20 for 20: PG-13
Discover how to give your patients the experience they deserve in this week’s 20 for 20, from CEO Mike Comer.
Discover how to give your patients the experience they deserve in this week’s 20 for 20, from CEO Mike Comer.
More than you think! If you hear a song by Van Halen, and remember the band, (and after a short and un-scientific survey of my team at the corporate office, that is a rapidly declining number!) you probably think of frontman David Lee Roth. In the 1980’s, he gained a reputation as temperamental and self-indulgent … Continued
About 25 years ago I was hired to assist a wound center in Sherman Oaks as it moved away from its management company, Curative. It was one of the first instances of a hospital insourcing their wound center and canceling their management contract. To say that the process was contentious would be a gross understatement. … Continued
20 years ago, I founded Wound Care Advantage with the goal of supporting hospital-based wound centers so they could avoid the costs of management companies and better treat the patients they serve. Over the years we’ve had a lot of successes, made many mistakes, and learned a lot of lessons. To celebrate, we’re launching 20 … Continued
Melissa Bailey, WCA’s Vice President of Strategic Partnerships, has been promoted to the position of President effective immediately.
A brief overview of the actions we have taken for our people, patients, and partners.
Last week, we discussed the “Site-Neutral Rule,” which would reduce Evaluation and Management charges for off-campus outpatient programs, including wound care and hyperbaric medicine centers. This week, 38 Hospitals sued Health and Human Services (HHS), challenging the rule. The lawsuit alleges that HHS Secretary Alex Azar exceeded his authority when this rule was implemented January 1, 2019.
In the final rule released in 2018 for 2019, CMS decided to reduce the E&M Level reimbursement for all off-campus departments of the hospital, including exempted centers. This reduction only affects CPT code G0463. If you have an off-campus provider-based department of the hospital, you will now be reimbursed 70% of the OPPS rate for 2019 with further reduction down to 40% in 2020.
The OIG released the results of a MAC audit report on Hyperbaric Oxygen Therapy (HBOT) services. Based on the sample charts, they estimated there were over $39 million in HBOT overpayments for the sample year alone in this jurisdiction.
The OIG reported that 85 percent of claims made by WPS did not comply with Medicare requirements, resulting in overpayments amounting to a staggering $42 million.