SGR UPDATE - URGENT MESSAGE
As of 12/19, the House and Senate appear unable to reach agreement on a "fix" to the SGR cut scheduled to take effect on January 1. Each respective body has enacted legislation postponing the cut but they are in disagreement on the length of the postponement, as well as how to pay for the short-term fix.
In light of the ongoing disagreement, the Centers for Medicare and Medicaid Services (CMS) has released the following announcement:
The negative update under current law for the 2012 Medicare Physician Fee Schedule is scheduled to take effect on Sun Jan 1, 2012, eight business days from today. Consequently, as on numerous occasions in the past, CMS will instruct its Medicare claims administration contractors to hold claims containing 2012 services paid under the Medicare Physician Fee Schedule for the first 10 business days of January 2012 (i.e., Sun Jan 1 through Tue Jan 17). The hold should have minimal impact on provider cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.
Medicare Physician Fee Schedule claims for services rendered on or before Sat Dec 31 are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.
CMS will notify you on or before Wed Jan 11, 2012, with more information about the status of Congressional action to avert the negative update and next steps regarding the claims hold.
From the American Medical News: Medicare 27.4% doctor pay cut set for 2012 unless Congress Acts
CMS says its hands are tied on the payment formula but agrees to scale back additional pay reductions planned for interpreting imaging scans. The agency also is moving ahead with rules on noncompliance penalties for electronic prescribing and quality reporting.
Red the full article HERE from the amednews.com
From the American Medical News: Physician texting provides quick communication -- and an easy way to violate HIPAA
After years of using pagers, and constantly waiting on return calls, physicians now consider texting to be an efficient and fast way to connect with colleagues.
Read the full article HERE from the amednews.com
From the American Medical News: Medical identity theft a growing problem
With 1.5 million victims in the U.S., physicians can take a few simple steps to ensure that patients aren't using someone else's name to get care.
Read the full article HERE from the amednews.com.
From the American Medical News: MedPAC plan repeals SGR, but cuts doctor pay
The AMA and others in organized medicine are speaking out against the recommendations.
Read the full article from the amednews.com HERE
From the American Medical News: Hardship waivers last chance to avoid Medicare e-prescribing penalty
Physicians facing a 2012 pay reduction will not receive any more time to report paperless prescription activity.
Read the full article from the amednews.com HERE
From the American Medical News: Staying in Private Practice offers its own rewards
The number of small, privately owned practices continues to shrink as economic pressures and long hours take their toll on the owner-physician.
Read the full article from the amednews.com HERE
From the AMA's Health System Reform Insight: Opposition to the IPAB escalates
A controversial provision of the Affordable Care Act (ACA) that has been highlighted recently in the media calls for establishing an Independent Payment Advisory Board (IPAB). The purpose of this 15-member panel would be to extend Medicare program solvency through the use of a spending target system and an expedited congressional process for approving Medicare cost savings.
Read the full article HSRI Opposition to the IPAB.pdf .
From MGMA - Special Alert: CMS releases 2012 proposed physician fee schedule
The Centers for Medicare & Medicaid Services (CMS) released the Medicare proposed physician fee schedule for 2012 late Friday afternoon. In the proposed rule, CMS estimates the 2012 conversion factor to be $23.9635, which represents a 29.5 percent cut to Medicare physician payments unless Congress intervenes. CMS will accept public comments on the rule until Aug. 30th, and intends to issue the final rule by Nov. 1.
Click HERE to see the full email from MGMA and more of the provisions to the proposed rule.
20% Error Rate in Processing Claims, AMA Study Finds
June 21, 2011 - Almost 1 in 5 claims physicians file with commercial health insurers have a processing error that often mistakenly delays payments or rejects them entirely, according to the American Medical Association's (AMA's) 2011 National Health Insurer Report Card.
Read the full article published by Medscape Medical News HERE.
From BROWN/MCCARROLL Health Law E-Alert:
The Centers for Medicare & Medicaid Services (CMS) Announces a New Program to Prevent Medicare Fraud
On June 17, 2011, CMS announced that it will begin to use predictive modeling technology to prevent Medicare fraud. The program is designed to stop fraudulent claims before they are paid. CMS stated that the technology is similar to the technology used by credit card companies, which uses real-time data to spot suspect charges. CMS will begin this program on July 1, 2011.
Physician practices still not in 5010 ballpark as deadline looms
A recent MGMA survey of physician practices makes clear that a large percentage will have trouble meeting the Jan. 1, 2012 deadline for using the HIPAA 5010 transaction set.
Read the full article published by FierceHealthIT HERE.
CMS to Modify Medicare ePrescribing penalty program
Under the Centers for Medicare & Medicaid Services (CMS) ePrescribing rule, physicians must issue at least 10 electronic scripts (e-scripts) by June 30, 2011, to avoid an ePrescribing penalty that amounts to a 1% reduction from their total Medicare Part B allowable charges in 2012.
The AMA continually stressed to CMS that the agency's sudden decision in November 2010 to require physicians to meet these criteria by June 30 of this year in order to avoid 2012 penalties was unreasonable.
Read the full article from the AMA Health System Reform Insight HERE.
Medicare quality bonuses elude nearly half of reporting doctors.
Total payouts were up in the third year, but only one in five eligible professionals participated in the voluntary program.
Read the full article from the American Medical News here.
Is your practice reporting on PQRS measures? NBP can walk you through the steps to successfully report on PQRS measures so your practice can receive incentive payments.
For more information contact Amanda Bailey:
abailey@mybillingpartner.com
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