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We just wanted to share with you this interesting item from our newsletter archives. A news brief in the Jan. 22, 1990, issue of our sister publication the Medicare Compliance Alert (now, Medical Practice Compliance Alert) stated:

Medicare payments to physicians can't increase more than 9.1% in [fiscal year] 1990, if practitioners want to avoid an inflation adjustment penalty in FY 1992. The initial "performance standard," announced by HHS in the Dec. 29 Federal Register, is part of the new physician payment reform law.

We've compiled a list of the most read Part B News online stories since Dec. 1 and this much is clear -- the end of consultation billing weighed heavily on the minds of Part B providers. Four of the top five stories dealt with consults, the other story tackled the 10-day hold on Part B claims at the start of 2010.

Part B News subscribers can read our top five stories by clicking the links listed below. If you're not a subscriber, you can sign-up for a free trial and then access these stories. With the free trial, you receive full access to our news, analysis and expert guidance for 21 days.  

As a follow-up to our ordering and referring providers in PECOS story this week, here's a Feb. 19 statement from CMS on this issue:

CMS will delay until Jan. 3, 2011, the implementation of Phase 2 of Change Request (CR) 6417 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Claims Processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)) and CR 6421 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Claims Processed by Durable Medical Equipment Medicare Administrative Contractors (DME MACs)). 

The uncertain future of Medicare payment rates might be playing a role in physician participation with the Medicare program.

I spoke with American Academy of Family Physicians (AAFP) President Lori Heim, MD, today and she mentioned 87% of AAFP members were Medicare participating providers in 2009. That's down five percentage points from 92% of its members with par-status in 2008. She added she's hearing more and more physicians are making the tough decision to not take on new Medicare patients, too.

CMS announced today the agency will delay the new ordering and referring PECOS rule until Jan. 3, 2011.  

Under the rule, Medicare providers will receive denials for services (such as a lab test or office visit) that stem from referrals or orders from providers not in CMS's Provider Enrollment Chain and Ownership System (PECOS) - even when the billing provider's enrollment information is in PECOS. The rule was to take effect April 5.

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