Physicians encouraged to warn patients of new Medicare scam Seniors in California are being targeted by a new Medicare card phone scam. Medicare beneficiaries are getting calls from scammers telling them their new Medicare card will arrive between April and June 2018, which is true. However, they go on to state beneficiaries must first buy a temporary card for $5.00 to $50.00 and provide personal information before they receive their new Medicare card. THIS IS NOT TRUE. It is true that Medicare is issuing a newly designed Medicare card, which will contain the unique, randomly assigned Medicare Beneficiary Identification (MBI) ... April 5, 2018 Medicare Medicare, Scams 0 0 Comment Read More »
CMS proposes 1.84% Medicare Advantage payment increase The Centers for Medicare and Medicaid Services (CMS) has proposed increasing baseline Medicare Advantage payment rates for 2019 by an average of 1.84 percent. According to CMS, the proposed payment increase is based on better use of encounter data and changes to the risk adjustment model used to pay for aged and disabled beneficiaries. Medicare Advantage is at an all-time high, with approximately one-third of all Medicare beneficiaries enrolled in a Medicare managed care plan. Enrollment has more than doubled over the past decade. CMS is accepting comments on the proposal until ... February 5, 2018 Medicare Medicare Advantage 0 0 Comment Read More »
On-Demand Webinar: Understanding Medicare Changes: An Impossible Dream? The California Medical Association (CMA) recently hosted a free webinar examining changes to the Medicare program for 2018 and providing tips for regulatory compliance, presented by the medical director of California’s Medicare contractor, Noridian Healthcare Solutions. The webinar is now available for on-demand viewing in the CMA resource library. This download is free for all. This review includes an overview of the Centers for Medicare and Medicaid Services’ (CMS) new Targeted Probe and Educate (TPE) program, a type of Medicare audit, and its review process; changes to Local Coverage Determinations ... February 5, 2018 CMA, Medicare Government Payors, Medicare, Noridian, Webinars 0 0 Comment Read More »
CMS announces new voluntary bundled payment model The Centers for Medicare and Medicaid Services (CMS) has announced a new voluntary bundled-payment model. Called the Bundled Payments for Care Improvement (BPCI) Advanced Model, it will be considered an advanced alternative payment model (APM) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This new, voluntary model comes less than two months after the CMS eliminated two mandatory bundled-payment models created during the Obama administration. MACRA’s Quality Payment Program (QPP) created two tracks for physician payment – the Merit-Based Incentive Payment System (MIPS) and Advanced APM track. Under ... January 30, 2018 Managed Care, Medicare Alternative Payment Models (APM), MACRA, Medicare, Merit-Based Incentive Payment System (MIPS) 0 0 Comment Read More »
CMA opposes proposed Medicare physician payment cuts The U.S. House of Representatives’ Ways and Means Committee is working to extend the “rural” work Geographic Practice Cost Index (GPCI) payment adjustment, which is set to expire December 31, 2017. In order to pay for the extension, the committee has proposed an overall cut to Medicare physician payments by identifying and lowering payments for “misvalued” services. In 2014, Congress included a physician-opposed provision in the Protecting Access to Medicare Act (PAMA), designed to hold down Medicare spending by requiring the Centers for Medicare and Medicaid Services (CMS) to identify ... December 28, 2017 Medicare Federal Legislative Advocacy, Geographic Practice Cost Index, GPCI, Medicare 0 0 Comment Read More »
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 ... October 19, 2017 Medicare Medicare 0 0 Comment Read More »
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 ... October 13, 2017 Medicare Medicare, Physician Quality Reporting System, PQRS, Quality Reporting, Value-Based Payment Modifier 0 0 Comment Read More »
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 ... September 27, 2017 Medi-Cal, Medicare Medicaid, Medicare, Regulatory Relief 0 0 Comment Read More »
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 ... September 27, 2017 Medicare CalHIPSO, MACRA, Medicare, Medicare Quality Payment Program (QPP), Webinars 0 0 Comment Read More »
CMS National Provider Calls include discussions on PQRS and Physician Compare in September The Centers for Medicare and Medicaid Service’s (CMS) September 2017 National Provider Call topics include the Physician Quality Reporting System (PQRS) on September 26 and on Physician Compare on September 28. PQRS provider call: While 2016 was the last program year for PQRS and the final data submission time frame for reporting 2016 PQRS quality data to avoid the 2018 payment penalty was January through March 2017, this call will cover PQRS penalties, feedback reports, and the informal review process for 2016 results and 2018 payment adjustment determinations. For more information ... September 27, 2017 Medi-Cal, Medicare CMS, Physician Compare, Physician Quality Reporting System, PQRS 0 0 Comment Read More »
