News and articles related to CMS

HHS Announces Intent to Delay ICD-10 Compliance Date


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).

Now Available on the CMS Web Site: Medicare Shared Savings Program 2012 ACO Narrative Quality Measures Specifications Manual and Application Crosswalks


From CMS

The Centers for Medicare & Medicaid Services (CMS) has added new information to the Medicare Shared Savings Program (Shared Savings Program) Web site at External

2012 Physician Quality Reporting System Educational Products Are Now Available!


From CMS

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the posting of 2012 Physician Quality Reporting System educational products at 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.

CMS Publishes new standards for EFT Transfers


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 Gentle Reminder from CMS


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:

CMS Announces Delay to the Prepayment Review and Prior Authorization for PMDs Demonstration and the Recovery Audit Prepayment Review Demonstration


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.

CMS Has extended the hardship exemption date to Nov. 8


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.

HHS announces refined survey standards to examine and help eliminate differences in care based on race, ethnicity, sex, primary language, or disability


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.

New ABN must be used effective a January 2012


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.

Affordable Care Act program to help healthcare professionals improve care for patients and reduce costs in their communities


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).

Federal Government Shuts Down Public Access to NPDB


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."

The Federal Health IT Strategic Plan has been published.


The Plan reflects federal government priorities to help eligible providers become meaningful users of health IT; support implementation of the Patient Protection and Affordable Care Act (PPACA); protect individuals’ privacy; empower consumers with access to their health information, and support enhanced learning and innovation. The Plan lists 5 goals:

Goal I: Achieve Adoption and Information Exchange through Meaningful Use of Health IT

OIG Report on NGS Medicare Overpayments from 2006 - 2009


An OIG audit found that 957 of the 1,407 selected line items for which National Government Services made Medicare payments to providers for outpatient services for the period January 2006 through June 2009 were incorrect.

The deficiencies in the 957 incorrect line items included
(1) incorrect units of service,
(2) a combination of incorrect units of service claimed and incorrect Healthcare Common Procedure Coding System (HCPCS) codes,
(3) HCPCS codes that did not reflect the procedures performed, and
(4) a lack of supporting documentation.


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