Archive for May, 2010|Monthly archive page

The Doc Fix Is On The Table Yet Again…

In Uncategorized on May 27, 2010 at 5:36 pm

Matthew DoBias of ( reports that:

House leaders are eyeing a legislative package that would increase physician Medicare payments over the next 19-months—until the end of 2011—but trim back some benefits for safety net health programs.

Under the measure, physicians would not see a 21% pay cut that’s scheduled to go into effect June 1, according to two sources with knowledge of the ongoing negotiations between House and Senate leaders.  If approved, it would be the third attempt to rework the troublesome sustainable growth-rate formula used to determine physician reimbursement. Previous attempts have proven too costly for some debt-wary lawmakers.  The package was expected to have been approved by the House Rules Committee Wednesday evening, clearing the way for final passage today.

House leaders huddled behind closed doors to help shape the bill’s framework, which attempts to patch the SGR while also extending unemployment insurance benefits as well as the timeline for a higher level of aid for COBRA premiums.  But those last two measures could be scaled back, ending in November rather than December—a move that would keep the unpaid provisions in the bill under $100 billion.  

Sources stressed that negotiations were fluid.  “We’re looking at the options,” Rep. Chris Van Hollen (D-Md.), a member of the House leadership team, echoed. Van Hollen said he expects the House to pass the bill before Memorial Day, though it remains unclear whether or not the Senate will support the package.


Medicare Timely Filing Limit Shortened To 12 Months

In Uncategorized on May 26, 2010 at 6:43 pm

CMS has reduced its timely filing limit for submitting Part A and B claims to Medicare to 12 months to comply with the Patient Protection and Affordable Care Act (PPACA).  Medicare will deny claims with dates of service on or after January 1, 2010 received later than one calendar year beyond the date of service, according to MLN Matters article MM6960.  This is a change from the previous requirements, which allowed providers to submit Part A and Part B claims by the end of the calendar year that followed the fiscal year in which the service was furnished. 

MLN Matters article MM6960 states the following: Medicare contractors are adjusting (as necessary) their relevant system edits to ensure that: Claims with dates of service prior to October 1, 2009 will be subject to pre-PPACA timely filing rules and associated edits Claims with dates of service October 1, 2009 through December 31, 2009 received after December 31, 2010 will be denied as being past the timely filing deadline Claims with dates of service January 1, 2010 and later received more than one calendar year beyond the date of service will be denied as being past the timely filing deadline.  Note: For claims for services that require the reporting of a line item date of service, the line item date is used to determine the date of service.  For other claims, the claim statement’s “From” date is used to determine the date of service.