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Deadline to file for meaningful use hardship exemption is March 15

In mid-December, Congress adopted a last-minute bill that gives CMS the authority to grant a blanket exemption for all eligible physicians who apply for the exemption from the 2015 meaningful use penalties. This action prevents the Centers for Medicare and Medicaid Services (CMS) from implementing Medicare payment penalties for physicians who fail to demonstrate meaningful use of a certified electronic health record (EHR) system in 2015. New rules released last year state that eligible professionals must attest that they met the requirements for stage 2 meaningful use for a period ...

CMS to hold webinars for providers on updates to the Physician Compare website

The Centers for Medicare and Medicaid Services (CMS) will host a series of one-hour webinars about recent updates to the Physician Compare website and future plans for public reporting, including benchmark and star ratings. 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 affiliations, and group practice information. In 2014, the website also began phasing ...

Noridian posts updated Medicare Physician Fee Schedule

California's Medicare contractor, Noridian, has posted an updated 2016 Medicare Physician Fee Schedule on its website. Last week, Noridian had removed the fee schedule because it contained several technical errors that needed to be fixed. This update is not expected to cause any delays in reimbursement for physicians, because under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt. The updated fees are valid for dates of service from January 1 through December 31, 2016. To see the ...

AMA publishes guide to physician-focused alternative payment models

The legislation that repealed the Medicare sustainable growth rate—the Medicare Access and CHIP Reauthorization Act (MACRA)—created major new opportunities to advance alternative payment models (APM). Starting in 2019, MACRA will provide a 5 percent annual bonus payment to physicians who participate in APMs and it exempts them from participating in the fee-for-service meaningful use and quality reporting programs (MACRA's Merit-Based Incentive Payment System). In addition to accountable care organizations, medical homes and bundled payments for hospital-based episodes, MACRA also provides for the development of “physician-focused” APMs. The American Medical Association ...

United Healthcare to delay implementation of multiple procedure payment reductions until March 1

In its December 2015 Network Bulletin, United Healthcare (UHC) announced that the multiple procedure payment reductions scheduled to begin with November 15, 2015, dates of service have been delayed until March 1, 2016. UHC previously announced in August that it would begin applying multiple procedure payment reductions to the following services: Technical component of diagnostic cardiovascular and ophthalmology procedures Professional component of diagnostic imaging services Some endoscopy procedures According to UHC, the new claim edits will apply for UHC commercial claims and ...

Physicians urged to preemptively file for meaningful use hardship exemptions

Because of a delay in the publication of regulations governing the Medicare meaningful use program, physicians are being urged to preemptively file for a 2015 hardship exemption to avoid penalties in 2016. Physicians should apply for an exemption under the “extreme and uncontrollable circumstances” category, even if they are uncertain whether they will meet the program requirements this year. Doing so will not preclude physicians from receiving an incentive if they do meet meaningful use requirements, but applying can serve as a safety net in staving off a penalty. In order ...

CMA urgers CMS to implement less burdensome, physician-led MACRA payment models

The California Medical Association (CMA) is urging the Centers for Medicare and Medicaid Services to adopt principles that will assure access to high-quality care for all Medicare patients during the transition to the alternative payment models included in the Medicare payment reform legislation. In April, President Obama signed into law the Medicare Access and CHIP Reauthorization Act (MACRA), which repeals the badly broken Medicare sustainable growth rate formula and replaces it with new payment systems. After more than a decade of fighting for change by CMA and others in organized ...

CMS changes enrollment requirements for Part D prescribers

Beginning on June 1, 2016, all physicians and other providers who prescribe Medicare Part D drugs must be enrolled in Medicare or have a valid record of opting out. Failure to do so will result in a denial of the pharmacy claim or the beneficiary’s request for reimbursement. The Centers for Medicare and Medicaid Services (CMS) had originally intended to begin enforcing this regulation last June, but the agency delayed implementation to allow sufficient time for beneficiaries and Medicare Part D plans to prepare. All physicians and other prescribers who are ...

CMA urges Congress to fix EHR meaningful use program

The California Medical Association, the American Medical Association and a coalition of medical societies are urging Congress to immediately reform stage 2 of the electronic health record (EHR) meaningful use program, and to delay stage 3. Frustrated with the Center for Medicare and Medicaid Services' (CMS) refusal to fix the program, organized medicine has turned to Congress to make the necessary reforms before meaningful use drives physicians out of the Medicare program. “We are writing to express our strong concerns with the decision by the Obama Administration to move ahead ...

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 ...