CMS has approved the updated ABN form with an expiration date of 6/30/2023. The deadline date for use of this updated form, originally mandated by August 31, 2020, has been extended to 1/1/2021 due to the pandemic. The renewed form may be implemented prior to the mandatory deadline. Read on for links to the form, instructions and important clarifications.
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.
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/CMS 