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CMS unveils new Medicare Beneficiary Identification cards

The Centers for Medicare and Medicaid Services (CMS) recently unveiled the newly designed Medicare card, which will contain the unique, randomly assigned Medicare Beneficiary Identification (MBI) number replacing the current Social Security-based number.  CMS will begin mailing the new cards to people with Medicare benefits in April 2018, with the deadline for replacing all existing Medicare cards by April 2019 as required under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). CMS will allow a 21-month transition period beginning no sooner than April 2018, where health care providers ...

Physicians have until December 1 to dispute 2016 PQRS and QRUR findings

The Centers for Medicare and Medicaid Services (CMS) recently released data that indicates which physicians will be subject to the 2018 payment penalties associated with the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (Value Modifier) programs. Physicians who have concerns about the findings in their report(s) have until December 1, 2017, to file for an informal review of their data.  The penalties stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA). Failure to successfully report on PQRS in 2016 ...

CMA pushes top 10 priorities for Medicare/Medicaid regulatory relief

California physicians are overwhelmed with unnecessary, burdensome regulations that take time and resources away from providing quality patient care. These regulations are a major contributing factor to the disturbing trend in physician burnout. The California Medical Association (CMA) submitted comprehensive comments urging the Centers for Medicare and Medicaid Services (CMS) to reduce the regulatory burdens under the Medicare and Medicaid programs. As part of the comment period for the proposed Medicare physician payment rule for 2018, CMS is soliciting ideas from physicians to reduce Medicare and Medicaid regulatory hassles. CMA ...

MACRA 90-day reporting deadline approaching

Beginning with the 2017 reporting year, eligible physicians who do not participate in the Medicare Quality Payment Program (QPP) will see a negative 4 percent payment adjustment in 2019. QPP is the new physician payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA) and administered by the Centers for Medicare and Medicaid Services (CMS). During the 2017 transition year, CMS will allow physicians to select one of three “pick your pace” participation options. Participating at any level in 2017 will ensure that you will not be hit ...

Noridian reports spike in provider deactivations and lost revenue

Noridian, Medicare’s administrative contractor for California, has seen a spike in the number of providers deactivated for not responding to Medicare revalidation notices, resulting in a gap in billing privileges and lost revenue for physicians. Noridian will send revalidation notices via email two or three months prior to the revalidation due date. Revalidation notices sent via email will indicate "URGENT: Medicare Provider Enrollment Revalidation Request" in the subject line to differentiate from other emails. If the email is returned as undeliverable, only then will Noridian will send a paper revalidation ...

CMA urges CMS to further reduce MACRA administrative burdens

The California Medical Association (CMA) recently submitted comments on proposed 2018 changes to the Medicare Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Though not perfect, CMA is pleased that the Centers for Medicare and Medicaid Services (CMS) has listened to physician feedback and has made changes that will significantly reduce the administrative burdens on physicians, particularly for small and rural practices. We appreciate the agency’s responsiveness to many of our concerns about the ability of physicians to successfully participate in the ...

CMS now accepting QPP hardship applications for 2017

The Centers for Medicare and Medicaid Services (CMS) is now accepting hardship exceptions from the Medicare Quality Payment Program (QPP) for the 2017 reporting year. Beginning with this reporting year, physicians who do not participate in QPP will see a negative 4 percent payment adjustment in 2019. Physicians who do participate may qualify for bonus payments. Physicians and groups that qualify for the QPP’s Merit-Based Incentive Payment System (MIPS) can submit a hardship exception application for one of the following reasons: Insufficient internet connectivity ...

CMS dedicates new webpage to Medicare Beneficiary Identification number change

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires the Centers for Medicare and Medicaid Services (CMS) to remove Social Security numbers from Medicare cards to prevent identity theft. CMS has said it will in 2018 begin issuing new Medicare cards that replace the current identification number—which is the beneficiary's Social Security Number—with an all-new Medicare Beneficiary Identification (MBI) number. CMS has developed a new webpage to help physicians navigate the transition to the new MBI number, including a recently developed resource on how to talk to your ...

Updated payor profiles for 2017 now available

The California Medical Association’s (CMA) Center for Economic Services is publishing updated profiles on each of the major payors in California including Aetna, Anthem Blue Cross, Blue Shield of California, CIGNA, Health Net, UnitedHealthcare, Medicare/Noridian and Medi-Cal. Each profile includes key information on health plan market penetration; a description of the plan’s dispute resolution process; and the name and contact numbers for medical directors, provider relations, and other key contacts.  Don’t waste your time searching the internet for this information – members can download CMA’s Payor Profiles free of charge ...

CMS releases proposed Medicare physician fee schedule for 2018

The Centers for Medicare & Medicaid Services (CMS) recently released the proposed 2018 Medicare Physician Fee Schedule. The California Medical Association (CMA) is pleased to note that there are a number of positive proposed changes that would help physicians improve patient care. CMS is also soliciting ideas from physicians to reduce Medicare and Medicaid regulatory hassles. Highlights of the proposed rule include:  Request for information on regulatory relief: CMA applauds CMS’ invitation for physicians to submit ideas for regulatory, policy, practice and procedural changes to improve the health care system to ...