News
CMS has published a reminder to physicians of the preventive and screening services now covered by Medicare and is encouraging patients and physicians to take full advantage of preventive benefits. The benefits include adult immunizations, bone mass measurements, cancer/diabetes/glaucoma/cardiovascular screenings, diabetes supplies, initial physical exams and smoking cessation counseling.
For more information, go to http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0752.pdf.
January 12th, 2008
As part of a settlement agreement with the New York Attorney General, United Healthcare has committed to various measures intended to improve the accuracy and transparency of its Premium® Designation program. The commitments include full disclosure of its methodology, reasonable advance notice of changes and assessment results, and reviewing quality prior to cost-efficiency. A letter from John H. Rennick, Jr., MD, Senior Medical Director of the North Carolina Medical Society can be found at www.ncmedsoc.org.
January 12th, 2008
A January 2008 DMA memo has been released addressing the forthcoming federally-mandated, tamper-resistant prescription pad requirements for all Medicaid prescriptions. As of April 1, 2008, all Medicaid recipients’ paper prescriptions must be on pads including specific features as defined in the memo satisfying at least one of the following tamper resistant characteristics:
• Prevent unauthorized copying of a completed of blank prescription form.
• Prevent erasure or modification of information written on the prescription by the prescriber.
• Prevent the use of counterfeit prescription forms.
As of October 1, 2008, all Medicaid paper prescriptions must include features satisfying all three tamper resistant characteristics. Medicaid prescribers may implement use of tamper-resistant prescription pads fully compliant with this new law at anytime.
Click here for memo: http://www.dhhs.state.nc.us/dma/bulletin/pdfbulletin/0108TamperReistant.pdf
January 12th, 2008
Beginning early December 2007, physician practices received Notices, Claim Forms and Claim Instructions for a second settlement in the Love case with Highmark Blue Cross Blue Shield.
Continue Reading January 3rd, 2008
Just one day after the Senate approved the measure, the US House passed S. 2499 by a vote of 411 to 3 on December 19, 2007. Responding to the action, AMA Board Chair Edward Langston, MD, said, “It is extremely disappointing that after all the hard work in the House earlier this year to replace two years of Medicare physician payment cuts with increases that would help physicians keep up with medical practice costs, the final action passed by the House and Senate stops the cut for just six months, which creates uncertainty for both Medicare patients and physicians.”
Continue Reading January 3rd, 2008
Physicians wishing to change their current Medicare participation or non-participation status must do so before December 31, 2007. The three options for Medicare participation have been described in detail at http://www.ama-assn.org/ama1/pub/upload/mm/399/medicarepayment08.pdf.
To opt out of the program physicians must file an affidavit with specific data elements. The minimum opt-out period is two years during which no Medicare payment may be made to that physician or to his/her Medicare patients. A list of Requirements of an Opt-Out Affidavit can be found at: www.ncmedsoc.org.
For a list of physicians who have opted out thus far: Opt Out.pdf
December 14th, 2007
CMS has finalized and selected 119 quality measures from the 148 proposed measures for inclusion in the 2008 professional reporting process. Five of these measures have been specified for EHR-based submission. Complete specifications are available at http://www.cms.hhs.gov/PQRI.
The NCMS is a member of the AMA Physician Consortium for Performance Improvement, a program to support clinical quality improvement through identification, development, testing and maintenance of performance measures and measurement resources. Measurement review is coordinated through the NCMS Quality of Care and Performance Improvement Committee. Through this process, physicians have the opportunity to vet measures before they are implemented into nationally used quality measure sets. Physicians are urged to participate in this process whenever proposed measurements are presented for review and comment. Be watching for updates in the Bulletin.
December 14th, 2007
The North Carolina Division of Medical Assistance (DMA) reports that over 1,200 individuals and 1,200 physician groups statewide have not successfully reported their NPI to Medicaid. To check whether DMA Provider numbers are associated with the correct NPI, all providers should click on the following link to search the NC DMA NPI database with their NPI or Medicaid provider number: http://www.ncdhhs.gov/dma/WebNPI/default.htm. Upon executing a database search with either number, instructions appear with a link to a printable form to report or correct NPI information.
Beginning January 1, 2008, with the exception of Pharmacy providers, NC Medicaid providers must begin submitting both the NPI and the Medicaid Provider Number on all claims. While claims will not deny at this time if this information is not submitted, not providing this information now may result in claims denial once NPI is fully implemented.
December 14th, 2007
By Kevin B. O’Reilly, AMNews staff. Oct. 22/29, 2007.
The ruling from a trial court may be appealed. In a separate case, the U.S. Supreme Court will hear arguments over the constitutionality of lethal injection protocols.
The only state medical board in the country with policy declaring physician participation in executions “a departure from the ethics of the medical profession” and grounds for discipline was rebuked in state court late last month.
Continue Reading December 14th, 2007
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) Semiannual Report to Congress reported total fiscal year (FY) 2007 savings and expected recoveries of $43 billion; $5 billion more than last year and more than double the savings and recoveries of just five years ago.
OIG’s FY 2007 $43.08 billion in savings encompasses $39 billion in implemented recommendations and other actions to put funds to better use; $1.9 billion in audit receivables, up from $789 million in FY 2006; and $2.18 billion in investigative receivables, an increase of $578 million from FY 2006.
View OIG press release.
December 14th, 2007
Next Posts
Previous Posts
