Mid-Atlantic Health Law TOPICS
Recent Physician Billing Developments
Recent Medicare developments in the area of physician billing include:
Physician Rights: A recent case decided by the U.S. Second Circuit, which has jurisdiction in New York, held that physicians who reject Medicare assignment may sue Medicare regarding Part B reimbursement. Although Medicare policy does not allow appeals by non-assigned physicians, the court found that allowing appeals only by assignee-physicians was arbitrary and capricious.
Medicare Billing Compliance: The federal government has issued compliance guidance for activities of third-party billing companies. This publication by the Office of the Inspector General should be of interest to all providers wishing to evaluate the integrity of their billing systems.