Washington - Health and Human Services (HHS) Secretary Kathleen Sebelius and Attorney General Eric Holder today announced the launch of a ground-breaking partnership among the federal government, State officials, several leading private health insurance organizations, and other health care anti-fraud groups to prevent health care fraud. This voluntary, collaborative arrangement uniting public and private organizations is the next step in the Obama administration’s efforts to combat health care fraud and safeguard health care dollars to better protect taxpayers and consumers.
News and articles related to CMS
The following is from a CMS email recently sent out:
Looking for a high-quality provider? Medicare can help.
Do you need surgery and aren’t sure which hospital to choose? Does your mom need nursing care? Are you leaving the hospital, but you still need care in your home? Medicare’s online tools can help you find high-quality providers for any of these situations.
As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the posting of 2012 Physician Quality Reporting System educational products at http://www.cms.gov/PQRS on the CMS Web site.
2012 Physician Quality Reporting System Measures List – this document identifies and explains the measures used in Physician Quality Reporting, including information on the reporting options/methods, measure developers and their contact.
New standards for electronic funds transfers in health care, required by the Affordable Care Act, will reduce up to $4.5 billion off administrative costs for doctors and hospitals, private health plans, states, and other government health plans, over the next ten years, according to estimates included in new rules published today by the U.S. Department of Health and Human Services (HHS).
A recent notice on the Medicare Part B Website is titled : Electronic Inquiries Must Not Include Protected Health Information
The content is:
Providers are reminded that National Government Services is unable to accept e-mail inquiries that include beneficiary/claim-specific information due to protected health information (PHI) Internet security policy requirements. When sending your request, please make sure it does not include any of the following information:
News from CMS.
On November 15, 2011 CMS announced three demonstration projects. The CMS plans to conduct these demonstration projects to strengthen Medicare by aiming at eliminating fraud, waste, and abuse. Reductions in improper payments will help ensure the sustainability of the Medicare Trust Funds and protect beneficiaries who depend upon the Medicare program.
If you missed the November 1st exemption deadline, CMS has extended the deadline to declare hardship exemption to November 8th. Please read more to get the links to apply for the exemption.
CMS has mandated that physicians e-prescribe at least 10 prescriptions by June 30th, and at least 25 by the end of 2011. These prescriptions must be associated with eligible Evaluation and Management (E/M) services on Medicare participants - EM codes, not procedures.. The physician must also have the reporting code G8553 on the claim.
The U.S. Department of Health and Human Services today released final standards to more consistently measure race, ethnicity, sex, primary language, and disability status, thereby improving the ability to highlight disparities in health status and target interventions to reduce these disparities.
From the CMS website:
The latest version of the ABN (with the release date of 3/2011 printed in the lower left hand corner) is now available for immediate use and can be accessed via the link below. In order for providers and suppliers to have time to transition to using the newly posted notice, mandatory use of this version begins on January, 1 2012. All ABNs with the release date of 3/2008 that are issued on or after January 1, 2012 will be considered invalid.
Today, the Centers for Medicare & Medicaid Services announced that it was accepting applications for a new Innovation Advisors program to help health professionals deepen skills that will drive improvements to patient care and reduce costs. These health care improvements will benefit people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Made possible by the Affordable Care Act, this initiative will be managed by the Center for Medicare and Medicaid Innovation (Innovation Center).
CMS has created a web page with information and tools for the conversion to ICD 10. They will be keeping the web site up to date will all of the latest ICD 10 information. It is worth visiting and bookmarking.
The web site is at http://www.cms.gov/ICD10/02b_Latest_News.asp#TopOfPage
The Federal Government has published a final rule that provides guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs.
As a result of improper use of the National Provider Data Bank (NPDB). Public access to the information has been shut down for at least 6 months. Martin Kramer, a spokesman for the U.S. Health Resources & Services Administration stated "The National Practitioner Data Bank was never meant to be a public file," he added "By statute, it's not a public file."