News

FDA Recalls August 12 - 18, 2025

“We are wondering if you might be able to help us with the following matter. We are finding that it may be possible that insurance companies may pay for interpretation services for patients. Are you able to confirm this? If so, do we put something specific on the claim and send the invoice as well? We are just trying to figure out how to offset some of this cost as most of the patients that require interpretation are coming in for nail care and it costs us more to pay the company than we get for services provided. Any help you can provide would be greatly appreciated.”

Description: Measure 487 Social Drivers of Health measures the percentage of patients 18 years and older screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety. These particular issues could have a direct impact on the outcome of the care we provide. This is a good measure to participate in because it has podiatric implications

FDA Recalls August 5, 2025 - August 10, 2025

CMS Proposes Physician Payment Rule to Significantly Cut Spending Waste, Enhance Quality Measures, and Improve Chronic Disease Management for People with Medicare.

Consider an internal audit referred to as a compliance audit of your chart notes/medical record documentation and billing/coding to determine if you are potentially at risk of an audit or clawback by CMS, the Centers for Medicare and Medicaid Services or by a commercial health insurance carrier and determine what steps need to be taken to mitigate those risks. It is inevitable that in all likelihood a provider will be audited. An audit should never be more than an inconvenience. It should not be a life-changing event. If a clawback takes place, it would be bad enough if face value reimbursements were requested after the fact. Unfortunately, this is usually not what occurs. The assumption is that since the billing, coding and documentation did not support the claim(s) that were filed, the requested amount to be repaid will be far greater. Interest, penalties and an extrapolation is instituted referred to as the Statistically Valid Random Sample or SVRS that will result in an amount that needs to be repaid that is far greater than what was initially reimbursed.