The carrier Palmetto GBA will transition to cover Medicare Administrative Contractor (MAC) Jurisdiction 11, comprised of North Carolina, South Carolina, Virginia and West Virginia, the carrier has confirmed with Part B News.

Palmetto has not said when the transition will begin or when it will be completed. CMS's MAC reform website still shows the Jurisdiction 11 bid contract under protest.

It's worth noting other MAC transitions have not gone so well in previous years. This transition might be more difficult for Part B physician practices in North Carolina and Virginia. Palmetto is already the Part B carrier for South Carolina and West Virginia. But Cigna is the carrier for North Carolina and Trailblazer is the carrier for Virginia.

Some physician practices billing consultation codes (99241-99245, 99251-99255) to private payers running Medicare Advantage plans have recently reported receiving denials.

After CMS eliminated the codes Jan. 1, private payers could choose to continue reimbursing the codes or follow CMS's lead.

At first, most continued accepting the codes. But practice management consultants recommended that practices try to keep up with policy updates from payers contracted with the practice. Several payers - such as Humana, UnitedHealthcare and Anthem (pdfs) - have since said they will no longer accept consult codes.

Practices also must monitor denials. Receiving a denial for using a consult code is another way to learn a payer no longer accepts the codes (although it's finding out the hard way).

Have you come across private payers no longer taking consult codes? If so, who?

Physicians own fewer and fewer practices while hospitals are taking them over at a rapid clip, according to six years of survey data from the Medical Group Management Association (MGMA). You can see how these two trends appear to correlate in this chart, courtesy of the MGMA. We're running our own Part B News survey on this same topic, which I'd love for you to take (it's just a five-minute survey). The real question: Are your physicians thinking about merging with local groups or selling out to a hospital?

The House Ways and Means Committee posted the text of The American Jobs and Closing Tax Loopholes Act of 2010 (HR 4213), along with summary documents. Here's my read of the bill's Medicare payment provisions:

• 1.3% increase to Medicare reimbursements from June 1 through Dec. 31.
• 1% increase to Medicare payments from Jan. 1, 2011 through Dec. 31, 2011.
• Physician reimbursement rates will not drop during 2012 and 2013. Payments could go up to keep up with spending growth.
• Medicare reimbursements would be subject to sustainable growth rate (SGR) cuts in years 2014 and beyond.
• Physician practices in California would see higher payments because of updates to the geographic adjustment factor, or GAF. Physicians have protested payment imbalances in the Golden State over the last several years.

Congressional Democrats released a summary of "The American Jobs and Closing Tax Loopholes Act of 2010" (H.R. 4213), which would delay the sustainable growth rate (SGR) cut to Medicare payments for the next several years.

Here's what it says about the SGR and physician pay:

Medicare physician payment rates are scheduled to be reduced by more than 20 percent in June. This provision would provide reasonable updates in physician payment rates for the rest of this year and next year. For 2012 and 2013, rates would continue to increase if spending growth on physician services is within reasonable limits, with an extra allowance for primary and preventive care. Rates could not be reduced in 2012 or 2013, but after that rates would return to their current law levels. This provision is being estimated by the Congressional Budget Office.