By SAM WHITEHEAD
Until last year, Georgia’s Medicaid coverage for new moms with low incomes lasted 60 days.

That meant the Medicaid benefits of many women expired before they could be referred to other medical providers for help with serious health problems, said Dr. Keila Brown, an OB-GYN in Atlanta. “If they needed other postpartum issues followed up, it was rather difficult to get them in within that finite period of time,” said Brown, who works at the Family Health Centers of Georgia, a group of community health centers.

Georgia lawmakers, recognizing the state’s high rate of pregnancy-related deaths, have taken action. In 2021, Georgia extended the Medicaid coverage window to six months [Read More]

Maximize Your Learning Events With These Best Practices

By EWA MATUSZEWSKI
I will admit to being taken aback by how many positive comments I received on my last column: Don’t Get Trained – Learn! I appreciate all of the feedback and your interest. I hope I’m not wearing out my welcome by staying on this topic for June as well.

While it may be unusual for a healthcare executive to spend so much time in curricula development, it is a significant part of my work life. I attribute that not only to my love of learning but the sheer volume of new information coming out daily on health and well-being (and the billing [Read More]

What Is In A Diagnosis Code? More than you might Think for Medicare Advantage Payments

By ROLF LOWE
The International Classification of Diseases (ICD) used by both providers and payers to identify diagnoses and procedures was developed by the World Health Organization and has been in place since the mid 1970’s. The utilization of ICD codes for various aspects of delivering healthcare services has increased since their introduction and is now an integrated part of many payment and reimbursement models. The Centers for Medicare & Medicaid Services (CMS) collects information on the ICD codes as a condition of payment, including it as an area of information to provide on the CMS [Read More]

LANSING LINES

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

House Education Focus On COVID-19 Policy Is ‘Waste Of Time,’ Dems Say

More bills limiting mask mandates and vaccines in schools are “wasting time” on issues that won’t help students, Rep. Darrin Camilleri (D-Brownstown Twp.) said after the House Education committee voted out a package on COVID-19 policy in schools.

SBs 600-603 would prohibit mandatory vaccinations, face masks or testing for students to attend school or school events.

The bills were all reported with recommendation from the committee on a 7-5 vote.

But Camilleri, who voted no, said moving forward with the legislation is a waste of time when [Read More]

House Insurance Committee Chair Daire Rendon (R-Lake City) began the process of passing legislation that penalizes auto insurers that are not fully compensating the providers of those taking care of people catastrophically injured in car accidents.

Although it wasn’t on the agenda, Rendon took up Rep. Ryan Berman’s (R-Commerce Twp.) HB 5870, which hits insurers acting in bad faith that don’t pay the bill sent to them by providers three times the amount of the overdue payment plus attorney costs.

She then took testimony from health care providers who claimed they hadn’t been compensated under the law for, in some cases, 10 months. They claimed they are having to take money out [Read More]

By MICHELLE ANDREWS
Andrew Bade, who was diagnosed with Type 1 diabetes nearly two decades ago, is accustomed to all the medical gear he needs to keep his blood sugar under control. His insulin pump contains a disposable insulin cartridge, and a plastic tubing system with an adhesive patch keeps in place the cannula that delivers insulin under his skin. He wears a continuous glucose monitor on his arm.

Bade, 24, has used the same equipment for years, but every three months when he needs new supplies, his health insurance plan requires him to go through an approval process called prior authorization.

Getting that approval can take as many as three weeks, and [Read More]

By EWA MATUSZEWSKI
While I may occasionally substitute the word training for learning, my strong preference when bringing professionals together to gain new insights is to focus on the learning that is taking place. Training too often connotes the visual of people gathered in a classroom being told from an “expert” how to tackle a particular issue or topic, while learning takes on a more comprehensive approach and includes sharing experiences among those assembled.

I broach this matter today because late last month, our organization sponsored a conference on Health Information Exchange (HIE) presented by Practice Transformation Institute and supported through a grant from BCBSM. A mainly in-person event, I attended virtually [Read More]

By STEPHEN SHAVER
Wachler & Associates, PC

The week of May 9, healthcare providers began to find out if their requests to file late reports under the Provider Relief Fund were granted. Providers whose requests were granted will have 10 days to file the required reports, while providers whose requests were denied can likely expect a repayment demand. These decisions are the latest chapter in the saga of the ever-shifting reporting requirements under the PRF.

Although initially intended to keep the nation’s healthcare providers afloat during the early days of the COVID-19 pandemic, the PRF has since descended into a bureaucratic labyrinth of compliance traps ready to snare the unsuspecting provider. The [Read More]

By RALPH Z. LEVY JR.
A prior article in this publication (IRS Attack on Zeroed Out Taxable Income in Recent Tax Court Cases) discussed the lessons that physician and other incorporated medical practice groups could learn from taxpayer losses in two then recent Tax Court cases in use of the “zero out” technique in the payment of compensation to the group’s owners. Under this approach, the practice group typically compensates its physician-owners or other licensed professional shareholders by payment of a portion of the anticipated pre-tax operating profits as compensation (salary) in regular increments during the tax year and then it will distribute the bulk of its profits in bonuses [Read More]

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

40% Of Health Clinics Saying No To Opioids

Doctors in Michigan are writing fewer opioid prescriptions, but the state’s death rate continues to climb. Also, more than 40% of the health care clinics have a sign on their doors: We do not prescribe opioids.

Those are two of the major takeaways from a three-hour presentation at the Spring Scientific Convention sponsored by the Michigan Osteopathic Association earlier this month.

A trio of physicians told the members that many doctors are “afraid” of being prosecuted by the state for alleged overuse of the addictive painkillers. To avoid any such action, [Read More]