Part B News | Editors' Blog

by: Charles Fiegl Jan 24, 2011

Federal anti-fraud programs recovered more than $4 billion in fiscal year 2010. HHS, CMS and the Department of Justice (DOJ) stand to recoup more, and prevent further waste and abuse, with new enforcement tools created by a new regulation released today. Here are three provisions in the rule that the federal agencies highlighted today.

Surgeons face uphill battle to get EHR bonus

by: Grant Huang Jan 21, 2011

CMS launched a new website that your providers must personally log into in order to be paid under the Electronic Health Record (EHR) Incentive Program. The website, dubbed the "Medicare & Medicaid EHR Incentive Program Registration and Attestation System," also checks to see if your providers even qualify for the bonus payments. If the site decides you don't qualify under the 90% rule (most relevant to surgeons), you don't have a way to appeal -- and that may not change anytime soon, according to a CMS official I exchanged emails with.

CMS statement on AWV denials

by: Charles Fiegl Jan 20, 2011

Here's CMS's full statement on claims denials involving providers billing the new annual wellness visit exam. CMS has investigated complaints that claims submitted by physicians for the new Annual Wellness Visit that went into effect on January 1, 2011, are being improperly denied, and has determined that this is not a national problem, but that there are a few contractors that have improperly denied these claims.

Repeal and replace with what?

by: Charles Fiegl Jan 18, 2011

Debate on repealing the Patient Protection and Affordable Care Act of 2010 will begin with consideration of H.R. 2 -- Repealing the Job-Killing Health Care Law Act of 2011 (pdf) -- this afternoon. Following its probable passage this week, the House will consider another resolution that instructs committees “to report legislation replacing the job-killing health care law” (pdf).

CMS updates claims codes for workers comp

by: Grant Huang Jan 17, 2011

CMS is focusing on workers compensation payments in its latest round of changes to the list of Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) that are sent to you from payers. A total of three new CARCs and RARCs are being added, while seven are being modified. You will start seeing the new codes appearing on affected claims in April, when the changes are implemented, according to Transmittal 2131 to the Medicare Claims Processing Manual, released Jan. 7.

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