Medicare
E-Prescribing Deadline Reminder
June 30, 2012 is the deadline for physicians to report on at least 10 electronic scripts in order to avoid the 2013 Medicare e-prescribing program penalty. Physicians who are not able to meet the requirements of the program should apply for a hardship exemption applicable to their specific situation before the June 30, 2012 deadline…. Read More »
Tips on Maintaining Medicare Billing Privileges
The process of enrolling in Medicare has become increasingly complex. Whether you are renewing your application or submitting an initial application, the consequences of not adhering to the guidelines can be severe. The following are tips to help maintain your Medicare billing privileges. First, be sure to notify CMS within 30 days of changing… Read More »
Medicare Part D Drug Plans Can Withhold Payments on Suspicious Claims
In a growing effort to prevent “doctor shopping,” Medicare Part D prescription drug plan sponsors can now safely withhold pharmacy payments on suspicious claims without violating prompt payment requirements. A recent CMS Notice clarifies that when a sponsor suspects fraud with respect to a particular claim, payment need not be made until the claim has… Read More »
E-Prescribing Significant Hardship Exemption Deadline is November 1
Just a reminder that the deadline for requesting significant hardship exemptions under the Medicare electronic prescribing (“eRx”) incentive program is November 1, 2011. Starting in 2012, eligible professionals who are not successful electronic prescribers under the eRx incentive program will be subject to a payment adjustment. The final rule incorporates four additional hardship exemptions for… Read More »
“DOC FIX” BILL SIGNED INTO LAW
The “doc fix” bill has been signed into law. Although formally known as the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act, the legislation is more commonly known as the “doc fix” bill because it holds off a scheduled drop in payments to doctors. The Act was passed by the Senate… Read More »
Fraud Waste and Abuse Training Requirements Eliminated for Providers
A final rule published in the April 15, 2010 Federal Register makes clear that enrolling in Medicare is considered enough proof that providers know about fraud, waste and abuse issues, and that Medicare Advantage (“MA”) plans do not need to require additional compliance training. In the 2007 MA regulations, CMS stated that it would hold… Read More »
30 Day SGR Freeze Extension Passed in Senate
On March 2, 2010, the Senate passed a 30 day extension of the sustainable growth rate (“SGR”) freeze. The bill will now go to the President for his signature. The legislation extends the Medicare payment freeze through March 31, 2010, which will temporarily void the 21% reduction in Medicare reimbursements. This is only a… Read More »
CMS ADOPTS PAYMENT POLICY & RATE CHANGES FOR SERVICES IN HOSPITAL OUTPATIENT DEPARTMENTS AND AMBULATORY SURGICAL CENTERS FOR 2010
The Centers for Medicare & Medicaid Services (“CMS”) has announced that most hospitals will receive an inflation update of 2.1 percent in their payment rates for services provided to Medicare beneficiaries in outpatient departments. Due to a Medicare requirement, CMS will reduce the update by 2.0 percentage points for hospitals that did not participate in quality data… Read More »
REMINDER: NOVEMBER 15, 2009 DEADLINE FOR MEDICARE PART D CREDITABLE COVERAGE NOTICES
Employers with group health plans need to provide Medicare Part D notices of creditable or non-creditable coverage to Medicare-eligible individuals by November 15, 2009. Employers can satisfy this requirement by including the notice in enrollment materials or in separate mailing during the fall. When preparing materials for distribution this fall, employers should be aware of… Read More »
CMS Proposes Medicare Payment Increase for ASCs in 2010
CMS recently issued a notice of proposed rulemaking that includes proposals for policy changes and payment rates for services in ambulatory surgical centers (“ASCs”), which would continue the expansion of surgical procedures that Medicare would cover for services performed in ASCs. The proposed rule seeks to make sure that beneficiaries have access to outpatient services… Read More »
