Payments to Corporate Officer Subject to Employment Taxes

September 26, 2017

During an employment tax audit of an S corporation, the IRS determined that wages paid to the taxpayer’s corporate officer were unreasonably low, and recharacterized portions of distributions as wages. The issue raised in a Chief Counsel Advice (CCA) is whether the audit involved an issue of worker classification. Corporate officers are statutory employees under …

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CMS Reveals New Medicare Card Design

September 23, 2017

The Centers for Medicare & Medicaid Services (CMS) gave the public its first look at the newly designed Medicare card. The new Medicare card contains a unique, randomly-assigned number that replaces the current Social Security-based number.  CMS will begin mailing the new cards to people with Medicare benefits in April 2018 to meet the statutory …

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2016 PQRS Feedback Reports and Annual QRURs Available

September 21, 2017

The 2016 Physician Quality Reporting System (PQRS) Feedback Reports and 2016 Annual Quality and Resource Use Reports (QRURs) are now available: PQRS Feedback Reports provide program results for 2016, including if you are subject to the 2018 PQRS downward payment adjustment The 2016 Annual QRURs show how physicians, physician assistants, nurse practitioners, clinical nurse specialists, …

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Accuracy Matters – Top CPT Modifiers of Concern Medicare

September 20, 2017

Accuracy matters! I recently saw where Novitas Medicare Intermediary receives nearly 1.7 million requests from Part B providers each year to correct minor errors or omissions of claim-specific information, which costs time and money for providers and the Medicare Program. Did you know the most requested claim correction is adding, changing, or deleting a modifier? Modifier …

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2018 Physician Quality Reporting System (PQRS) Downward Payment Adjustment Notification Coming Soon

September 19, 2017

The Centers for Medicare & Medicaid Services (CMS) will soon begin distributing letters to Physician Quality Reporting System (PQRS) individual eligible professionals (EPs), EPs providing services at a Critical Access Hospital (CAH) billing under method II, and group practices regarding the 2018 PQRS downward payment adjustment. The letter indicates that the recipient did not satisfactorily …

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Billing Medicare for Ambulance Transports

September 14, 2017

In a September 2015 report, the Office of the Inspector General (OIG) released results of a study of Medicare Part B ambulance claims. According to the report, almost 20 percent of ambulance suppliers had inappropriate and questionable billing for ambulance transport, creating vulnerabilities to Medicare program integrity. The OIG identified a number of key problems, …

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Ex-IT Worker Gets 2.25 Years For Clinic Hack

September 14, 2017

A 29-year-old Texas man was sentenced to 27 months in prison Wednesday for hacking into the servers of a medical clinic where he lost his information technology job and buying merchandise from Staples on the clinic’s dime, according to the U.S. Department of Justice. Brandon Coughlin, who pled guilty to wire fraud and damaging a …

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General billing questions – Medicare inpatient visits

September 12, 2017

What does the physician bill when admitting a patient as an inpatient from observation? Medicare payment for the initial hospital visit includes all services provided to the patient on the date of admission by that physician, regardless of the site of service. The physician may not bill initial observation care or observation discharge management for …

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Piecemeal physician practice consolidation hampers antitrust intervention

September 11, 2017

From Becker’s Hospital Review: Physician practice consolidation evades federal agencies’ attempts to address antitrust concerns because it occurs largely through small acquisitions or individual hires, according to a study published by Health Affairs. After reviewing claims data from 2007-13 for several states encompassing about 12 percent of the U.S. population, researchers found most of the …

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Ultrasound Services Company Was a Personal Service Corporation

September 6, 2017

A husband and wife owned a C corporation that provided ultrasound services to medical offices and clinics throughout southern Colorado. For the years at issue, the corporation calculated its tax liabilities at the reduced graduated corporate tax rate of 15%. Upon audit, the IRS argued that the company was a Personal Service Corporation (PSC) and …

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