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CMS to MACs: Participate in ALJ appeals

Medicare looks for more active participation by MACs defending decisions to deny claim payments at the ALJ level. Read full entry»

Latest News

CMS Updates for the Week Prior to 09/22/2014

September 28th, 2014 by PitchStone Health Staff

Pitchstone Health analysis of the one CMS transmittal released last week that is relevant to physician practices. R3070CP: New Waived Tests Adds 25 lab tests to the list of those that can be billed by labs with a CLIA waiver.… Read full entry»

LCD Updates for September 8 to September 15

September 28th, 2014 by PitchStone Health Staff

From September 8 to September 15, 24 LCD (Local Coverage Determination) updates took effect: Jump to: CGS | FCSO | Highmark | Noridian | Palmetto GBA | WPS CGS L31846: Polysomnography and Sleep Studies PitchStone Summary: Revises sleep study coverage to allow for billing of… Read full entry»

Physician practices set to open exclusively for Medicare Advantage patients

September 28th, 2014 by Scott Kraft

Humana plans at least four physician practices exclusively for use by Medicare Advantage patients. Read full entry»

Healthcare headlines from around the Web

September 25th, 2014 by Scott Kraft

This week around the Web, a CVS partnership around medical records, a key HIPAA deadline passes and a physician paints a dark picture of the state of medicine. Read full entry»

ACA plan buyers to have more choice in 2015

September 24th, 2014 by Scott Kraft

People looking to buy health insurance through the state and federal marketplaces in 2015 can expect to have more plans to choose from than those who bought in 2014, according to an announcement from the Department of Health and Human Services. HHS interprets the findings… Read full entry»

Around the health blogosphere – a look at what health care bloggers are writing about

September 24th, 2014 by Scott Kraft

This week, health bloggers are talking about the public vs. private health treatment dilemma, how to respond to blatant overpricing for services, and how to tell patients to track data, rather than recommend applications that collect data. Read full entry»


Hospice services set to get more scrutiny – barrier to entry to get higher

September 22nd, 2014 by Scott Kraft

Long-awaited government crackdown on hospice providers may be about to begin. Read full entry»

CMS: Affordable Care Act drives surge in Medicare Advantage enrollment

September 19th, 2014 by Scott Kraft

MA plans becoming more popular every year since passage of the Affordable Care Act. Read full entry»


LCD Updates for September 1 to September 8

September 19th, 2014 by PitchStone Health Staff

From September 1 to September 8, the following LCD (Local Coverage Determination) updates took effect: Jump to: Palmetto GBA     Palmetto GBA L31536: Hospice – Liver Disease PitchStone Summary: Updates to citations and information sources for reformatting purposes. Does not impact coverage. Effective 9/5/2014… Read full entry»

CMS Updates for the Week Prior to 09/15/2014

September 19th, 2014 by PitchStone Health Staff

We reviewed all of the 8 CMS transmittals released last week and have summarized the 5 most relevant to physician practices. R174NCD: Screening for Hepatitis C Virus (HCV) in Adults Announces national coverage policies for screening for Hepatitis C for high-risk patients and adults 45-65.… Read full entry»