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Medicare/CMS
Medicare Advantage Private Fee For Service Plans: Itís what you DONíT know that can hurt you.
Medicare/CMS Laws & Rules
Tuesday, 02 June 2009

               Frequently we get calls from members who have treated a Medicare beneficiary, submitted the bill and received anything but what would normally have been expected in reimbursement. To follow are some of the more common issues and then the facts to consider before accepting a patient that has a Medicare Advantage Private Fee For Service (MA PFFS) Plan, sometimes known as a Medicare replacement plan.
               Frequent complaints to the FCA insurance/legal office include:

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Medicare Enrollment is REQUIRED If Treating Medicare Beneficiaries
Medicare/CMS Laws & Rules
Tuesday, 02 June 2009

               From time to time we get calls from members who do not want to enroll in Medicare and only treat

their patients on a cash basis. These are very dangerous waters.

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Stricter Medicare Enrollment Process effective April 1, 2009
Medicare/CMS News
Tuesday, 24 March 2009

Beginning April 1, 2009, Medicare is implementing stricter enrollment policies.

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When NOT to Show Patient Paid Amounts on Medicare Claims
Medicare/CMS News
Thursday, 29 January 2009
(excerpted from CMS IOM Pub 100-04, Ch. 1, sec. 30.3.1.1 (2), 30.3.3.B (2), Ch 26, Sec 10.4

http://www.floridamedicare.com/Part_B/Billing_and_Coverage/140555.asp)

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Medicare's 2009 OIG Work Plan Released
Medicare/CMS News
Monday, 26 January 2009
Medicare’s 2009 Office of the Inspector General’s Work Plan has been released. 

The full report can be found at http://www.oig.hhs.gov/publications/docs/workplan/2009/WorkPlanFY2009.pdf.

Following are portions significant to physicians, especially chiropractors.  These broad measures will look at the appropriate use of the AT and GA modifiers and the adequacy of documentation to substantiate the necessity of care, including billed excluded services.
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NPI User and Maintenance Tips
Medicare/CMS News
Tuesday, 16 December 2008

Following is information from the NPPES (National Plan and Provider Enumeration System) on keeping your NPI number safe and updated.

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Medicare's 2009 Office of Inspector Generalís Work Plan has been released.
Medicare/CMS News
Monday, 08 December 2008
Portions significant to physicians, especially chiropractors, will be posted on the FCA website. These broad measures will look at the appropriate use of AT and GA modifiers and the adequacy of documentation to substantiate the necessity of care, including billed excluded services.
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OIG 2009 Work Plan Summary
Medicare/CMS News
Friday, 05 December 2008

Medicare's Office of Inspector General has released their 2009 Work Plan.  The entire work plan is 115 pages. Check out the whole plan or the portions applicable to Chiropractors.

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Administrative Appeals for Medicare Provider Enrollment
Medicare/CMS News
Friday, 18 April 2008
(Good News for members having difficulties enrolling in Medicare)
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FCA Q&A: DCs Treating Medicare Patients in Assisted Care Facility
Medicare/CMS News
Sunday, 05 June 2005
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