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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.

FDA Recalls July 30, 2025 - August 5, 2025

Description: REGCLR5 measures the percentage of patients with a plantar foot ulcer who were compliant with offloading and healed their ulcer in 10 weeks. This measure requires the utilization of remote monitoring where you put the patient in a boot that has a gyrometer in it and you are able to track how many hours a day that the patient is utilizing the boot. You are measuring that the patient is being compliant with the treatment plan.

The Proper Use of the 25 Modifier