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In
this issue
CMS
delays implementation of new policies for ordering/referring providers
The
Centers for Medicare and Medicaid Services (CMS) delayed until April 5 the
implementation of the second phase of CR
6417 and CR
6421, which requires ordering/referring providers to be enrolled in the
Medicare Provider Enrollment, Chain and Ownership System (PECOS).
Implementation was originally scheduled for Jan. 4. At this time, CMS has
not published the formal request to change the implementation
date. Continue to check the CMS
Web site.
These
policies would deny Medicare reimbursement to Part B providers who are not
enrolled in PECOS. Providers who enrolled in Medicare prior to 2003
who have not completed the revalidation process are not included in PECOS.
The
Medical Group Management Association (MGMA) and 55 other associations sent
a letter
to CMS expressing concerns about, and recommended changes to, the new payment
policy. MGMA will continue to advocate on behalf of our membership with
respect to this change.
CMS streamlines the 2010 Medicare electronic
prescribing bonus program
The
physician fee schedule final regulation outlines
a simplified approach for groups seeking the 2 percent Medicare electronic
prescribing (e-prescribing) incentive bonus. For 2010, the rule requires
eligible providers to report an e-prescribing code only when a patient
visit generates an e-prescription. The provider only needs to report the
code 25 times during the 2010 reporting period, which spans the entire
calendar year. The Centers for Medicare & Medicaid Services (CMS) will
base incentive payments on the covered professional services furnished by
an eligible professional during the reporting year.
In
addition, the number of eligible denominator codes has increased. Beginning
in 2012, the program will impose penalties on eligible providers who are
not successful e-prescribers.
Learn
more about the 2010 e-prescribing bonus program and other changes made in
the 2010 final physician fee schedule by signing up for MGMA's Dec. 3
Webcast, "Medicare
Update 2010: The Good, the Bad, and the Downright Ugly," and
discover how policy and procedural changes in the 2010 Medicare program
will affect your reimbursement and practice operations.
CMS
issues correction to 2010 Medicare Conversion Factor
The
Centers for Medicare and Medicaid Services (CMS) issued a minor
correction to the 2010 conversion factor for Medicare physician services. The
conversion factor for CY 2010 is $28.3895 instead of $28.4061, as
previously indicated in the 2010 final physician fee schedule. CMS posted
this information on the CMS
Physician Fee Schedule website.
MGMA
supports proposal to rescind MA fraud training requirement
Medical Group
Management Association (MGMA) members have expressed concerns regarding
Medicare Advantage (MA) plans requiring “downstream entities” such as
physician practices with which they contract to go through fraud and abuse
training. The deadline for training is Dec. 31. It has been MGMA’s position
that requiring additional fraud, waste and abuse certification through MA
plans imposes an unnecessary burden on Medicare providers. As a result of
our advocacy efforts, the Centers for Medicare & Medicaid Services
(CMS) recently issued a proposed rule that would deem all Medicare-enrolled
providers as having met these redundant MA training requirements. MGMA
submitted comments to the agency strongly supporting the proposal. The
deadline for public comments is Dec. 8.
Given
that this proposed change is unlikely to be finalized before the end of the
year, MGMA, along with the American Medical Association (AMA) and others,
is asking CMS to take immediate action to clarify that physicians enrolled
in the Medicare program need not comply with the December 31 deadline. In
the interim, if MA plans request that you complete training you may
consider sharing information about the CMS proposed rule to educate them
about the pending changes. See pages - 54644
& 54721. MGMA will provide updates as soon as more information
becomes available.
CMS
to host another free PQRI conference call
On
Thursday, Dec. 10, from 1:30 p.m. – 3:30 p.m., EST, the Centers for
Medicare & Medicaid Services’ (CMS) will host a national provider
conference call on the Physician Quality Reporting Initiative (PQRI). Registration
for this call is required, and registration closes on Dec. 9 at
1:30p.m.
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