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If you can’t find the information you are looking for or need help with a question, contact the FCA Insurance and Legal Liaison Office.

MEDICAID Non-Provider Alert
By FCA Help Desk   
Wednesday, 19 May 2021
Medicaid claims will deny if a Referring, Ordering, Prescribing, or Attending Provider is NOT Enrolled in Medicaid.
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Be Alert for Medicare Audit Requests
By FCA Help Desk   
Wednesday, 28 April 2021

An FCA member has shared with the FCA he received a request for Medicare records for a Medicare CERT audit. Although this was a "Second Request", the member has no record of receiving the initial request.

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CMS: Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension
By the FCA Help Desk   
Thursday, 01 April 2021
(From CMS Newsletter of March 30, 2021)  "In anticipation of possible Congressional action to extend the 2% sequester reduction suspension, we instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021, for a short period without affecting providers’ cash flow. This will minimize the volume of claims the MACs must reprocess if Congress extends the suspension; the MACs will automatically reprocess any claims paid with the reduction applied if necessary." 
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Senate Passes Bill Delaying Medicare Sequester Cuts
By the FCA   
Friday, 26 March 2021

(From Modern Healthcare)  The U.S. Senate voted Thursday to delay Medicare payment cuts for the rest of the year, a big win for hospitals and providers.   The 2% cuts originally took effect in 2013 but were paused by Congress last year in response to the pandemic and its effect on providers' finances.  The cuts totaling $18 billion were scheduled to resume next week absent Congressional action. 

The legislation still needs consideration by the House.  Please stay tuned for more news and potential calls to action.  Profound thanks to all FCA members who reached out to Senators Rubio and Scott through this past week's email campaign posted on the FCA website.

 
2% Medicare Sequester Moratorium Ends March 31st. Contact Your U.S. Senators TODAY!
By Debra Minor Brown   
Monday, 22 March 2021

Medicare Cuts Coming April 1st Without Action From U.S. Senate!

Background

H.R. 1868 contains two critical sections:

 

  • Section 1: The Statutory Pay-As-You-Go (PAYGO) Act requires across-the-board cuts (sequestration) to certain programs, including Medicare, if certain legislation affecting mandatory spending or revenues increases net deficits. Legislation that Congress designates as an emergency or otherwise excludes from the PAYGO scorecard does not trigger sequestration. Restrictions on the content of reconciliation bills prevented the American Rescue Plan Act of 2021 from including a provision to avert sequestration.
  • H.R. 1868 will protect Medicare and other programs from PAYGO sequestration. If not passed, the Medicare Physician Fee Schedule would see an additional 4% cut – the maximum sequestration cut allowed – beginning in 2022.
  • Section 2: The bill also extends a separate Medicare sequester relief provision, first enacted in the CARES Act, that expires March 31. It would postpone cuts through the end of 2021.

 

Please email your U.S. Senators today and ask them to support H.R. 1868, legislation that would postpone the 2% cut scheduled for April 1st and stop the cuts associated with the American Rescue Plan. Every email received on Capitol Hill lets lawmakers know how important this issue is and how they can help Medicare patients who choose to see a chiropractor for their health care needs.  

We've provided a convenient fill-in form below, with help from the Congress of Chiropractic State Associations (ChiroCongress). It takes less than a minute to contact your US Senator on this important issue!  

 
Medicare Beneficiaries May Suddenly Not Owe ANY Copays
By the FCA Help Desk   
Monday, 15 June 2020
Qualified Medicare Beneficiaries, QMBs, cannot be charged for any Copayments or Deductibles.  Who is a QMB?  A patient who is eligible for both Medicare and Medicaid.

With the Coronavirus pandemic, many Medicare Beneficiaries have recently qualified for Medicaid.  This applies whether the patient has regular or traditional Medicare, or if they have an Advantage or Medicare replacement plan.  As Medicaid eligibility can change from month to month, at any time of the month, a Medicare patient may become dually eligible between visits.
 
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Medicare Denials 1/1/2020 for old patient I.D. numbers
By Mollie Frawley   
Thursday, 14 November 2019
Effective January 1, Medicare will reject claims without the Medicare Beneficiaries current MBI number.
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New Medicare Card: Claim Reject Codes After January 1
By Help Desk Coordinator   
Thursday, 24 October 2019

Starting January 1, 2020, you must use Medicare Beneficiary Identifiers (MBIs) when billing Medicare regardless of the date of service:

Advisory from Medicare. 

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HIPAA and New Medicare I.D. Numbers
By Help Desk Coordinator   
Thursday, 19 April 2018
New Medicare cards are being issued that replace social security numbers with MBI, Medicare Beneficiary Identifiers. See Medicare's alert on keeping these numbers private and secure.
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OIG's Recent Report on Chiropractic Services
By Mollie Frawley, R.N., FCA Help Desk Coordinator   
Monday, 05 March 2018

Many chiropractors in Florida have received a copy of a recent report from the Office of Inspector General, U.S. Department of Health and Human Services that calls for better controls to prevent fraud, waste and abuse related to chiropractic services in Medicare.  This report is based on services between 2010 and 2014 and provides us two important lessons. 

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