For months, the deadline to get your providers up-to-date in CMS's enrollment database has been Jan. 3, 2011. Providers not in the Provider Enrollment Chain and Ownership System (PECOS) by that date will theoretically see their claims reject automatically until they get in. The real rub was that even providers who are up to date will see automatic claims rejections on claims involving orders or referrals from other provider who are not in PECOS. 

However, CMS said more recently that enforcement -- i.e., automatic claims rejections -- will not begin on Jan. 3, 2011. The agency hasn't decided when to start enforcement. That changes now, with a transmittal released Dec. 16, CMS has made its decision. The hammer comes down JULY 5, 2011 (read more about the ordering/referring rule's enforcement date) ...

Medical associations want CMS to start reprocessing Medicare claims effected by retroactive geographic adjustments in 2010. Dozens of organizations sent a letter urging the agency to reprocess claims as soon as possible.

"Throughout 2010, Congress enacted short-term, stop-gap measures for durations as short as one month," the letter (pdf) states. "On three occasions, Congress failed to act in time and Medicare payments were cut by more than 20%. The payment uncertainties and delays were highly disruptive. Many practices were forced to seek loans to meet payroll expenses, lay off staff, or cancel capital improvements and investments in electronic health records and other technology."

Click here to read more on claims reprocessing

Public opinion on the health reform law remains divided, though seniors appear to be warming to some of its measures, according to the latest tracking poll from the Kaiser Family Foundation. About 42% of all Americans have a "generally favorable view" of the law, while 41% a "generally unfavorable view," the Kaiser survey found.

Interestingly, seniors (defined as those ages 65 and up), who were initially more opposed to the law than younger people, are softening their stance. When surveyed one month after the law passed in March, 56% of seniors had an unfavorable view; the latest figure is 40%. At the same time, seniors who don't have an opinion increased from 16% to 26%, suggesting that opposition is giving away to confusion and uncertainty, according to Kaiser. Seniors who approve of the law have held steady at about 34% (read more about public opinion on health reform law) ...

You're not alone if you had problems with CMS's HIPAA Eligibility Transaction System (HETS) on Dec. 4. A new release of HETS designed to handle large traffic volumes experienced significant problems that day when ... it could not support large traffic volumes, the agency states in a notice.

"Although it performed well in the test environment, the system could not support the production traffic and was backed out" on Dec. 6, CMS says.   

"CMS is aware of the impact of the current performance and connection problems on Medicare providers using this system to get needed beneficiary eligibility information. We regret the inconvenience and want to assure the provider and clearinghouse community that correcting HETS problems is a top priority for CMS. Your continued patience is appreciated."

The number of Medicare patients subject to higher premiums will more than double between 2011 and 2019, according to an analysis by the non-profit Kaiser Family Foundation in Washington. Depending on how many of your Medicare patients are considered "higher-income," you could see many more of them getting hit with higher premiums gradually over the next nine years.

The changes are caused by two lesser-known provisions in the health reform law that are aimed at cost control. Upper-income Part B patients already pay higher monthly Part B premiums, but the health reform law freezes the income thresholds that determine which patients get hit. The 2010 levels are $85,000 for individuals and $170,000 for couples.