Outpatient Radiology Prior Authorization process.  This is being instituted, many believe, to allow UHC to direct patients away from outpatient hospital settings and into outpatient freestanding imaging  Read More »


The RAC is Back

Recovery audit contractors are hoping a new report on their past success recovering money for Medicare will cause CMS to reverse course on its decision to limit the number of claims they can review.