|As part of CMS’s revalidation efforts, all suppliers and providers who are not currently receiving EFT payments are required to submit the CMS-588 EFT form with the Provider Enrollment Revalidation application, or at the time any change is being made to the provider enrollment record by the provider, supplier or delegated official.|
Emergency March 2012 Update, Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA) to the CY 2012 Medicare Physician Fee Schedule (MPFS) Database
|This article was revised on March 29, 2012, to correct a reference to the CR. In the “What you Need to Know Section”, the article referenced CR 7677 instead of CR 7767. All other information is the same. Please review and share with your staff.|
Yes, new coding requirements are being implemented by all Work Comp payers, making billing even more complicated than it already is! Don’t get caught off guard and without money coming in the door… be sure your billing is being managed by a knowledgeable company so your reimbursement is realized… a company like MBC! We are ready, willing and, most importantly, able to manage your claims!
Eligible professionals who met the eRx payment adjustment inclusion
criteria, but who failed to meet the reporting requirements in 2011, may
receive the 2012 eRx payment adjustment starting January 1, 2012. The 2012
eRx payment adjustment for not being a successful electronic prescriber
will result in an eligible professional or group practice participating in
eRx GPRO receiving 99 percent (one percent less) of their Medicare Part B
Physician Fee Schedule (PFS) amount that would otherwise apply to such
services. Please share with appropriate staff.
On December 23, 2011, President Obama signed into law the Temporary Payroll
Tax Cut Continuation Act of 2011 (TPTCCA). This new law prevents a
scheduled payment cut for physicians and other practitioners who treat
Medicare patients from taking effect immediately. Please be sure to share
this information with appropriate staff since this law affects many aspects
of the Medicare program.
Thanks to all the political pressure, including those of you who reached out to your Representatives this week, the House Republicans joined the rest of the House to pass the Senate bill extending the payroll tax cut for two months. This bill also freezes the current Medicare rates and avoids the 27% cut (at least until March).The President is expected to sign the bill today. This means that a House-Senate conference committee will be established to negotiate a longer-term patch on the payroll tax cut and the Medicare payment rate. House leaders have already named the members of that committee (below). Senate appointees will be made in the coming week or so.For us this means Medicare reimbursement rates will be frozen at current rates and the 27% cut scheduled for January will not take effect until March unless a new deal is reached between now and then. However, the therapy cap exceptions process is not part of this two month bill and as of now still expires January 1. Therefore, we will need to lobby the conference committee to include it in the year-long package.
The Centers for Medicare & Medicaid Services (CMS) announced on Friday, December 23, that it would allow Medicare Administrative Contractors (MACs) to have the ability to relax the testing review requirement stated in the Medicare Claims Processing Manual, Chapter 24 General EDI and EDI Support Requirements, Section 50.5 EDI Testing Accuracy. This announcement allows trading partners to request transition into version 5010 production status without the full review of electronic test claims.
The Centers for Medicare and Medicaid Services (CMS) today issued a final rule with comment period that updates payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY) 2012. More than 1 million providers of vital health services to Medicare beneficiaries – including physicians, limited license practitioners such as podiatrists, and NPPs such as nurse practitioners and physical therapists – are paid under the MPFS. CMS projects that total payments under the MPFS in CY 2012 will be approximately $80 billion. (go to link below for more info)
Effective for Dates of Service (DOS) on or after January 1, 2011, Medicare
provides 100 percent payment (in other words, waives any deductible,
coinsurance or copayment) for many Medicare-covered preventive services.
This article serves as a reminder and quick reference for the changes to
deductibles, copayments, or coinsurances for preventive services. Please
share with appropriate staff.
2011 Version of Advance Beneficiary Notice of Noncoverage Must Be Used Beginning Sunday, January 1, 2012
In May 2011, the Centers for Medicare and Medicaid Services (CMS) released an updated version of the Advance Beneficiary Notice of Noncoverage (ABN) (form CMS-R-131), which will replace the 2008 version of this form.