House committee releases bipartisan Medicare SGR reform bill Three congressional committees have been hard at work over the past few months on legislation that would eliminate the desperately broken Medicare sustainable growth rate (SGR) formula that is used to determine physician payment rates. On Friday, the health subcommittee of the U.S. House of Representatives Energy and Commerce Committee's health subcommittee released its bill to repeal the SGR. One Tuesday the bill was approved by the subcommittee and now heads to the full committee for consideration. The House Ways and Means Committee and the Senate Finance Committee have ... July 25, 2013 Medicare Insurance/Reimbursement, Medicare, SGR, Advocacy, Sustainable Growth Rate 0 0 Comment Read More »
CMA publishes Medicare quality reporting guide The Medicare Physician Quality Reporting System (PQRS) is a reporting program that uses a combination of incentive payments and payment reductions to promote reporting of quality information by eligible professionals. Up until now, this program has been voluntary and physicians have received bonuses for participating. That's about to change. Failure to participate now means physicians could face significant penalties in 2015 and beyond. Find out more in CMA's new guide, "Getting Started with the Medicare Physician Quality Reporting System." The guide is avaialble to members only. Contact: CMA's reimbursement help line, (888) ... July 25, 2013 Medicare Insurance/Reimbursement, PQRS, Medicare, Physicians Quality Reporting System 0 0 Comment Read More »
Medicare Transition Update: Noridian adds additional Meet and Greet Workshops At the request of the California Medical Association (CMA) and other organizations in California, Noridian has added seven additional Meet and Greet Workshops throughout the state. Transition of the Medicare Administrative Contract from Palmetto GBA to Noridian is scheduled for September 16, 2013 (Part B). Following is the list of locations in California: July 9-11 ... July 9, 2013 Medicare Medicare, Noridian 0 0 Comment Read More »
Extra! Extra! Read all about it! New Medicare transition webpage available As the California Medical Association (CMA) has previously reported, administration of the Medicare contract will change to Noridian Healthcare Solutions effective September 16, 2013 (Part B). In response to this important change, CMA has created a dedicated Medicare transition webpage, www.cmanet.org/medicare-transition, offering practices the ability to access the most recent updates and important information regarding the transition in one easy-to-access to location. July 9, 2013 Medicare Noridian, Medicare 0 0 Comment Read More »
Update your NPI information before the Medicare transition to Noridian According to a new report by the U.S. Department of Health & Human Services Office of the Inspector General, 58 percent of the databases used to determine provider identities and help to prevent the occurrence of fraud are inaccurate or incomplete. The National Plan and Provider Enumeration System (NPPES), which houses National Provider Identifier (NPI) numbers, is not always consistent with information in the Provider Enrollment, Chain and Ownership System (PECOS). The national revalidation effort by the Centers for Medicare & Medicaid Services (CMS) is a big step in improving ... July 9, 2013 Medicare Medicare, NPI, Noridian 0 0 Comment Read More »
Noridian Transition Date Set Transition of the Medicare Administrative Contract from Palmetto GBA to Noridian is scheduled for September 16, 2013 (Part B). To help physicians understand what is changing, Noridian is offering a series of Implementation 101 and EDI Support Services web-based workshops. Noridian is also holding in person “Meet and Greet” workshops at the following locations: June 11-13 Doubletree by Hilton Sacramento 2001 Point West Way Sacramento, CA 95815 June 18-20 Embassy Suites San Francisco Airport South 250 Gateway Boulevard South San Francisco, CA 94080 July 9-11 Embassy Suites Anaheim South 11767 Harbor Boulevard Garden Grove, CA ... June 6, 2013 Medicare Noridian, Palmetto GBA, Medicare 0 0 Comment Read More »
ACA: Medicaid Primary Care Rate Increase FAQ Under the provisions of the Federal Affordable Care Act (ACA), state Medicaid programs (Medi-Cal in California) are required to pay primary care physicians at Medicare rates for primary care services for two years. The increase is fully funded by the federal government. The requirement began January 1, 2013 and ends December 31, 2014. The California Department of Health Care Services (DHCS) submitted their state plan amendment (SPA) to implement the rate increase on March 29, 2013. Approval of the SPA is required by the Centers for Medicare and Medicaid Services ... April 19, 2013 Managed Care, Medi-Cal, Medicare ACA, Affordable Care Act, Medicare, Medi-Cal 0 0 Comment Read More »
CMA Webinar: Act now to avoid Medicare penalties in 2015 Over the past six years, the Centers for Medicare and Medicaid Services (CMS) has launched a number of initiatives that offer physicians the opportunity to increase their net revenue by participating in quality reporting programs. Until now, these programs have been voluntary and physicians have received bonuses for participating. That's about to change. Failure to participate now means physicians could face significant penalties. The American Academy of Family Physicians estimates that participating in these initiatives in 2013, rather than waiting until 2014, could save a physician $19,000 in avoided penalties. To ... March 18, 2013 Medicare Bonuses, Penalties, Medicare 0 0 Comment Read More »
Department of Justice to decide Medicare MAC contract protest The Centers for Medicare & Medicaid Services (CMS) announced in September 2012 that Noridian has been named the new Medicare Administrative Contractor (MAC) for Medicare Parts A and B in Jurisdiction E (previously called Jurisdiction 1). Two protests were filed, challenging the award. On January 18, 2013, the Government Accountability Office denied the two protests. As permitted by law, both protestors (Palmetto GBA and CGS) subsequently filed complaints with the U.S. Court of Federal Claims challenging the Jurisdiction E MAC contract award. The protests were filed on February 1, 2013. ... March 18, 2013 Medicare Noridian, Palmetto, Medicare 0 0 Comment Read More »
