CMS extends Physician Compare preview period The Centers for Medicare and Medicaid Services (CMS) has extended the Physician Compare preview to November 16, 2015, to allow more time for physicians to preview their data for the 2014 quality measures that will be reported on the Physician Compare website later this year. The Affordable Care Act required CMS to create a website that would allow consumers to search for and compare physicians and other health care professionals who provide Medicare services. That site—the "Physician Compare" website, initially launched in 2010—provides contact information, specialties and clinical training, hospital ... November 9, 2015 Medi-Cal, Medicare Medicare, Physician Compare, Physician Quality Reporting System, PQRS, CMS 0 0 Comment Read More »
CMS issues final 2016 Medicare payment rule; includes reimbursement for end-of-life discussions On Friday, the Centers for Medicare and Medicaid Services (CMS) released the final 2016 Medicare physician fee schedule. One of the biggest changes in the CMS proposal is the assignment of codes to pay physicians for end-of-life consultations. Key policies finalized in the 2016 payment rule include: Advanced care planning: The final fee schedule includes two CPT codes to reimburse for advance care planning. Compensating health care professionals for time spent with patients discussing treatment wishes and goals of care is a critical step forward in honoring patient treatment preferences, particularly ... November 9, 2015 Medicare Medicare 0 0 Comment Read More »
Noridian Medicare announces web-based provider enrollment workshops Noridian, the Medicare Administrative Contractor for California, announced that it will offer web-based workshops focusing on provider enrollment. These webinars are intended for the Part B provider using the online Provider Enrollment, Chain and Ownership System (PECOS) to change enrollment information, track revalidation or set up a sole proprietorship. The Internet-based PECOS process can be used in lieu of the Medicare enrollment application (i.e., paper form CMS-855). The advantages of PECOS are: Faster than paper-based enrollment (45-day processing time in most cases, vs. 60 days for paper) ... October 14, 2015 Medicare Noridian, Medicare, PECOS, Provider Enrollment Chain and Ownership System 0 0 Comment Read More »
Noridian announces new audits Noridian, California's Medicare administrative contractor, has announced it will be conducting service-specific targeted audits of procedure codes 99205 and 99233 when rendered by providers with specific specialties: 99205 performed by cardiology (Centers for Medicare and Medicaid Services specialty designation 06) and pulmonary (29) 99233 performed by internal medicine (11) and hematology/oncology (83) Noridian conducts these targeted reviews based on data analysis. An analysis of these procedure codes, when performed by physicians in these specialties, indicated a higher utilization by California providers when compared ... August 5, 2015 Medicare Medicare, Noridian, Audits 0 0 Comment Read More »
Spending for federal health programs is expected to remain 'modest' over the next 10 years Total health care spending growth for federal health programs such as Medicare and Medicaid is expected to average 5.8 percent in aggregate over 2014-2024, according to a report published by the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. The authors noted that this rate of growth is still substantially lower than the 9 percent average rate seen in the three decades before 2008. “Growth in overall health spending remains modest even as more Americans are covered, many for the first time. Per-capita spending and medical ... July 30, 2015 Medi-Cal, Medicare Centers for Medicare and Medicaid Services, Medicaid, Medicare, Affordable Care Act 0 0 Comment Read More »
CMS releases proposed 2016 Medicare physician fee schedule The Centers for Medicare and Medicaid Services (CMS) recently released the 2016 proposed Medicare physician payment rule. The rule reflects the 0.5 percent increase in payment as of July 1, 2015, and the additional 0.5 percent increase in payment on January 1, 2016, recently adopted by Congress. Overall, Medicare will pay physicians nearly $700 million more in 2016 than they will have paid in 2015. Most notable in the payment rule is CMS’ proposal to pay for advance care planning and end-of-life counseling. The fee schedule would establish two new ... July 29, 2015 Medicare CMS, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS to begin provider reimbursement for end-of-life care On July 8, the Centers for Medicare & Medicaid Services (CMS) released the first proposed update to the Medicare physician payment schedule since the repeal of the sustainable growth rate (SGR) formula through the Medicare Access and Children’s Health Insurance Plan (CHIP) Reauthorization Act of 2015. One of the biggest changes in the CMS proposal is the assignment of codes to pay providers for end-of-life consultations. In addition the department would make advance care planning “an optional element” of a beneficiary's annual wellness visit. The American Medical Association (AMA) lauded ... July 14, 2015 Medicare CMS, End of Life Issures, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS announces changes to make Medicare ICD-10 transition less disruptive for physicians The Centers for Medicare & Medicaid Services (CMS) announced that it will provide a one-year grace period during which it will allow for flexibility in the claims payment, auditing and quality reporting processes as the medical community gains experience using the new ICD-10 code set. The ICD-10 implementation date of October 1, 2015, has not changed. The changes announced include: Claim denials: Medicare review contractors will not deny claims based solely on the specificity of the ICD-10 diagnosis code as long as a valid code from the right family of codes ... July 13, 2015 Managed Care, Medicare CMS, ICD-10, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
Slight increase to Medicare reimbursement rates effective as of July 1 A 0.5 percent physician payment increase will go into effect for dates of service from July 1 through December 31, 2015. This mid-year increase is a result of the Medicare Access and CHIP Reauthorization Act. The Centers for Medicare & Medicaid Services released the updated RVU files reflecting the payment increase and new conversion factor, $35.9335 (previously $35.7547). Noridian, the Medicare Administrative Contractor for California, has posted the new fee schedule that will be in effect from July 1 through December 31, 2015. There will be an additional 0.5 ... July 6, 2015 Medicare Medicare 0 0 Comment Read More »
CMA supports bill to eliminate RAC incentives that cause punitive and burdensome auditing The California Medical Association (CMA) has announced its support of a bill introduced in Congress on May 22 that would reform the Medicare Recovery Audit Contractors (RAC) system. It is titled the Fair Medical Audits Act of 2015 and was introduced by North Carolina Congressman George Holding. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 established the Medicare RAC program to combat fraud and waste in the Medicare system. Initially launched in 2005 as a demonstration project in three states (California, Florida and New York), the Centers for ... June 2, 2015 Medicare Advocacy, Federal Legislation, Medicare, Recovery Audit Program 0 0 Comment Read More »
