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Last day to change your Medicare participation status for 2019 is December 31

Once again, it’s time for physicians to decide if they want to make changes to their Medicare participation status. Physicians have until December 31, 2018, to make changes for the 2019 participation year. As always, physicians have three choices regarding Medicare: Be a participating provider; be a non-participating provider; or opt out of Medicare entirely. Details on each of the three participations options are as follows: A participating physician must accept Medicare-allowed charges as payment in full for all Medicare patients.   A non-participating provider can make assignment decisions on ...

New Medicare ID card mailing completed in California

The Centers for Medicare and Medicaid Services (CMS) recently completed mailing new Medicare ID cards to California beneficiaries. The new Medicare ID cards, required under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), contain a unique, randomly assigned Medicare Beneficiary Identification (MBI) number, which replaces the previous Social Security-based number. CMS has prepared a “Still Waiting for Your New Card?” handout (in English or Spanish) to provide to patients who did not receive a new Medicare ID card. Patients may be directed to the MyMedicare.gov website or to ...

California to begin receiving new Medicare cards in May

The Centers for Medicare and Medicaid Services (CMS) began mailing new identification cards to Medicare beneficiaries this month, as required under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The new cards contain a unique, randomly assigned Medicare Beneficiary Identification (MBI) number that will replace the current SSN-based Health Insurance Claim Number (HICN). The new MBI will also be used for Medicare transactions like billing, and eligibility and claim status checks. The first wave of cards mailed this month will be to newly-enrolled Medicare beneficiaries. Beginning in May ...

Tip: Get ready for the new Medicare beneficiary cards and ID numbers

The Centers for Medicare and Medicaid Services (CMS) will begin mailing new identification cards to California Medicare beneficiaries between April and June 2018, as required under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The new cards will contain a unique, randomly assigned Medicare Beneficiary Identification (MBI) number replacing the current Social Security-based number.   CMS will allow a 21-month transition period beginning April 2018, where health care providers will be able to use either the patient’s current Medicare number or the patient’s new Medicare number. CMS has developed ...

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) ...

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 ...

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 ...

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 ...

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 ...