What would you think if I told you that Medicare will require laboratories to disclose to CMS payment rates from private insurers? Or that they will identify physicians who order a high volume of CT tests and require them to pre-authorize those tests in 2020?  How about that CMS will begin its own analysis of the time and cost of providing services in order to determine RVUs, a job currently ...

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Certain medical stories are irresistible to the popular press: ICD-10 external cause codes that are ridiculous (W61.43XD, pecked by a turkey, subsequent encounter) or medical practices using their electronic health records in a way that increases their revenue. A recent headline was eye-catching, as headlines are meant to be, “Report finds more flaws in digitizing patient files.”  The New York Times reported that the Office of Inspector General (OIG) ...

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Recently, a member of my family was involuntarily admitted to the psychiatric unit of a major teaching hospital in New York City and remained there for two and a half weeks.  During that time, the unit kept him safe and provided medication for mood stabilization and thinking.  After seeing my family member, my first priority was to talk with the attending physician and care team. Evidently, the attending doesn’t like to ...

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The X-Files fans will remember the poster that Agent Mulder had on his bulletin board with a picture of a flying saucer and the words, “I want to believe.”  That’s how I feel reading EMR notes sometimes.  I want to believe, but I doubt. I know how this happens.  The EMR vendor, the practice implementation team and the doctor have a meeting to develop the “normal” template for a hospital admission ...

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