At this point, there are three comprehensive healthcare reform bills passed by key United States Congressional Committees, i.e. the Senate Finance Committee, the Senate Health, Education, Labor and Pensions (HELP) Committee, and a consortium of House committees, referred to as the House Tri-Committee, consisting of the Energy and Commerce, Ways and Means, and Education and
Medicare & Reimbursement
AMA Medicare Action Kit – States Where Medicare Cuts Will Decrease Physician Participation
By Michael Cassidy on
Posted in Medicare & Reimbursement
The AMA has predicted that the proposed Medicare SGR (sustainable growth rate) physician fee schedule decrease will reduce physician Medicare participation in 22 states. Log onto the Medicare Payment Action Kit and see the predicted impact in your state.
Click here for the Medicare Payment Action Kit.
AMA & MGMA Lobby for Support to Reverse the SGR Medicare Physician Cut
By Michael Cassidy on
Posted in Medicare & Reimbursement
Urgent: Call your senators and urge support of legislation repealing SGR
The Senate is scheduled to begin consideration of S. 1776, the “Medicare Physicians Fairness Act of 2009,” on Monday afternoon, Oct. 19. This just-introduced legislation eliminates the 21.5 percent cut in Medicare physician reimbursement for 2010 and repeals the sustainable growth rate (SGR)…
New Medicare Recoupment Rules Protect Providers
By Michael Cassidy on
Posted in Medicare & Reimbursement
Prior to passage of the Medicare Modernization Act of 2003 (MMA), CMS was not restricted in recouping overpayments, despite the provider’s ongoing appeal rights.
Finally, as of November 16, 2009, CMS will implement new rules required by MMA to restrict immediate recoupment. Section 1892(f) of the Social Security Act prohibits recoupment of overpayment during a supplier…
October 1, 2009: Effective Date of New Stark Rules
By Michael Cassidy on
Posted in Fraud - Stark, Medicare & Reimbursement
This is just a reminder of the effective date for certain new Stark Rules:
1. CMS prohibits percentage formulae conjunction with space on equipment leases, fair market value exception transactions and indirect compensation effective October 1, 2009.
2. Per click leases are prohibited effective October 1, 2009.
3. "Under arrangement" relationships have been changed because…
MGMA Comments to Baucus Proposed America’s Healthy Future Act of 2009
By Michael Cassidy on
Posted in Legal News, Medicare & Reimbursement
Medical Staff Joint Commission Standards: MS.01.01.01 is the New MS.1.20
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Joint Commission has released a revised draft of Hospital Accreditation Standard MS.1.20, which was first proposed in June 2007 and intended to establish a balance of power between hospital administration and hospital medical staffs. Although originally scheduled to become effective January 1, 2009, the controversy and uproar accompanying the proposals in 2007 were so…
DMEPOS Accreditation Required September 30, 2009
By Michael Cassidy on
Posted in Medicare & Reimbursement
The Centers for Medicare & Medicaid Services (CMS) reminds Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) suppliers enrolled with the National Supplier Clearinghouse (NSC) they are required to obtain accreditation by September 30, 2009. Without accreditation, DMEPOS suppliers’ billing privileges will be revoked on or after October 1, 2009. Further, without accreditation, DMEPOS suppliers will not…
MGMA Identifies Key Physician Healthcare Reform Issues In Baucus Bill
By Michael Cassidy on
Posted in Medicare & Reimbursement
- Replacing the scheduled 21.5 percent reduction in 2010 Medicare physician payments with a 0.5 percent increase;
- Requiring that all eligible health professionals participate in Medicare’s Physician Quality Reporting Initiative by 2011;
- Creating a 10 percent bonus payment for primary-care and general-surgery providers who practice in health professional shortage areas. Funding for this five-year bonus,
…
Senate Finance Committee Chairman Introduces Health Reform Bill
By Michael Cassidy on
Posted in Medicare & Reimbursement
Senate Finance Committee Chairman Max Baucus (D-MT) has introduced the America’s Healthy Future Act of 2009. It is scheduled for a full Committee markup on September 22, where Democrats hope to obtain more Republican support.
The bill offers initiatives that will help all Americans meet the requirement of having health coverage, such as the expansion…