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News
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President Obama signed into law the Medicare 2.2% fee increase. As reported by MGMA Washington Connexion, CMS has published the following statement.
On June 25, 2010, President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.” This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010. The Centers for Medicare & Medicaid Services (CMS) has directed Medicare claims administration contractors to discontinue processing claims at the negative update rates and to temporarily hold all claims for services rendered June 1, 2010, and later, until the new 2.2 percent update rates are tested and loaded into the Medicare contractors’ claims processing systems. Effective testing of the new 2.2 percent update will ensure that claims are correctly paid at the new rates. We expect to begin processing claims at the new rates no later than July 1, 2010. Claims for services rendered prior to June 1, 2010, will continue to be processed and paid as usual.
Claims containing June 2010 dates of service which have been paid at the negative update rates will be reprocessed as soon as possible. Under current law, Medicare payments to physicians and other providers paid under the MPFS are based upon the lesser of the submitted charge on the claim or the MPFS amount. Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2 percent update rates will be automatically reprocessed. Affected physicians/providers who submitted claims containing June dates of service with charges less than the 2.2 percent update amount will need to contact their local Medicare contractor to request an adjustment. Submitted charges on claims cannot be altered without a request from the physician/provider.
Physicians/providers should not resubmit claims already submitted to their Medicare contractor.
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Jun 18
2010Today, CMS directed contractors to lift the hold that affected claims with dates-of-service June 1 or after. These claims were being held until June 17, now contractors are to begin processing claims on a first-in/first-out basis.
Per this release from CMS:
Congress continues to debate the elimination of the negative update that took effect June 1, 2010. The CMS is hopeful that Congressional action will be taken to avert the negative update. We continue to monitor Congressional actions, and if Congress changes the negative update that is currently in effect, we are prepared to act expeditiously to make the appropriate changes to Medicare claims processing systems.
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Jun 15
2010Medicare contractors have been instructed to hold claims with dates-of-service from June 1, 2010 forward until Friday, June 18 to allow congress more time to respond to the pending Medicare fee schedule changes. This is an extension of the hold that was set to end Monday, June 14. Below is the notification to providers from Cahaba Government Benefit Administrators®, LLCs
Dear Medicare Part A, Part B Providers,and Partners,
The 2010 Medicare Physician Fee Schedule
The Continuing Extension Act of 2010, enacted on April 15, 2010, extended the zero percent (0%) update to the 2010 Medicare Physician Fee Schedule (MPFS) through May 31, 2010. At this time, Congress is debating the elimination of the negative update that took effect June 1, 2010. The Centers for Medicare & Medicaid Services (CMS) is hopeful that Congressional action will be taken within the next several days to avert the negative update.
To avoid disruption in the delivery of health care services to beneficiaries and payment of claims for physicians, non-physician practitioners, and other providers paid under the MPFS, CMS had instructed its contractors on May 27th to hold claims for services paid under the MPFS for the first 10 business days of June (i.e., through June 14, 2010). This hold only affects MPFS claims with dates of service of June 1, 2010, and later.
Given the possibility of Congressional action in the very near future, CMS is now directing its contractors to continue holding June 1 and later claims through Thursday, June 17, lifting the hold on Friday, June 18.
This action will facilitate accurate claims processing at the outset and minimize the need for claims reprocessing if Congressional action changes the negative update. It also should minimize the provider and beneficiary burdens and costs associated with reprocessing claims.
We understand that the delayed processing of Medicare claims may present cash flow problems for some Medicare providers. However, we expect that the delay, if any, beyond the normal processing period will be only a few days. Be on the alert for more information regarding the 2010 Medicare Physician Fee Schedule Update.
Thank you,
Provider Outreach & Education (POE)
Cahaba GBA- J10 A/B MAC
Cahaba GBA- Title XVIII Part B Carrier for Mississippi
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Jun 6
2010Below is an email from Cahaba GBA, the J10 A/B Medicare Administrative Contractor for the states of Alabama, Georgia, and Tennessee.
Regarding Medicare's holding of claims for the first 10 days in June for claims with dates of service beginning June 1, 2010:
Dear Medicare Part A and Part B Providers,
Information Regarding the Holding of June 2010 Claims for Services Paid Under the 2010 Medicare Physician Fee Schedule
The Continuing Extension Act of 2010, enacted on April 15, 2010, extended the zero percent (0%) update to the 2010 Medicare Physician Fee Schedule (MPFS) through May 31, 2010. The Centers for Medicare & Medicaid Services (CMS) believes Congress is working to avert the negative update scheduled to take effect June 1, 2010. To avoid disruption in the delivery of health care services to beneficiaries and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the MPFS, CMS has instructed its contractors to hold claims containing services paid under the MPFS (including anesthesia services) for the first 10 business days of June. This hold will only affect MPFS claims with dates of service June 1, 2010, and later.
This hold should have minimum impact on provider cash flow because, under the current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt. Be on alert for more information about the 2010 Medicare Physician Fee Schedule Update.
Thank you,
Provider Outreach & Education (POE)
Cahaba GBA- J10 A/B MAC
Cahaba GBA- Title XVIII Part B Carrier for Mississippi