Breaking News: Congress passes temporary fee fixAs expected Congress is in process of averting the 27% pay cut and replacing with (drum roll please) a flat rate increase; i.e., 2012 will see the same rates as 2011. This is ANOTHER temporary fix only good through December of this year. This means the roller coaster will begin again next January. All the formal voting must take place but it looks like this should pass with out issue. As we've said earlier, make certain any payers paying a percentage of Medicare are using the 2011 schedule and NOT the proposed 2012. The Medicare conversion factor for 2012 is the same as it was in 2011; i.e., $34.0376.SGR Update from HBMA GR CommitteeThe House and Senate have both voted to approve legislation preventing the scheduled 27.4% SGR related cut from taking effect on March 1. The legislation goes to the President who has indicated that he will sign the bill.Below is a recap of all of the health provisions included in the bill: HBMA Special Alert re PECOSOver the past eighteen months, HBMA has been working with CMS to provide feedback regarding the use of and making improvements to the Internet-based Provider Enrollment, Chain and Ownership System, also known as PECOS. While many of you may still be using paper as your form of provider enrollment, we would encourage you to use the PECOS system as many improvements have and continue to be made to that system based on feedback from HBMA and other stakeholders.NGS has officially afforded limited amnesty for 5010 transitionCompliance is still essential BUT there are some permitted delays as described in the email below:National Government Services Implementation of Medicare Fee-for-Service Strategic Implementation Plan for 5010/D. Enforcement Discretionary Period In response to the Centers for Medicare & Medicaid Services (CMS) announcement of a 5010/D.0 Enforcement Discretionary period plan, National Government Services is taking the following actions: CMS Delays Limitation on "Brown Bagging" prescription drugsA recent article indicated providers could not write a prescription to have patients bring prescription drugs to a CHC for administration. This would have been problematic for some CHCs. However, a recent CMS transmittal changes the effective date to 1/1/2013. See the link below for the full story:https://www.cms.gov/transmittals/downloads/R2368CP.pdf Subcommittee on Health Center FinanceFQHC Medicare – Program Assistance Letter 2011-04As we all know Medicare is growing and is expected to do so for years to come. In the FQHC world, Medicare accounts for just shy of 10% of revenues or $750 million in 2010. Outside of CHCs, Medicare is the undisputed behemoth of the healthcare industry. FQHCs make up roughly 1% of the annual disbursements from this payer. While this may seem inconsequential to some, this fact presents both opportunities and areas of caution for our industry. In one of the latest Program Assistance Letters (PAL), HRSA details the steps for FQHC and look a like organizations to enroll and bill claims to Medicare. This document can be found at http://bphc.hrsa.gov/policiesregulations/policies/pal201104.html . While the document is quite detailed allow me to offer a brief summary. The Impact of CMS Changes on the FQHC Revenue CycleBy Robert Skeffington, CHBME, PMG Inc.2011 has already seen the most significant changes to the revenue cycle for Federally Qualified Health Centers (FQHCs) in many years. |
