Advocacy News

Scammers impersonating CMS are sending phishing fax requests for medical records and documentation, falsely claiming to be part of a Medicare audit.

Momentum is building on Capitol Hill to rein in Medicare Advantage plan upcoding.

A new report examines modifier 25 billing patterns with intravitreal injections and outlines CMS plans for additional review.

The Centers for Medicare and Medicaid Services (CMS) announced on May 21 plans to expand efforts to audit payments to Medicare Advantage (MA) in the coming months.

Here’s how ophthalmologists can request removal from the program.

It does not include a fix for 2025 cuts, but the process is far from over. See where things stand after the Energy and Commerce Committee vote.

The bill would eliminate the 2.8% cut to 2025 Medicare physician payment and provide an inflationary update to Medicare payments for the rest of this year. Call on your lawmakers to back this short-term fix.

Physicians across the country are facing increasing challenges from both “upcoding” and “downcoding” tactics used by Medicare Advantage insurers — tactics that can impede high-quality patient care, create unnecessary administrative burdens, and reduce reimbursement for physicians.

Certain Medicare Advantage (MA) plans are extracting more than $50 billion in overpayments by exaggerating the severity of beneficiaries’ health conditions. Ophthalmologists are fighting back.

The new recommendations to Congress call for a single-year positive update to the Medicare Physician Fee Schedule.