Medicare Proposes Physician Pay, Policy Changes via Fee Schedule

Medicare’s 2023 draft physician fee schedule (PFS) proposes changes in policies for telehealth, opioid use disorder treatment, and dental services, as well as a plan for the limited use of fee-for-service funds to address social needs. In addition, the draft rule would expand opioid treatment and recovery services, including a bid for wider use of … Read more

Telemental Health Linked to Greater Post-Hospitalization Follow-up

High use of telemental health services by patients with serious mental illness (SMI) who live in nonmetropolitan US counties is associated with improvements in key outcomes, including greater post-hospitalization follow-up, new research suggests. In a nationwide study, researchers drew on Medicare data from nearly 3000 counties covering the period from 2000 to 2018. Results show … Read more

Psychiatrist Found Guilty in $110 Million Fraud Scheme

A Florida jury has found a Palm Beach psychiatrist guilty of one count of conspiracy to commit healthcare fraud and wire fraud and 11 counts of healthcare fraud. Mark Agresti, MD, 59, was convicted of illegally billing $110 million of medically unnecessary urinalysis services for patients living at Good Decisions Sober Living (GDSL), a drug … Read more

High Praise, Condemnation for CMS Aduhelm Coverage Plan

Medicare has received a key endorsement of its plan to restrict payment for the controversial Alzheimer’s disease (AD) drug aducanumab (Aduhelm) — but also drew pleas from other groups for more generous reimbursement of the drug, as well as expected similar medications currently in development . The Centers for Medicare & Medicaid Services (CMS) received … Read more