Palmetto GBA will transition to serve as Medicare Administrative Contractor (MAC) Jurisdiction 11, comprised of North Carolina, South Carolina, Virginia and West Virginia, the carrier has confirmed with Part B News.

Thanks to members of Congress, you need not worry about enforcement of the Red Flag Rules on June 1. In a May 28 press release, the Federal Trade Commission (FTC) announced it would delay enforcement until Dec. 31, 2010. But be warned: Enforcement could still start before the end of the year.

You've heard a lot by now about how the historic Patient Protection and Affordable Care Act (PPACA) will revolutionize health care for consumers, employers and others. What has received little attention, however, is how the new law will alter your dealings with private payers.

Your best bet to avoid costly claim rejections is to ensure that all your providers are up-to-date in CMS's Provider Enrollment Chain Ownership System (PECOS) by July 6, agency officials say. You also need to confirm the PECOS status of providers who refer patients to you or order any covered item or test prior to July 6; you won't be paid for these if they're not in PECOS.

CMS ordered carriers to delay processing your claims with the 21.3% sustainable growth rate (SGR) cut for the first 10 business days of June after Congress failed to delay the decrease before leaving for its Memorial Day break.

You can be sure that your payments will be different for claims processed after June 1 thanks to fee schedule tweaks mandated by health reform and implemented by CMS. Expect a payment increase when you practice in a rural area, but a decrease if you operate in an urban setting due to a minor dip in the conversion factor to $36.0791, a Part B News analysis shows.

Your Medicare reimbursements will drop 21.3% on June 1 after efforts in Washington to delay the devastating payment cut failed. Senate leaders chose not to act on a Medicare payment fix before Memorial Day, thus allowing the sustainable growth rate (SGR) cut to go through.

Is it ever appropriate for a nurse practitioner (NP) to sign off for a physician on the physician's orders and/or interpretations reports? I was recently told that if our practice has a policy that states the physician can give permission for the NP to sign off on his work it would be all right.

Nurse practitioners (NPs) and physician assistants (PAs) have similar denial rates for the ten codes most frequently billed by both specialties, an NPP Report analysis of CMS claims data shows. NOTE: The bold numbers above the bars show the difference in denial rates between NPs and PAs. A blue number shows NPs have the higher denial rate while a red number shows PAs have a higher rate.

When you're hiring a non-physician practitioner (NPP), chances are the decision is between a nurse practitioner (NP) and a physician assistant (PA). There's often a lot of overlap between the roles each of these specialties can fill, and it may not be readily apparent to you which is the better choice for your practice, experts say.