Wednesday Barack Obama appointed Dr. Donald Berwick as the Administrator to the Centers of Medicare and Medicaid Services using a recess appointment. Dr. Berwick is a Harvard professor and a patient care specialist. He would be able to serve in his role though next year without Senate approval. Currently there are no hearings scheduled...
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CMS has posted an update their 2010 MA Part C and Cost Plan Technical Reporting Specifications. The update contains clarifications to commonly asked questions from plans. Part C reporting is a compliance requirement and plans that fail to submit data on time and in good fail will receive a compliance letter and notification. The...
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A key change included in the health reform legislation of 2010 was a change to the payment methodology for Medicare Advantage plans. As of today, CMS has not released their policy or the methodology for applying the STARs rating to payment adjustments but the legislation does provide some insights in to the overall approach....
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CMS has planned a major overhaul of their MARx system impacting enrollment file layouts and changes to TRR processing in April 2011. Here is a run down of the changes: IMPACTED SYSTEM / INTERFACE DESCRIPTION FROM TO Enroll Disenroll File Combining transaction codes 60, 61, 62 and 71 in to a single transaction code...
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On June 25, 2010, President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.” This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010. The Centers for Medicare & Medicaid...
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By KEVIN FREKING THE ASSOCIATED PRESS WASHINGTON – To help Americans become smarter health care shoppers, Medicare this month started publishing a range of what it pays for 30 common procedures and report how frequently hospitals perform them. The release of the information fits with the Bush administration’s strategy of moving more people into...
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Since December of 2005 we have been holding weekly Part D Providers conference calls to address issues physicians and other health care providers were having with Part D. We have seen a gradual decline in the participation on those calls and this past week, we only had one question on the call. To that...
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CMS has released the 2007 MA/MAPD Call letter. Download it here.
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CMS on Monday said that reimbursement rates for Medicare Advantage plans in 2007 will increase by only about 1.1% on average, rather than 4% as scheduled, because of a technical adjustment of how physicians code beneficiaries for billing, CQ HealthBeat reports. According to CQ HealthBeat, past small increases in reimbursement rates have led to...
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CMS is expected to issue final 2007 Medicare Advantage (MA) payment rates April 3. But some established Medicare managed care organizations aren’t holding their breath: They anticipate satisfactory reimbursement for next year’s MA product lines…. Visit AISHealth to read the entire story.
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