The temporary increase in 2013 and 2014 is mandated by a provision of the 2010 federal healthcare overhaul and aims to bring Medicaid primary-care payments in line with the level provided by Medicare. The provision, released Wednesday, would increase average Medicaid primary care payments by 34%, according to one estimate cited by CMS.
“Promoting high-quality primary-care is a pillar of the Affordable Care Act, and this proposed rule helps States and physicians provide every American, no matter where they live, access to the care they need to stay healthy,” HHS Secretary Kathleen Sebelius said in a news release (PDF). “This new rule can help improve health and reduce costs by preventing illnesses before they happen and catching small problems before they turn into big ones.”

Medicaid physicians eligible for the increased funding include family medicine, general internal medicine, pediatric and related subspecialists, according to HHS’ news release. The increased payment requires no matching payments by states.

The increased payments aim to encourage primary-care physicians to provide checkups, preventive screenings and vaccines to Medicaid beneficiaries. The rule also acknowledges that federal officials hope the increased rate encourages more physicians to participate in the Medicaid program because more clinicians will be needed under the program’s coming expansion. Other provisions of the Patient Protection and Affordable Care Act will begin expanding Medicaid’s enrollment by at least 16 million in 2014.

“We’re optimistic that this will help us attract and keep primary care doctors caring for Medicaid patients in our state,” Andy Allison, director of the Arkansas Division of Medical Services, said in a call with reporters.

Cindy Mann, director of the Center for Medicaid and CHIP Services at CMS, acknowledged in the call with reporters the limited efficacy of a temporary boost in physician reimbursements. Her agency plans to study the impact of the increased physician pay and “options” for continuing such benefits after the boost expires by 2015.

Medical Management Strategies has published a HIPAA 2012 Handbook

(1) HIPAA Compliance Policies and Procedures for 2012
(2) Government, Court and Legal Forms,
(3) CMS HIPAA Information Series,
(4) United States Department of Health & Human Services Summary of the HIPAA Privacy Rule and HIPAA Compliance Assistance,
(5) HIPAA Laws and Law References,
(6) Customized Forms for Your Practice and Associate Forms and Privacy Officer Job Description,
(7) Index of Forms and Forms for Your Practice (Customized with your practice’s name on them)
(8) HIPAA Action Plan and Checklist
(9) EHR’s and HIPAA: Assessing your Health IT environment and ensuring HIPAA compliance

To buy our HIPAA 2012 Handbook, click on the button below!

For more information please call Chris Wolman @ 805.285.185

On Tuesday, June 12, 2012 @ 12:00 PM PST and @ 5:00 PM PST. Join MMS and GHS for an in-depth webinar on HIPAA compliance. MMS will be hosting an onsite seminar on Wednesday, June 13 @ 12:00 PM PST and @ 5:00 PM PST
Contact: cwolman@mmsofslo.com or 805.547.1255 ext. 148 to RSVP your practice!

Google Analytics/Keyword Searches:
Medical Management Strategies (MMS) offers Health Insurance Portability and Accountability Act (HIPAA) consulting for physicians, office managers, practices, hospitals, insurance companies, and the healthcare community. Through MMS HIPAA consulting we have developed and helped practices accomplish and overcome HIPAA in San Luis Obispo, Los Angeles, San Francisco, California, the West Coast, practices all over the United States of America, and outlying regions of the United States of America. MMS offers HIPAA consulting onsite or remotely for staff. MMS’s HIPAA consultants wrote our newest HIPAA Handbook, HIPAA Policies and Procedures, and HIPAA in regards to Electronic Health Record. Our HIPAA 2012 Handbook is unlike any other HIPAA book known.
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The webinar will be availible for Clients and Non-Clients.

On February 16 at 1:45 PM (PT) and 4:45 PM (PT).

This webinar will go over problems and implications experienced from 5010, how to avoid these problems, and cash flow issues!

Space is filling up quick, and please RSVP with Chris. Contact Chris at cwolman@mmsofslo.com and 805.710.3306

Click MGMA letter for a letter from the MGMA to the Department of Health and Human Services, and several of the items that the MGMA has noticed!

MGMA letter

This is a real problem that needs a solution. Medical Management Strategies has found th solution to 5010! Please contact us and RSVP to this webinar so we can help you and your practice too!

January 2012 Update – 5010 Transition

Most payers are still struggling with the 5010 EDI (Electronic Data Information) transition. Again, this has effected anyone involved with electronic billing for medical claims which is pretty much everyone industry wide. Here is the most recent update to items noticed that occurred in January of this year.

(1) Noridian Medicare: (DME Billing)
Noridian Medicare has been experiencing major issues with processing 5010 claims since January 1st. Their 5010 system is experiencing intermittence outage. Noridan is working to fix the problem. You may experience delay in payment compensations.
(2) Medicare Update on 2012Payments:
a) Medicare has begun to release EOBs (Explanation of Benefits) for the beginning of January dates of service and releasing the 10 day hold.
b) Medicare is still delaying their 5010 implementation until April 1, 2012. During this 90 day non enforcement period (1-1-3-31-12), Medicare will have the systematic capability to perform up or down version conversions of incoming claim formats (either converting these to the 5010 format when necessary for cross over claims (billing secondaries) and/or leaving them in the 4010 EDI format. What has been occurring is these transitions are not always perfect and has created its own set of issues as well.
(3) Medicare and Blue Cross
Medical Management Strategies has also noticed that with all the changes going on in the industry for Electronic Data Information going to the new version 5010, there have been a number of significant issues that have occurred for Medicare and Blue Cross payers particularly. Medicare has had a number of issues to deal with this January which included revamping fee schedules, processing claims from clearinghouses in the older version since they put a hold on converting to the 5010 until April 1st, applying deductibles, etc. as well as crossover issues. Although they’ve been trying to notice everyone of how these transitions have been dealt with, there are still a number of issues particularly with clearinghouses to Medicare as well as crossover claims. Clearinghouses are reporting acknowledgements of claims going to Medicare and Medicare then stating they never received the batches.

From Medical Management Strategies Perspective…

For MMS, we’ve been monitoring all clients’ claims closely to make sure we try and minimize cash shortfalls. Not all Electronic claims are going through smoothly and what we’re finding is it is hit and miss. Many claims go through without an issue and then some don’t. As we discover this each time, we are working these through timely as best we can. A lot of this is out of our hands as this is an industry wide adjustment to claims processing in general and many of the payers are struggling with this on a daily basis. Most of us will notice a drop in cash flow during this transition. MMS will keep you updated as we learn more.

For the latest informatio please check Bob’s Blog

@

Click HERE!!!

www.bobsayers.com

or read it right here!!!

SGR status update

A congressional conference committee composed of Senate and House members from both parties will convene the week of Jan. 23 to discuss legislation to prevent the 27.4 percent Medicare physician payment cut scheduled for March 1. The committee will also tackle the more controversial extension of unemployment benefits and a cut in the Social Security payroll tax for another year. Lawmakers could not reach common ground on these issues in December 2011 when they approved a 2-month extension to avoid disruptions on Jan. 1 and provide time for further negotiations on a larger legislative package.

The effective date for any participation status change during the extension remains January 1, 2012, and will be in force for the entire year.

Contractors will accept and process any participation elections or withdrawals made during the extended enrollment period that are post-marked on or before February 14, 2012.