INDUSTRY INSIGHTS
Here you will find answers to frequently asked questions
and recent articles we have written.
Responding to Audit Requests
They Want 100 Charts to Audit – REALLY? Audits are on the rise in a major way. Some payers, particularly Medicare Advantage Plans under Humana and BCBS, are targeting vision care submissions made through the vision plan they are subcontracting with for routine care. ...
Payer Down Coding
Unfortunately, down coding of claims is becoming a more common occurrence. Down coding occurs when a payor changes the service code (CPT code) that the provider submitted to one that represents a lower level of service than was actually provided to the patient. This...
Windows 10 End of Support
Microsoft has announced they will discontinue support for Windows 10 effective October 14, 2025. This will include ALL versions of Windows 10. Microsoft cites the significant advances in security in Windows 11 as the prevailing reason. Windows 10 is the most common...
MIPS 2025 Update
Not many providers understand MIPS and few ODs choose to participate in MIPS, but we do get questions about it. If you wonder how it applies to you, this article should help. Does MIPS apply to you? MIPS does apply to optometrists who bill Medicare and generally...
Salt Typhoon, Text Messaging and HIPAA
Several telecommunications companies, including AT&T, Verizon, and others, recently experienced an unprecedented cyberattack. The attack, labeled "Salt Typhoon" by Microsoft, is one of the largest in U.S. history. The hackers were and, in some cases, still are...
Ending Windows 10 – What To Do
Microsoft has announced they will discontinue support for Windows 10 effective October 14, 2025. This will include ALL versions of Windows 10. Microsoft cites the significant advances in security in Windows 11 as the prevailing reason. Windows 10 is the most common...
Update on the Corporate Transparency Act
PCS receives many questions about the Corporate Transparency Act. Here is the most recent information. To review, the Corporate Transparency Act was passed to document ownership in US corporations. Several parties filed class action lawsuits against this law; one...
Update on FTC Eyeglass Rule
A little history… Based on reluctance on the part of too many eye care practitioners to provide patients with a copy of their glasses prescriptions, the Federal Trade Commission (FTC) promulgated the Eyeglass Rule in 1978 – over 45 years ago. PCS provided a review of...
Update on FTC rule on non-competes
PCS receives many questions about the non-compete ban. Here is the most recent information. The 2023 FTC ruling essentially banned using non-competes in almost every business sector. Healthcare was not excluded. The law prohibited the use of any future non-competes...
Supreme Court Chevron Decision
Dorothy, You’re Not In Kansas Anymore Mark June 28, 2024 on your calendar as potentially one of the most significant dates in the compliance and regulatory world’s history. On that date, the Supreme Court concluded Loper v. Raimondo, overturning a 40 year old ruling...
Answers to 11 Common Questions About Employee Vacation Time Rights
Summer months and holidays are common times when your employees would like to spend time with their family and friends. It is also a time when your patients, especially students of all ages, often want to take care of their eyecare needs. These two desires/needs can...
UPDATE ON EMPLOYEE CLASSIFICATION
Washington and many states are increasing oversight and investigation into employee misclassification – predominantly employees being paid inappropriately on a salaried basis. For years, PCS has encouraged our colleagues to weigh the significant consequences of...
FTC Effectively Bans All Non-Competes
As PCS has been stating for over a year, the implementation of an FTC rule banning most all non-competes was imminent – and now has happened. Although sweeping in its scope and seemingly non-existent exemptions, the 570-page rule is still very complex. While some...
How Social media works to help or hurt your practice
Whether you are participating in social media related to your practice or not, your patients are. The average person spends about 145 minutes on social media every day. 90% of users follow at least one brand on social media. Facebook, with 2.9 billion monthly active...
Update on Federal Pregnant Works Fairness Act
The Pregnant Workers Fairness Act was signed into law by President Biden in December 2022, and the law went into effect in June 2023. The law requires all employers to provide reasonable accommodation to all employees for pregnancy and related complications as long...
United Healthcare Breach Update
By now, everyone is aware of the UHC breach and its massive impact on most healthcare providers. The resolution of this problem has proceeded at a snail’s pace. Some, but not most, systems are back in operation, but specific clearinghouses, payers, and EMRs remain...
Removing Reviews from Google
Sometimes a review may be inappropriate, or you may disagree with it. You can ask Google to remove or delete an inappropriate review from your Business Profile and in certain circumstances, Google can remove reviews that violate Google's policies. You can read...
The United Healthcare Breach
WHAT HAPPENED? Most are aware of the massive cyberattack on United Healthcare (UHC) revealed over the past few weeks. The breach has been traced to an employee download that allowed cybercriminals access to huge amounts of the database. The impact of this breach is...
FTC Eyeglass Rule and Contact Lens Rule
Recently, PCS has become aware of an apparent increase in violations of the prescription release requirements under Federal law. An update on the requirements of these laws appears in order. Eyeglasses The FTC’s Ophthalmic Practice Rule related to eyeglass...
The Corporate Transparency Act
The Corporate Transparency Act went into effect in January of 2024, and may require your practice to report information about ownership to the government. *** Update March 22, 2024 *** On March 1, 2024, the U.S. District Court, N.D. of Alabama declared the act...