◆ A North Carolina physician who at times has been the nation’s top-paid provider of balloon sinuplasty services was indicted for adulteration of medical devices, paying illegal remunerations, making and using materially false health care documents, mail fraud and conspiracy, the U.S. Attorney’s Office for the Eastern District of North Carolina said Jan. 5.[1] According to the indictment, from 2014 to 2018, Anita Louise Jackson of Raleigh, who owned the practice Greater Carolina Ear, Nose, and Throat, “billed Medicare more than $46 million for allegedly rendering more than 1,200 incidents of ‘balloon sinuplasty’ services to more than 700 patients,” the U.S. attorney’s office said.
◆ CMS said Jan. 7 it has created HCPCS code J0248 for VEKLURY (remdesivir) antiviral medication when it’s administered in outpatient settings.[2] “This code is available for use by all payers and is effective for dates of service on or after December 23, 2021,” according to MLN Connects.
◆ CMS will enforce its vaccine mandate at hospitals and other health care facilities regulated by the Medicare conditions of participation in 25 states where it isn’t on hold because of a preliminary injunction, according to its website.[3] The Supreme Court is now considering challenges to the mandate in the other states.
