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Hello,
CMS
releases 2010 proposed physician fee schedule
The
Centers for Medicare & Medicaid Services (CMS) just released the 2010
Medicare proposed physician fee schedule and a related press
release and fact
sheet. The regulation includes provisions that confirm a 21.5 percent
reduction in 2010 Medicare physician payments unless Congress enacts
legislation to reverse this cut. Long advocated for by the Medical
Group Management Association (MGMA), the regulation also proposes to
“remove physician-administered drugs from the definition of “physician
services” for purposes of computing the physician update formula in
anticipation of enactment of legislation to provide fundamental reforms to
Medicare physician payments.”
MGMA
will analyze the regulation’s impact on medical group practices, post this
analysis online as a member benefit and send formal comments to the agency
detailing Association concerns. Look for updates in MGMA Washington
Connexion and on the MGMA
Public Policy website as the Association reviews this 1128 page
document.
Urge
your senators to repeal the Medicare physician payment formula!
Providers
treating Medicare patients will receive an estimated 21.5 percent cut in Medicare
reimbursement in 2010 unless Congress intervenes. The Medical Group
Management Association (MGMA) needs you to target your senators today and
tell them to finally repeal the flawed Medicare physician payment policy.
Urge Congress to not base any new health care reform payment system on the
current Medicare payment policy.
Use the MGMA
Advocacy Center and tell your senators to replace it with a method that
accurately reimburses physician practices for the costs of providing
quality care to Medicare beneficiaries.
Although
Congress is now considering various reform proposals, we need you to e-mail
your senators today to ensure they repeal the SGR!
Read
current information on the MGMA
Health Care Reform Resource Center.
MGMA
voices concerns over initial meaningful use definition
In a
comment letter to the Office of the National Coordinator for Health Information
Technology (ONC), the Medical Group Management Association (MGMA)
highlighted concerns with the first draft set of criteria that eligible
professionals will have to meet to qualify for the electronic-health record
(EHR) incentives as part of the American Recovery and Reinvestment Act of
2009 (ARRA). MGMA criticizes the lack of administrative data in the
definition, recommends a phased-in approach that applies to non-physician
providers and supports the Certification Commission for Health Information
Technology as the official certification entity.
ARRA
stipulates that in order to qualify for up to $44,000 under the Medicare
incentives or up to $63,750 under the Medicaid incentives, eligible
professionals will have to be “meaningful users” of an EHR. ONC recommended
a series of increasingly stringent meaningful-use requirements between
2011, the first payment year of the subsidy program, and 2015. In 2015, if
an eligible professional is not a meaningful EHR, they will face decreased
Medicare payments.
Read
the MGMA comment letter on meaningful use.
Read
the complete text of the draft meaningful use.
HHS,
CMS rescind Medicaid regulations limiting outpatient hospital benefit
category
The
Department of Health & Human Services and the Centers for Medicare
& Medicaid Services (CMS) announced the rescission of a Medicaid
regulation published Nov. 7. The regulation would have limited the
outpatient hospital and clinic service benefit for Medicaid beneficiaries
to the scope of services that Medicare recognizes as outpatient hospital
services. CMS opted to rescind the rule because the agency determined it
would have a greater effect than previously anticipated.
Read
the announcement
CMS requires DME
suppliers to obtain surety bonds
The Centers for Medicare
& Medicaid Services (CMS) released a transmittal
that would require durable medical equipment prosthetics and orthotics
suppliers (DMEPOS) to obtain $50,000 surety bonds for each location
using a separate National Provider Identifier as a prerequisite for
participating in the Medicare program.
Certain DME suppliers are
exempted from this new requirement:
- Suppliers with comparable
surety bonds under state law.
- Suppliers in a private
practice making custom orthotics and prosthetics who are solo owners
and operators who only bill for these supplies.
- Physicians and nonphysician
practitioners who only supply DME to their own patients. Nonphysician
practitioners included in this exemption are physician assistants,
nurse practitioners, clinical nurse specialists, certified registered
nurse anesthetists, certified nurse midwives, clinical social workers,
clinical psychologists, and registered dietitians or nutrition
professionals.
- Physical and occupational
therapist in a private practice who are solo owners and operators who
only bill for these supplies. The therapists also only supply DME to
their own patients as part of their service.
This transmittal took
effect May 4 for nonexempt suppliers who are completing an initial
enrollment application or making changes to their enrollment application.
For all other nonexempt providers, the effective date is Oct. 4. Nonexempt
suppliers are required to submit a copy of the surety bond along with their
CMS-855S to the National Supplier Clearinghouse.
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July 1, 2009
- CMS releases 2010 proposed physician fee schedule
- Urge your senators to repeal the Medicare physician payment
formula!
- MGMA voices concerns over initial meaningful use
definition
- HHS, CMS rescind Medicaid regulations limiting outpatient
hospital benefit category
- CMS requires DME suppliers to obtain surety bonds
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