(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."
(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.
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!
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.
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.
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.
The FCA has received confirmation from some members that they have received letters from FCSO requesting repayments on audited claims denied by Strategic Health Solutions (SHS). There has also been at least one notice of additional payments received on codes reported as under coded. There are no reports of the repayments including an extrapolation to all payments made in 2015.
This is VERY good news.
The positive is that there was no extrapolation. Most chiropractic physicians affected will be dealing with a couple thousand of dollars at most instead of tens or hundreds of thousands of dollars.
So what should those doctors who were audited do now?
Medicare is taking
steps to remove Social Security numbers from Medicare cards. CMS will start
mailing new cards to people with Medicare benefits in April 2018. All Medicare
cards will be replaced by April 2019.
