CMS ANNOUNCES POLICY, PAYMENT RATE CHANGES FOR THE PHYSICIAN FEE SCHEDULE IN 2012 The Centers for Medicare & 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) … Continue Reading
CMS has finally released the final rule for the Medicare Shared Savings Program, which is the program that establishes the rules for Accountable Care Organizations (ACOs). The initial industry objections to the ACO concept and the proposed regulations was that it was so complicated, so limited and potentially so expensive that it would be impossible, … Continue Reading
Eligible professionals (EPs) must successfully e-prescribe for Medicare patients 10 times before June 30, 2011 using claims-based reporting to avoid the penalty in 2012. Earning the e-prescribing incentive for 2011 will not necessarily exempt an EP or group practice from the 1 percent penalty starting on January 1, 2012. For 2013, the 1.5 percent penalty is based … Continue Reading
Highmark Medicare has posted the 2011 Medicare ASC fee schedule for PA, NJ, MD and Delaware/Metro DC. https://www.highmarkmedicareservices.com/partb/reimbursement/ascfee11.html… Continue Reading
Congress approves Medicare physician payment fix The House of Representatives passed legislation this morning that averts a 24.9 percent Medicare payment cut to physicians that was scheduled to take effect on Jan. 1. The measure passed the Senate Wednesday evening by unanimous consent. To pay for the legislation, the bill changes policy regarding overpayments … Continue Reading
MGMA reported today: Senate passes a 1-year Medicare physician payment patch; House to act next The Senate passed today by unanimous consent legislation preventing a 24.9 percent cut in Medicare physician payments. The Medicare and Medicaid Extenders Act of 2010 (H.R. 4944) extends the current Medicare payment rates through Dec. 31, 2011. This one-year halt of … Continue Reading
Pres. Obama signed the Physician Payment and Therapy relief Act of 2010. This act extends the temporary 2.2 % medicare Physician Fee Schedule increase, which replaced the projected 23% SGR decrease for 2010, but only for one more month.… Continue Reading
CMS published the payment policies under the 2011 Medicare Physician Fee Schedule on Tuesday, January 13, 2011. The Med Law Blog will be posting comments on significant provisions over the next several weeks. Please let us know if there is a particular issue you would like addressed.… Continue Reading
CMS will process claims tomorrow, June 18, with 21 percent cut As the clock continues to tick toward the June 18 final deadline for implementation of the 21.3 percent cut in Medicare physician payments produced by the sustainable growth rate (SGR) formula, U.S. Senate debate continued June 17 over H.R. 4213, the American Jobs and … Continue Reading
The U.S. House of Representatives is expected to consider legislation to block the pending 21.2 percent cut to physician Medicare payments soon. The cuts will take effect June 1 unless final legislation is signed into law before then. The proposed bill, H.R. 4213, “The American Jobs and Closing Tax Loopholes Act of 2010” also includes numerous other … Continue Reading
Senate failure to pass 30-day extension causes 21.3 percent cut to Medicare physician payments on April 1. The Senate has adjourned for 2 weeks without postponing the Sustainable Growth Rate (SGR) Medicare Physician Fee Schedule reduction. For the past several months, since the problem arose 1/1/10, carriers have responded by advising physicians to … Continue Reading
The Senate failed to act on The House bill to postpone the Sustainable Growth Rate (SGR) Medicare Physician Fee Schedule cut. Therefore the mandatory 21.5% Medcare cut will happen on March1. Legislators have promised renewed efforts but there is no immediate relief in sight. However, CMS is suggesting anpther 10 day hold to provide time … Continue Reading
CMS has issued MAC instructions for processing purchased services. Denials are keyed to the answer to question 20 on CMS-1500 (or ANSI X12 837P – line level PS1), which is the question regarding “Outside Lab.”… Continue Reading
The Centers for Medicare & Medicaid Services (CMS) has become aware of a scam where perpetrators are sending faxes to physician offices posing as the Medicare carrier or Medicare Administrative Contractor (MAC). The fax instructs physician staff to respond to a questionnaire to provide an account information update within 48 hours in order to prevent … Continue Reading
