Clarification has been received from the Florida Agency for Health Care Administration regarding the availability of HIE (Health Information Exchange) for chiropractic physicians who are reporting (QPP) Quality Performance Data in MIPS (Merit-based Incentive Payment System) or APMs (Advanced Alternative Payment Models)
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.
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.
Medicare is beginning the revalidation process again. If a practitioner or practice fails to respond timely to these requests they will be deactivated AND will not be able to bill Medicare or collect from the patient for services rendered while deactivated. Members are encouraged to alert their staff to look for any correspondence from Medicare or First Coast Service Options and respond urgently. Revalidations can be time consuming and frustrating. The financial impact could be significant, however, if not handled with urgency and importance. Continue reading for important links to help you revalidate with greater success.
Current ABN for Medicare: Effective as of June 21, 2017
The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131 and form instructions were last approved by the Office of Management and Budget (OMB) for renewal, effective June 21, 2017.
Are you using the most current version of the ABN form? Are you completing it correctly?
The ABN is null and void if incorrectly or improperly completed and utilized.
March 2017: The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. While there are no changes to the form itself, providers should take note of the newly incorporated expiration date on the form. With the 2016 PRA submission, a non-substantive change has been made to the ABN. In accordance with Section 504 of the Rehabilitation Act of 1973 (Section 504), the form has been revised to include language informing beneficiaries of their rights to CMS nondiscrimination practices and how to request the ABN in an alternative format if needed. The effective date for use of this ABN form is 6/21/2017. Read more to download the form.
Medicare/CMS 