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Annual Wellness Visit: Audit Reveals EMR Template Vulnerability for Busy Medical Group

Background The Centers for Medicare & Medicaid Services (CMS) provides eligible Medicare recipients preventive services. In the first year following the recipient’s effective date, Medicare covers an Initial Preventive Physical Examination (IPPE). This is also known as a Welcome to Medicare visit. Each year after, the recipient may participate in an Annual Wellness Visit (AWV). The IPPE and AWV are intended to help patients maintain good health by catching signs of disease early on and…

What is a SMRC Audit and What Should You Do?

The Centers for Medicare and Medicaid (CMS) has established multiple levels of subcontractors to identify and minimize evidence of improper payments. Each provider has a Medicare Administrative Contractor (MAC). Currently the MACs include: is Noridian Healthcare Solutions, LLC (Noridian), CGS Administrators, LLC (CGS), National Government Services, Inc. (NGS), Novitas Solutions, Inc. (Novitas), Palmetto GBA, LLC (Palmetto), and First Coast Service Options, Inc. (First Coast). View coverage by state. In addition to the contractor assigned to your organization, CMS has…

Why Do IRFs Still Need to Know About 1135 Waivers?

Our world has continued to change since March 2020 when the COVID-19 pandemic and the Public Health Emergency (PHE) were implemented. Many of the rules and regulations outlined by the Centers for Medicare & Medicaid Services (CMS) are continuing to be altered, due to the continuation of the PHE. The Medicare Benefit Policy Manual (MBPM), Chapter 1 houses the regulations that have traditionally governed Inpatient Rehabilitation Facilities (IRFs). On March 13, 2020, CMS issued blanket…