Noridian sends out another wave of Medicare revalidation requests As called for under the Affordable Care Act (ACA), Medicare Administrative Contractors (MACs) have been requiring physicians to revalidate their Medicare enrollments. Between now and March 23, 2015, MACs will continue reaching out to physicians, notifying them of the need to revalidate. The most recent round of revalidations requests went out by December 30, 2013. The revalidation requirement is necessitated by new screening criteria called for under the ACA. Newly enrolling and revalidating providers will be placed in one of three screening categories representing the level of risk to the ... February 7, 2014 Medicare Affordable Care Act, Medicare, Noridian, PECOS, ACA, Provider Enrollment Chain and Ownership System 0 0 Comment Read More »
CMA releases fact sheets regarding Covered California grace period, updates toolkit Recognizing the Affordable Care Act’s “grace period” provision to be one of the most confounding provisions of the law, the California Medical Association (CMA) has published an FAQ sheet dedicated entirely to helping physicians make sense of the issue. The fact sheet, “Covered California: Understanding the Grace Period for Subsidized Exchange Enrollees," is available through CMA’s exchange resource center. Federal law allows Covered California enrollees who receive financial subsidies to keep their health insurance for three months, even if they have stopped paying their premiums. This is known as the “grace ... February 7, 2014 General Grace Period, Health Care Reform, Health Insurance Exchange, Covered California 0 0 Comment Read More »
CMS updates EFT authorization agreement The Office of Management and Budget recently approved changes to the CMS 588, Electronic Funds Transfer (EFT) Authorization Agreement. The revised EFT agreement is available on the CMS Forms List. As of January 1, 2014, new EFT authorization agreements submitted must be on the new form. Submissions on the old forms will be returned to the applicant. February 5, 2014 General CMS 0 0 Comment Read More »
Did you know you can request reconsideration if you're getting dinged with a 2% Medicare eRx penalty? Physicians and group practices who were not successful electronic prescribers under the 2012 or 2013 Medicare eRx Incentive Program will be subject to a negative payment adjustment of 2 percent in 2014 on all Medicare Part B claims paid under the physician fee schedule. The Centers for Medicare and Medicaid Services (CMS) has notified physicians and group practices that did not meet the requirements and will be subject to the 2014 payment adjustment. Some practices have reported that their meaningful use attestation was not taken into consideration as an exemption. ... February 5, 2014 General Health Information Technology, Insurance/Reimbursement, E-Prescribing, Medicare 0 0 Comment Read More »
Anthem Blue Cross to move eligibility, benefits and claim status inquiry functions to Availity Web Portal in March Anthem Blue Cross has advised that effective March 14, 2014, patient eligibility, benefits and claim status inquiry functions will transition from its ProviderAccess portal to the Availity web portal. As of that date, practices will only be able to access this information via the Availity web portal. While BlueCard eligibility, benefits and claim status functions will also transition to Availity, the BlueCard Advisor function that allows practices to determine which Blues plan to send the claim to will continue to be available on the ProviderAccess portal. In order to access information ... February 5, 2014 General BlueCard, Managed Care, Anthem Blue Cross, Insurance/Reimbursement 0 0 Comment Read More »
Surviving the Second Month of Covered California As of January 15, Covered California reports that more than 625,000 individuals have enrolled in exchange plans. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff know what to expect. To help answer some of the more common questions, the California Medical Association (CMA) offers this second tip sheet to help physicians survive the second month of Covered California. Available to members only. February 4, 2014 General Health Insurance Exchange, Practice Resources, Covered California 0 0 Comment Read More »
Los Angeles Daily News publishes op-ed by CMA president The Los Angeles Daily News yesterday published an op-ed by Richard Thorp, M.D., president of the California Medical Association (CMA). In case you missed it, the piece, "Trial lawyer measure would undermine the promise of Covered California," can be read here. January 31, 2014 General MICRA 0 0 Comment Read More »
MICRA patient brochure now available in Spanish The California Medical Association (CMA)-led coalition working to protect California’s landmark Medical Injury Compensation Reform Act (MICRA) has published a patient education brochure to help inform California voters about the ballot initiative being pushed by trial attorneys. The ballot measure would impact access to care for patients, causing community health centers and physician offices across the state to close. The pamphlet, available in English and Spanish, can be distributed to patients during office visits and will be accompanied by talking points for physicians so you can have meaningful conversations with ... January 31, 2014 General MICRA, Patient Education, Professional Liability 0 0 Comment Read More »
CMS warns of fraudulent DME suppliers The Centers for Medicare and Medicaid Services (CMS) sent a letter this week to physicians asking them to pay attention to solicitations they receive from durable medical equipment (DME) suppliers and report any suspicious activity to the U.S. Department of Health and Human Services' Office of the Inspector General (OIG). According to CMS, most fraudulent solicitations are obvious in their wording or their attempts to get physicians to approve unnecessary medical equipment and supplies. These marketing schemes by DME suppliers can include: •Unsolicited orders for medical equipment or supplies, often with wording ... January 31, 2014 General Centers for Medicare and Medicaid Services, CMS, Fraud and Abuse, Quality of Care 0 0 Comment Read More »
Senate pro Tem considering MICRA legislation As both sides inch closer to a seemingly inevitable ballot war over California’s Medical Injury Compensation Reform Act (MICRA), a key figure in the legislature may be looking to step in before voters can weigh in on the issue. Earlier this month, Darrell Steinberg, president pro tem of the Senate, said that he was “thinking” about carrying a MICRA-related bill during the 2014 cycle. While Steinberg has previously stated that he wanted to see negotiations take place to avoid a costly ballot war between trial lawyers and physicians, the ... January 27, 2014 General Medical Liability, MICRA, Professional Liability 0 0 Comment Read More »
