ACOEP Member Center

The following information has been provided by the Centers for Medicare and Medicaid Services (CMS).

Earlier today, President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.”  The law reverses the 21.3% cut implemented on June 1 and establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rate through November 30, 2010.

The Centers for Medicare and Medicaid Services (CMS) has directed its contractors to discontinue processing claims at the negative rate and to temporarily hold all claims for services rendered June 1, 2010, and later, until the new 2.2 percent update rates are tested and loaded into the Medicare contractors’ claims processing systems. Effective testing of the new 2.2 percent update will ensure that claims are correctly paid at the new rates. CMS expects to begin processing claims at the new rates no later than July 1, 2010. Claims for services rendered prior to June 1, 2010, will continue to be processed and paid as usual.

All claims that contain June 2010 dates of service which have been paid reflecting the 21.3% cut will be reprocessed as soon as possible. Under current law, Medicare payments to physicians and other providers paid under the MPFS are based upon the lesser of the submitted charge on the claim or the MPFS amount. Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2 percent update rates will be automatically reprocessed. Physicians who submitted claims containing June dates of service with charges less than the 2.2 percent update amount will need to contact their local Medicare contractor to request an adjustment. Submitted charges on claims cannot be altered without a request from the physician. Physicians should not resubmit claims already submitted to their Medicare contractor.

Shawn Martin
Director of Government Relations
American Osteopathic Association

202-414-0140 | 800-962-9008
smartin@osteopathic.org

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ALERT: Possible BCBS Security Breach: Any osteopathic physician participating in a BlueCross BlueShield (BCBS) plan should be advised about a possible security breach.  Information about tens of thousands of physicians participating in BCBSA health plans nationwide might have been compromised after a laptop containing information about them was stolen in August.  The laptop included information that BCBS affiliates send to BCBS' Chicago headquarters weekly to update the BCBS' database of health care providers.  With increased focus on the FTC Red Flag Rules to address identity theft, as well as the new security regulations that require notification of security breaches, BCBS made this notification of the breach of physician information public on 10/5/09.  For more information, contact your BCBS carrier or the AOA Division of Socioeconomic Affairs at 1-800-621-1773 ext 8282.

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