CMA/AMA Successful in Getting Congress to STOP Physician Medicare Cuts U.S. Senate votes to stop nearly all of the Medicare payment cuts facing physicians for 2022 CMA has some good news to share on the federal front: Tonight the U.S. Senate voted to stop nearly all of the Medicare payment cuts physicians were facing on January 1, 2022. Earlier this week, the U.S. House of Representatives passed the legislation which included provisions to increase the debt ceiling – a must-pass bill for Congress and the nation. President Biden is expected to sign the bill before the debt ceiling deadline of ... December 11, 2021 General, Medicare Medicare Payment Cuts 0 0 Comment Read More »
Telehealth Expansion Due to COVID-19 President Donald Trump today announced the federal government is immediately suspending HIPAA enforcement and penalties to facilitate use of telehealth for health care services in both the Medicare and Medicaid programs. As of this morning, March 17, the Centers for Medicare and Medicaid (CMS) has announced that Medicare will immediately expand telehealth coverage for seniors so that they can be treated from home and not risk their own health and that of providers by being required to visit a medical office. Please see important information, guidelines and links here: CMA Newsroom ... March 17, 2020 General, Medi-Cal, Medicare COVID-19, telehealth 0 0 Comment Read More »
CMS completes issuance of new Medicare ID cards The Centers for Medicare and Medicaid Services (CMS) has now completed the process of mailing new Medicare cards to beneficiaries across all states and territories. The new Medicare ID cards, required under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), contain a unique, randomly assigned Medicare Beneficiary Identification (MBI) number, which replaces the previous Social Security-based number. CMS also reports that for the week ending January 11, 2019, fee-for-service health care providers submitted 58 percent of claims with the new MBIs. CMS is allowing a 21-month transition period (which ... January 22, 2019 Medicare MACRA, Practice Management, Public Payors 0 0 Comment Read More »
Medicare publishes 2018-2019 influenza vaccine pricing The Center for Medicare and Medicaid Services (CMS) recently published an update on Medicare’s influenza vaccine payment allowances and effective dates for the 2018-2019 flu season. The Medicare Part B payment allowance limits for seasonal influenza and pneumococcal vaccines are calculated at 95 percent of the average wholesale price. Payment allowances and effective dates for the 2018-2019 flu season: Code Labeler Name Drug Name Payment Allowance Effective Dates 90653 Seqirus ... October 26, 2018 Medicare Public Health, Public Payors 0 0 Comment Read More »
Last day to change your Medicare participation status for 2019 is December 31 Once again, it’s time for physicians to decide if they want to make changes to their Medicare participation status. Physicians have until December 31, 2018, to make changes for the 2019 participation year. As always, physicians have three choices regarding Medicare: Be a participating provider; be a non-participating provider; or opt out of Medicare entirely. Details on each of the three participations options are as follows: A participating physician must accept Medicare-allowed charges as payment in full for all Medicare patients. A non-participating provider can make assignment decisions on ... October 26, 2018 Medicare Medicare, Public Payors 0 0 Comment Read More »
CMA proposes site-neutral payments for some physician services The Centers for Medicare and Medicaid Services (CMS) has proposed eliminating the Medicare site of service payment differential for physician services. Under the proposed policy, Medicare would pay the same amount for office visit services provided by physicians in “off-campus” hospital outpatient departments as it would for the same office visit service provided in a physician’s office. Currently, Medicare pays a “facility fee” that results in a much higher rate for the same service when performed in outpatient clinics owned by hospitals, rather than in a physician’s office. For example, ... October 16, 2018 Medicare Advocacy, Payor Issues and Reimbursement 0 0 Comment Read More »
CMA pushes back on CMS' proposed Medicare payment changes The California Medical Association (CMA) recently submitted comprehensive comments to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2019 Medicare Physician Fee Schedule and MACRA Quality Payment Program rule. CMA is supporting CMS’s proposal to substantially reduce the Evaluation and Management (E/M) documentation requirements because it would reduce note bloat, improve workflow, and allow physicians to devote more time to their patients. However, CMA is strongly opposed to the proposal to restructure payment and coding for (E/M) office visits by collapsing the codes from five to two for ... October 16, 2018 Medicare Advocacy, Payor Issues and Reimbursement 0 0 Comment Read More »
Noridian announces improvements to Medicare portal Noridian, the Medicare Administrative Contractor for California, recently announced improvements to the Noridian Medicare Portal (NMP) that will make it easier for providers to identify reasons behind eligibility-related claim denials. When a claim is denied for eligibility-related reasons, providers can select the link under Claim Status in the “Related Inquiries” portion of the page to access details to assist with determining their next steps. Effective July 27, 2018, all NMP users can also send secure online messages to Noridian regarding medical reviews or to voice concerns to be addressed by ... October 16, 2018 Medicare Practice Management, Public Payors 0 0 Comment Read More »
CMS identifies and corrects errors in MIPS scoring logic Centers for Medicare and Medicaid Services (CMS) recently released 2017 Merit-based Incentive Payment System (MIPS) performance scores and payment adjustment information for the 2019 payment year. Physicians have been able to request targeted reviews if they believe an error was made in the calculation of their performance score. The requests CMS received through targeted reviews led them to take a closer look at a few prevailing concerns. Those concerns included the application of the 2017 Advancing Care Information and Extreme and Uncontrollable Circumstances hardship exceptions, the awarding of Improvement Activity ... September 14, 2018 Medicare MACRA, Practice Management 0 0 Comment Read More »
CalHIPSO Webinar: MIPS Reporting for 2018 The Health Services Advisory Group and the California Health Information Partnership & Services Organization (CalHIPSO) is hosting a free educational webinar on Thursday, October 4, 2018, on the Medicare Merit-Based Incentive Payment System (MIPS). This webinar will cover what you and your practice need to know as you look forward to MIPS reporting for the 2018 performance year. There are many factors to consider that effect your scores. The 2018 reporting year is very similar to 2017, with slightly higher thresholds and benchmarks. The webinar will explore various scenarios and ... September 14, 2018 Medicare MACRA, Practice Management, Professional Development & Education 0 0 Comment Read More »
