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Medicare Updates

Tuesday, April 1st, 2014

This evening (March 31), the Senate passed H.R. 4302, the “Protecting Access to Medicare Act of 2014,” which postpones the imminent 24 percent Medicare physician payment cut for 12 months, until April 1, 2015.  Although many Senators spoke against passing this 17th Medicare payment patch, the Senate vote was 64 to 35.  (Sixty votes were…  read more


Congress Intends To Pass Another Short-Term Medicare Pay Patch

Thursday, March 20th, 2014

The National Journal (3/20, Ritger, Subscription Publication) reports that “Congress intends to pass another short-term” payment patch “instead of the long-term solution physicians have been seeking for years, a House committee spokesman confirmed” yesterday. According to the Journal, this news “will come as a blow to” the American Medical Association and other “advocates of a permanent…  read more


Medicare EPs Must Attest by February 28 at 11:59 pm ET to Receive 2013 Incentive

Monday, January 13th, 2014

If you are an eligible professional (EP), the last day you can register and attest to demonstrating meaningful use for the 2013 Medicare EHR Incentive Program isFebruary 28, 2014. You must successfully attest by 11:59 p.m. Eastern Standard Time on February 28 to receive an incentive payment for your 2013 participation. You must attest to demonstrating meaningful use every…  read more


President Obama Signs the Pathway for SGR Reform Act of 2013

Thursday, January 2nd, 2014

–New Law Includes Physician Update Fix through March 2014– On December 26, 2013, President Obama signed into law the Pathway for SGR Reform Act of 2013. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients from taking effect on January 1, 2014. The new law provides for a 0.5 percent…  read more


Brief SGR Update

Thursday, December 19th, 2013

December 19, 2013 Yesterday the US Senate passed by a 64-36 margin a two-year Budget deal that includes a 3-month delay of the 24% Medicare SGR physician payment cut scheduled to go into effect January 1.  Last week, the House of Representatives passed the measure and it is expected to be signed into law by the…  read more



Thursday, November 14th, 2013

AMA Submits Recommendations to Senate Finance and House Ways & Means Committees on Repealing the SGR On Oct. 30, the Senate Finance Committee and the House Ways and Means Committee released a bipartisan, bicameral discussion draft proposal that “would permanently repeal the SGR update mechanism, reform the fee-for-service (FFS) payment system through greater focus on…  read more


EMPIRE BC/BS Changing 2014 Medicare Advantage Individual Plans

Wednesday, October 30th, 2013

Medicare Advantage Outreach and Education Bulletin Empire BlueCross BlueShield We want you to know about changes to our individual Medicare Advantage HMO and LPPO plan service areas. These changes will take effect Jan. 1, 2014. Some plan service areas will be eliminated or reduced. These service area changes do not impact your participation in the…  read more


Access to Jurisdiction K Local Coverage Determinations during the Federal Government Shutdown

Friday, October 11th, 2013

The Centers for Medicare & Medicaid Services (CMS) Coverage Database will not be updated on its usual weekly basis during the federal government shutdown. In the event that the shutdown continues through the Jurisdiction (JK) transition dates of October 18 and October 25, 2013, the JK local coverage determinations (LCDs) will be effective on the transition…  read more


2014 Proposed Physician Fee Schedule Rule Summary

Wednesday, August 7th, 2013

Below are links to a summary prepared by the AMA of the proposed 2014 Medicare physician payment rule.  Of particular note, on pp.7-8 of the summary is a specialty by specialty breakdown of the anticipated % impact of the proposed rule changes on allowable physician charges.  Also linked is the chart referenced on p.2 of…  read more


Nonphysician Practitioners Billing for Global and Technical Components of Radiological Procedures

Friday, February 1st, 2013

Effective January 1, 2013, National Government Services has restored an edit in our claims processing system to not allow payment for global radiologic procedures or the technical component of radiologic procedures when performed by a nonphysician practitioner. The basis for limiting nonphysician practitioners such as physician’s assistants and nurse practitioners from performing the technical component…  read more