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 ... September 25, 2017 Medicare Medicare, Noridian, Provider Enrollment Chain and Ownership System 0 0 Comment Read More »
Anthem Blue Cross rescinds termination of Medicare Advantage agreement with Brown and Toland Anthem Blue Cross has reached an agreement to extend its Medicare Advantage contract with Brown & Toland Physicians. Although Anthem Blue Cross previously announced the contract would be terminated effective October 1, 2017, the parties have since signed a contract extension through December 2018. The termination would have affected approximately 1,900 Medicare Advantage enrollees in San Francisco. Click here to see the letter sent from Brown & Toland. Physicians with questions can contact Brown & Toland Physician Services at physicianservices@btmg.com. August 17, 2017 Managed Care, Medicare Anthem Blue Cross, Medicare Advantage, San Francisco Medical Society 0 0 Comment Read More »
Anthem Blue Cross terminates Medicare Advantage agreement with Brown and Toland Effective October 1, 2017, Anthem Blue Cross will terminate its contract with Brown & Toland Physicians for its Medicare Advantage product. The termination will affect approximately 1,900 Medicare Advantage enrollees in San Francisco. Affected patients will be reassigned to Asian American Medical Group, Jade Health Care Medical Group or Imperial Health Holdings Medical Group. The termination was reportedly due to a failure to reach a contractual agreement with Brown & Toland. Physicians with questions can contact Brown & Toland representative Stephanie Mamane at (415) 972-4282 or smamane@btmg.com. August 9, 2017 Managed Care, Medicare Anthem Blue Cross, Medicare Advantage, San Francisco Medical Society 0 0 Comment Read More »
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 ... August 9, 2017 Medicare CalHIPSO, Centers for Medicare and Medicaid Services, CMS, MACRA, Medicare, Medicare Quality Payment Program (QPP), Merit-Based Incentive Payment System (MIPS) 0 0 Comment Read More »
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 ... August 8, 2017 Medi-Cal, Medicare CMS, Medicare, Centers for Medicare and Medicaid Services, MACRA 0 0 Comment Read More »
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 ... August 1, 2017 CMA, Managed Care, Medi-Cal, Medicare Aetna, Anthem Blue Cross, Blue Shield, Cigna, Health Net, Insurance, Medi-Cal, Medicare, Noridian, Payor, Payor Profiles, Running a Practice, UnitedHealthcare 0 0 Comment Read More »
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 ... July 24, 2017 Medicare CMS, Fee Schedule, Medicare, Regulatory Advocacy 0 0 Comment Read More »
CMA Open Payments data shows that only 5.6% of physicians looked at their records The Centers for Medicare and Medicaid Services (CMS) announced last week that in 2016, only 5.6 percent of physicians nationwide reviewed their data under the Medicare Open Payments program. Under the Open Payments program, drug and medical device manufacturers are required to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts. Medicare publicly released calendar-year 2016 Open Payments data on June 30 following a 45-day period during which physicians were able to review their data and dispute errors. According to CMS, only 34,871 ... July 24, 2017 Medicare CMS, Medicare, Medicare Open Payments Program 0 0 Comment Read More »
Survey finds nation's physicians not ready to fulfill MACRA reporting requirements Fewer than one in four physicians feel ready to meet the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP) reporting requirements, according to a survey of 1,000 physicians conducted by the American Medical Association (AMA). QPP is the new physician payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA). It replaces the fee-for-service reimbursement model with two paths to choose from: the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Over half of those surveyed (56 percent) plan to participate in MIPS in ... July 24, 2017 Medicare MACRA, Medicare, Merit-Based Incentive Payment System, Alternative Payment Models (APM) 0 0 Comment Read More »
New video shows physicians how to avoid Medicare payment penalties The American Medical Association (AMA) has published a short instructional video to help physicians avoid being penalized under the new Medicare Quality Payment Program (QPP). QPP is the new physician payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA) and is administered by the Centers for Medicare and Medicaid Services (CMS). Because QPP is new this year, AMA and the California Medical Association (CMA) want to make sure physicians know what they have to do to participate in QPP’s “pick your pace” options for reporting. This is ... July 21, 2017 Medicare MACRA, Medicare 0 0 Comment Read More »
