Medicare RAC court case keeps collections on uncertain footing The U.S. Court of Appeals for the Federal Circuit issued a decision in early March in a case filed by one of the Medicare Recovery Audit Contractors (RAC) after the Centers for Medicare and Medicaid Services (CMS) changed the timing for the payment of contingency fees on collections. The decision means the auditing program will be put on hold until CMS determines how to contract with its RACs. The RAC program is responsible for identifying fraud and waste in the Medicare system by detecting improper Medicare payments. Since 2008, when ... March 18, 2015 Medi-Cal, Medicare Centers for Medicare and Medicaid Services, Medicare, Recovery Audit Contractor, Audits 0 0 Comment Read More »
DHCS identifies another glitch in issuing primary care rate increase for CHDP claims The California Department of Health Care Services (DHCS) has experienced various difficulties issuing the Affordable Care Act primary care rate increase funds on Child Health and Disability Prevention (CHDP) Program claims. Before the rate increases were implemented, some practices had been instructed by DHCS to bill CHDP claims at their Medi-Cal rates. This caused concern – based on DHCS’s pricing logic of paying the lesser of Medicare’s rate or the billed charges – that some practices would not qualify for the retroactive increases once the systems were updated to ... March 17, 2015 Medi-Cal, Medicare CHDP, Child Health and Disabilityh Prevention Program, Affordable Care Act, DHCS 0 0 Comment Read More »
We Care for California coalition introduces legislation to increase Medi-Cal rates to Medicare levels Senate Health Committee Chair Ed Hernandez and Assembly Health Committee Chair Rob Bonta joined health care providers, medical students, patients and advocates on the steps of the Capitol on Wednesday to introduce AB 366 and SB 243, legislation that would not only restore a 10 percent cut to Medi-Cal reimbursement rates, but would also place reimbursement on par with Medicare, increasing payments rates for inpatient hospital services and most outpatient services. The proposals would also require the Department of Health Care Services to pay Medi-Cal managed care plans at ... March 9, 2015 Medi-Cal, Medicare Medic-Cal Cuts, We Care for California, Legislative Advocacy, Medi-Cal 0 0 Comment Read More »
Physician groups urge CMS to create contingency plans for ICD-10 transition The California Medical Association (CMA), American Medical Association (AMA), and 98 other state and specialty societies urged the Centers for Medicare and Medicaid Services (CMS) to put contingency plans in place for the October transition from ICD-9 to ICD-10 to avoid possible failures that could result in significant disruptions for physicians and Medicare patients. Now that CMS and the chairmen of the three Congressional health committees have announced they will not support a further delay in the implementation of ICD-10, organized medicine has turned its attention to CMS to ... March 9, 2015 Medi-Cal, Medicare CMS, ICD-10, ICD-9, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS extends PQRS reporting deadline for some reporting methods The Centers for Medicare and Medicaid Services (CMS) has extended the submission deadlines for two Physician Quality Reporting System (PQRS) reporting methods from February 28 to March 20 at 8 p.m., EST. The two affected reporting methods are: Direct electronic health record (EHR) submission or submission via a vendor using certified EHR technology Qualified clinical data registry (using the QRDA III format) reporting for PQRS and the clinical quality measure component of meaningful use for the EHR Incentive Program Submission timeframes for other PQRS reporting ... March 9, 2015 Medi-Cal, Medicare EHR, Physician Quality Reporting System, PQRS, CMS, Meaningful Use 0 0 Comment Read More »
Health care coalition joined by Sen. Hernandez, Assemblymember Bonta to reignite Medi-Cal legislation, reduce health care inequality Sacramento – Preceding today’s joint legislative informational hearing to address pitfalls within California’s Medicaid system (Medi-Cal), Senate Health Committee Chair Ed Hernandez and Assembly Health Committee Chair Rob Bonta joined health care providers, patients and advocates on the steps of the Capitol. Newly introduced, legislation to restore a 10 percent cut to Medi-Cal reimbursement goes a step further than in past efforts by proposing that Medi-Cal payments to providers be on par with what Medicare pays for the same services. “Expanding access to health care coverage, as we have done ... March 9, 2015 Medi-Cal State Legislative Advocacy, Timely Access, Medi-Cal 0 0 Comment Read More »
Medi-Cal deactivates some physicians in error On February 7, the California Department of Health Care Services (DHCS) performed a periodic review of activity and deactivated all providers that had not billed Medi-Cal for 12 consecutive months. All deactivated providers were notified by letter of the deactivation of their record. On February 17, however, DHCS found that a small subgroup of providers, those with multiple locations under the same National Provider Identifier (NPI), were incorrectly deactivated due to a system error. Physicians who received a deactivation letter and believe they were deactivated in error should contact DHCS at ... March 9, 2015 Medi-Cal Medi-Cal Provider Enrollment, Medi-Cal 0 0 Comment Read More »
CMS extends meaningful use EHR attestation deadline to March 20 The Centers for Medicare and Medicaid Services (CMS) has extended the deadline for physicians to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year. While the original deadline was February 28, physicians now have until 11:59 p.m., EST, on March 20, 2015, to attest. CMS extended the deadline to allow providers extra time to submit their meaningful use data, but urges providers to begin attesting for 2014 as soon as they can. This extension also allows eligible professionals, who have not already used their ... March 2, 2015 Medi-Cal, Medicare EHR, Meaningful Use, Medi-Cal, Medicare, PQRS, CMS 0 0 Comment Read More »
CMS to conduct ICD-10 claims testing for physicians in March and June On October 1, 2015, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. To help physicians prepare for this transition, the Centers for Medicare and Medicaid Services (CMS) will be conducting two national testing weeks, from March 2-6 and June 1-5. 2015. These testing weeks will give trading partners access to the Medicare Administrative Contractors (MAC) and Common Electronic Data Interchange (CEDI) for testing with real-time help desk support. While participants will not be able to conduct true end-to-end testing at ... February 26, 2015 Medi-Cal, Medicare CMS, Centers for Medicare and Medicaid Services, ICD-10 0 0 Comment Read More »
Physicians have until Feb. 28 to review 2013 PQRS payments and penalties The Centers for Medicare and Medicaid Services (CMS) announced last week that physicians who believe they received an incorrect Physician Quality Reporting System (PQRS) payment penalty can now use the new Look Up tool to verify information without calling the CMS Help Desk. The PQRS Look Up tool uses the same information that the CMS Help Desk accesses to verify whether a physician is subject to the 2015 PQRS payment adjustment, or if he or she should have received a 2013 PQRS incentive. To utilize the tool, physicians need to ... February 23, 2015 Medi-Cal, Medicare CMS, Physician Quality Reporting System, PQRS, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
