You can expect to see overpayment demands from CMS between now and November for Part B claims processed after April 1, 2011, the agency says. On April 1, CMS implemented a change request (CR 7026) that allowed its Common Working File to accept both Medicare as secondary payer (MSP) data and non-MSP data in claims adjustment lines. In English: Any patient who hasn't met the Medicare deductible, but has Medicare as the secondary payer, was issued coverage and had services paid as if the deductible were met, for claims processed anytime after April 1, 2011, CMS says.

CMS wants you and your peers to sign up for its new bundled payment initiative aimed at streamlining patient care during and after inpatient hospital stays while reducing Medicare costs, HHS Secretary Kathleen Sebelius announced in a conference call Aug. 23. The Bundled Payments for Care Improvement pilot program, set to launch in 2012, is the attempt to save money prompted by the health care reform law. It encourages providers to administer quality care by voluntarily participating in one of four bundled payment models.

The next time you get a request for records from your carrier or recovery audit contractor (RAC), you would be able to send it electronically under a new CMS pilot program. The Electronic Submission of Medical Documentation (esMD) lets you send any requested record as a PDF document, which typically means you scan or convert the required documents into PDFs. This could reduce the time it takes to meet a records request, although you will probably need to go through your claims clearinghouse to submit information via esMD.

Providers were overpaid by nearly $7 million between 2006 and 2009, according to the audit results released Aug. 17 from the Office of the Inspector General for the Medicare Administrative Contractor (MAC) Highmark.

The OIG found that 68% of 1,507 selected claims processed by Highmark, the MAC for Pennsylvania, Delaware, Maryland, New Jersey and the District of Columbia metro area were incorrectly paid for outpatient services between Jan. 1, 2006 and June 30, 2009.

Providers had not refunded any of the overpaid funds by the start of the OIG’s investigation, according to the report.

When you attest to having met meaningful use with your EHR, a CMS computer system does a fast, cursory check and then sets the gears in motion to deliver your bonus check, agency officials said during an Aug. 18 open door call. A CMS computer system “almost instantly” calculates attestation results entered on the EHR Incentive Program Registration and Attestation System website, said Travis Broome, an agency official. What’s more, right now there is no real fact-checking going on; as long as the attestation data meets the thresholds, the attestation is successful, he said.