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.

CMS is going out of its way to start showing progress on quality improvement and financial savings, releasing early results from three demonstration programs. The demos, which focus on both physician and hospital groups, are several years old and ongoing, but CMS released partial data that provides "strong evidence that offering providers financial incentives for improving patient care increases quality of care, and can reduce the growth in Medicare expenditures," the agency said in a press release (read more about Medicare demos) ...

Will bipartisan agreement on the need for a permanent fix to the Medicare payment formula eventually lead to an actual bipartisan agreement? For years there has been bipartisan agreement that the current payment formula is flawed, but there has been no bipartisan solution to fix it.

Republicans and Democrats said they needed to work together on a permanent fix while debating the merits of the one-year doc fix bill Thursday morning. "We need to put aside partisan politics and in the upcoming year, sit down and come up with a new formula to fix permanently how we pay our physicians," Rep. Joe Barton (R-Texas) said.  Rep. Frank Pallone (D-N.J.) later agreed, saying "we need to work together to achieve a permanent fix in the next Congress."

Click here to read more on the doc fix

The Senate Finance Committee has posted the text of the 1-year Medicare payment fix bill and a three-page summary document. Here are the links:

• Text of HR 4994, the Medicare and Medicaid Extenders Act of 2010;
• the summary document; and
• the Congressional Budget Office score of the bill (showing it is paid for).

The bill has support from Democratic and Republican leadership in the Senate and could pass by the end or today (Wednesday). It would then go to the House and on to the White House for approval.

Who knows -- maybe this could be wrapped up by Friday and we won't have to worry about payment cuts until December 2011?