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8 / 31 / 2023

Emergency Department Staffing: What’s the Trouble and Where are we Headed?

By
Allison Carty
Abstract On May 15, 2023, Envision Healthcare Corp. (“Envision”) announced that it and several of its subsidiaries had filed voluntary petitions for reorganization under Chapter 11 of the United...
8 / 23 / 2023

PHC August 2023 Real Estate Practice Newsletter

By
Mike Vandaveer
Healthcare Real Estate Transactions Mountain Point Medical Center – Salt Lake City, UT.  JLL Capital Markets, Medical Properties Group announced the sale of Mountain Point Medical Center, a 60,000 square...
8 / 10 / 2023

CMS Proposes Expanded Coverage for Carotid Artery Stenting (“CAS”)

By
Amy Crenshaw-Pritchett
Traditionally, carotid endarterectomy has been the primary method of treating high-grade asymptomatic and symptomatic carotid artery stenosis. However, a minimally invasive technique known as carotid artery stenting (“CAS”) has...
8 / 8 / 2023

Telehealth Changes After Public Health Emergency

By
Lori Carlin
COVID-19 public health emergency (PHE) ended on May 11, 2023. Medicare’s coverage of telehealth for outpatient services will be extended through the end of 2024. Patients may continue to...
8 / 3 / 2023

Mental Health Changes V24 to V28

By
Amy Crenshaw-Pritchett
While mental health awareness month occurred in May, we need not forget the upcoming changes to Medicare Advantage members in CY 2024 and beyond. On March 31, 2023, The...
8 / 3 / 2023

Proposed Rule Summary of Topics and Interesting Points: Physician Fee Schedule 2024

By
Kelly Loya &
Lori Carlin &
Amy Crenshaw-Pritchett
Pinnacle has reviewed the proposed rule changes for CY2024 related to the Medicare Physician Fee schedule.  CMS has also published a fifteen (15) fact-sheet summary.  The condensed overview below...
8 / 1 / 2023

Every PCP Should Be In a Shared Savings Contract: Where do we start?

By
Curtis Bernstein &
Kelly Conroy &
Daniela Yusufbekova
In a time where healthcare costs continue to rise, there is a diverse range of payment models in use, ranging from traditional fee-for-service to global capitated payment, to stunt...
6 / 26 / 2023

Modifier 25: Is Your Documentation Up to Par?

By
Lori Carlin
Modifier 25 Scenarios Is your documentation up to par to support Modifier 25? First, you should read The Center for Medicare and Medicaid Services (CMS) National Correct Coding Initiative...
6 / 21 / 2023

Medicare’s Change to the Split/Shared Billing Rules: Implications for Physician Compensation Planning

By
Andrea Ferrari &
Jodi Nayoski
1.  What is a split/shared service? This term refers to evaluation and management services that are performed partly by a physician and partly by a non-physician practitioner (NPP) who...
6 / 14 / 2023

As CMS Focuses on Quality, there are Monumental Changes to Reimbursement for Quality on the Horizon!

By
Amy Crenshaw-Pritchett
The Centers for Medicare and Medicaid Services (“CMS”) utilize risk adjustment factors to estimate the cost of Medicare Advantage (“MA”) beneficiaries and those associated costs of providing care.  Risk...