Skip Navigation LinksHome | Editors' Blog

Get ready for an influx of new Medicare beneficiaries as the Medicare Open Enrollment Period starts. This year, the period begins earlier on Oct. 15 and will last seven weeks, through Dec. 7. A major new wrinkle this year are CMS-published star ratings for Medicare Advantage (MA) plans. “This year CMS is highlighting plans that have achieved an overall quality rating of 5 stars with a high performer or ‘gold star’ icon so people with Medicare can easily find high quality plans,” the agency said in an Oct. 12 press release.

DecisionHealth stock imageWe report in the current issue of Part B News that you could get a revalidation notice from CMS this year, even for providers who already have recordsin the agency’s Provider Enrollment Chain Ownership System (PECOS).

Remember: CMS had previously said no providers with existing PECOS records would get revalidation notices until January 2012, when a big “wave” of notices would be sent out. The culprits are active provider transaction account numbers (PTANs), which cause the revalidations to be sent when they are on file with a Medicare contractor but not listed in a provider’s PECOS record, CMS has said. Now the agency has answered some questions about the PTAN and revalidation issue.

Image from www.pay.gov You’ll have an easier time forking over your $505 Medicare enrollment fee thanks to CMS integrating its web-based Provider Enrollment Chain Ownership System (PECOS) into Pay.gov, the federal government’s national online payment portal. Remember:The $505 enrollment fee applies to institutional providers, suppliers of durable medical equipment/supplies and independent diagnostic testing facilities (IDTFs). Your physicians and non-physician practitioners must also pay the $505 if they provide DME, prosthetics, orthotics and supplies.

Image from innovations.cms.govPrimary care practices would have a shot at collecting some extra cash while trying a new, more comprehensive clinical approach under a new CMS pilot program. The Comprehensive Primary Care Initiative (CPCI) is a four-year program that pay you an extra $20 per patient, per month, on top of regular Medicare fee-for-service charges. The $20 rate, dubbed a “monthly care management fee,” is good for the first two years; then the rate falls to $15 per patient, per month. Additional cash: If after two years, the total cost incurred by participating practices is less than that of non-participating practices, a portion of the savings is shared with participants.

Image from www.cms.govYou would be wise to save documentation – in whatever format you can – that shows you were honest and accurate in attesting to meaningful use for the Medicare electronic health record (EHR) incentive program, which is currently doling out money pretty much on the honor system, CMS says. Now the agency has issued its strongest statement yet on the need to preserve documentation for the future meaningful use auditing program.

Login

User Name:
Password:
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Blog Archive
Back to top