Archive for March, 2010|Monthly archive page

HITECH Provisions To Have Been Effective 2/17/10 Delayed…

In Uncategorized on March 18, 2010 at 5:52 pm

As we all know, HITECH provisions (which were contained in ARRA) were to go into effect as of February 17, 2010.  However, the mandatory opportunity for notice and comment mandated as part of the rulemaking process has not yet occured.  As such, the implementation of those HITECH provisions have been delayed.  The Department of Health & Human Services’ Office of Civil Rights posted the following notice on its website: 

HITECH Act Rulemaking and Implementation Update

OCR will implement important privacy and security provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act through notice and comment rulemaking, as required by the Administrative Procedure Act.  These provisions include: business associate liability; new limitations on the sale of protected health information, marketing, and fundraising communications; and stronger individual rights to access electronic medical records and restrict the disclosure of certain information.  OCR continues work on a Notice of Proposed Rulemaking (NPRM) regarding these provisions.  Although the effective date (February 17, 2010) for many of these HITECH Act provisions has passed, the NPRM and the final rule that follows will provide specific information regarding the expected date of compliance and enforcement of these new requirements.

However, interim final rules implementing HITECH Act provisions in two areas have already been issued and are currently in effect: enforcement and breach notification.  New civil money penalty amounts apply to HIPAA Privacy and Security Rule violations occurring after February 17, 2009.  Covered entities and business associates must comply now with breach notification obligations for breaches that are discovered on or after September 23, 2009. OCR announced previously that it would use its enforcement discretion not to impose fiscal sanctions with regard to breaches discovered before February 22, 2010. Since that date has passed, OCR will enforce the Breach Notification Interim Final Rule, including with the possible imposition of sanctions, as it does with the HIPAA Privacy and Security Rule requirements.


CMS Lifts Hold On Claims Processing

In Uncategorized on March 4, 2010 at 2:21 pm

According to the CMS web site:

On March 2, 2010, President Obama signed into law the “Temporary Extension Act of 2010.”  Among other things, this law extends through March 31, 2010, the zero percent update to the Medicare Physician Fee Schedule that was in effect for claims with dates of service January 1, 2010, through February 28, 2010.  Consequently, effective immediately, claims with dates of service March 1 and later which were being held by Medicare contractors will be released for processing and payment.  Please keep in mind that the statutory payment floors still apply and, therefore, clean electronic claims cannot be paid before 14 calendar days after the date they are received by Medicare contractors (29 calendar days for clean paper claims).

In addition, the new law extends through March 31, 2010, the exception process for therapy claims reaching the annual cap, retroactive to January 1, 2010.  Affected providers may submit claims for exceptions to the annual therapy caps, with dates of service January 1 through March 31, 2010, using the KX modifier, following the pre-January 1, 2010, requirements for therapy cap exceptions.

3-2-10 SGR Update – Temporary “13th Hour” (i.e., well past the 11th hour) Resolution

In Uncategorized on March 3, 2010 at 9:40 pm

Last night at approximately 9:00pm, the Senate passed the 30 day extension of the SGR freeze by a vote of 78 – 19.  The legislation, which was quickly signed into law by President Obama, extends the Medicare payment freeze (thereby temporarily voiding the 21% reduction) through March 31 and extends the Therapy Cap exception process through March 31.
Because this is only a temporary, stop-gap measure, Congress will have to pass either another extension or a permanent fix for both of these issues otherwise the 21% cut and resumption of the Therapy Cap for all will occur on April 1.

Stay tuned….

CMS Will Hold Medicare Claims For 10 Days To Allow For SGR Fix

In Uncategorized on March 3, 2010 at 9:39 pm
CMS has instructed its contractors to hold claims containing services paid under the MPFS for the first 10 business days of March (i.e., claims with dates of service March 1, 2010, and forward).  This hold should have a minimum impact on provider cash flow because, under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt.  However, the immense benefit of holding the claims will be to avoid processing and paying at one fee scheule (the 21.2% cut), only to later have to reconcile those payments with a different fee schdule, which eliminates the 21.2% cut.   

11th Hour Attempts To Address SGR & Medicare Physician Fee Schedule

In Uncategorized on March 3, 2010 at 9:36 pm

 Sadly, while much has been discussed relating to the SGR and possible “fixes” over the course of the past month, not very much has in fact been accomplished.   Of particular note: 

February 25, 2010:  The House of Representatives passed the legislation necessary to prevent the 21% SGR cut from taking place on Monday.  The House bill would extend for 30 days the SGR deadline.
February 26-March 2, 2010:  Sen. Jim Bunning stonewalls the legislative process by single-handedly objecting to the passage of legislation containing, among other key items of interest, the freezing of the 21.2% Medicare Physician Fee Schedule cut.