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2012 PFS Final Rule Stands Corrected

January 13, 2012

The Centers for Medicare & Medicaid Services (CMS) has published corrections to the 2012 Physician Fee Schedule final rule in the Jan. 4 Federal Register. Several typographical and technical errors needed correction in the preamble and addenda of the final rule that sets Medicare payments to physicians. These corrections are consistent with, and do not make substantive changes to, the policies and payment methodologies that were adopted in the 2012 PFS final rule, so CMS is waiving the standard 30-day comment period and delay in the effective date for these corrections. The document is final and the corrections are effective Jan. 1, 2012. Due to the number of corrections made to the preamble of the final rule, CMS is replacing the Addenda...

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Pres. Obama Signs Tax Bill Forestalling Physician Pay Cuts

January 13, 2012

On Dec. 23, 2011, just hours before leaving for the holidays, Congress acted to stall a 27.4 percent cut in Medicare payments that would have gone into affect Jan. 1 of this year. The measure was part of a larger package that included extensions of payroll tax cuts and unemployment benefits. President Barack Obama signed the Temporary Payroll Tax Cut Continuation Act of 2011 (TPTCCA) into law the same day. The legislation extends current payment rates for the first two months of 2012, by which time Congress will have to act once again to prevent drastically lower reimbursement for Medicare physicians. President Obama said he desires a full year extension of the tax cuts, and urged Congress not to allow a full-year renewal to get bogged down by the same partisan bickering that delayed the two-month extension. “When Congress returns, I urge them to keep working without drama, without delay to reach an agreement that extends this tax cut, as well as unemployment insurance through...

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Health Plans Must Comply with New EFT Transaction Standards

January 5, 2012

The Centers for Medicare & Medicaid Services (CMS) announced, Jan. 5, standards effective Jan. 1, 2012  for health care electronic funds transfer (EFT) transactions. The standards, unveiled in an interim final rule with comment period, will apply to all Health Insurance Portability and Accountability Act of 1996 (HIPAA)-covered entities. The purpose of the transaction standards is to “enable electronic data interchange using a common interchange structure, minimizing the industry's reliance on multiple formats,” according to the final rule. The standards also are expected to “significantly decrease administrative burden on covered entities by creating greater uniformity in data exchange” and reducing the number of paper forms needed to transmit data. Department of Health & Human Services (HHS) Secretary Kathleen Sebelius commented that the new standards would...

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House Votes: Physician Pay Cut Put Off

December 19, 2011

The Sustainable Growth Rate (SGR) cut of payments to physicians servicing Medicare payments is not going to happen, at least for two months. The  House of Representatives passed a bill similar to one passed by the Senate on Dec. 17 that postpones the impending 27.4 percent cut to physicians' Medicare reimbursement rates for two months.The Senate's amended version of the House bill, called the Temporary Payroll Tax Cut Continuation Act of 2011, would have extended the 0 percent update through Feb. 29, 2012. Both House and Senate bills would extend a number of other health provisions, including: Sec. 302. 2-month extension of MMA section 508 reclassifications. Sec. 303. Extension of Medicare work geographic adjustment floor. Sec. 304. Extension of exceptions process for Medicare therapy caps. Sec. 305. Extension of payment for technical...

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  • 2012 PFS Final Rule Stands Corrected 1
  • Pres. Obama Signs Tax Bill Forestalling Physician Pay Cuts 2
  • Health Plans Must Comply with New EFT Transaction Standards 3
  • House Votes: Physician Pay Cut Put Off 4

Recent News

Why So Much N22226? More 5010 Guidance

January 27th, 2012

The Centers for Medicare & Medicaid Services (CMS) has reissued communication to clarify Medicare’s capability to cross over version 4010A1 and National Council for Prescription Drug Programs (NCPDP) version 5.1 batch claims to the supplemental payers that have cut over to exclusive receipt of version 5010 837 claim formats or NCPDP D.0 batch claim formats…. Read more »

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Providers Must Agree to EFT for Medicare Payment

January 27th, 2012

Providers and suppliers have until March 31 to comply with the new Health Insurance Portability and Accountability Act (HIPAA) transaction standards for submitting claims electronically, and can even opt out and continue to submit paper-based claims if they so choose. If they want to get paid, however, they’ll have to accept the wave of the future.

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