Holding April 2014 Claims Paid Under MPFS

The MLN Connects™ Provider eNews contains important news, announcements, and updates for health care professionals. Friday, March 28, 2014 Information Regarding the Holding of April 2014 Claims for Services Paid Under the 2014 Medicare Physician Fee Schedule The 2014 Medicare Physician Fee Schedule (MPFS) final rule stipulated a negative update to the MPFS that was to be effective January 1, 2014. That reduction was averted for three months with the passage of the Pathway for SGR Reform Act of 2013, which provided for a 0.5 percent update for services paid under the MPFS through March 31, 2014. CMS is hopeful that there will be congressional action to prevent the negative update from taking effect onApril 1, 2014. CMS has instructed the Medicare Administrative Contractors to hold claims containing services paid under the MPFS for the first 10 business days of April (i.e., through April 14, 2014). This hold would only affect MPFS claims with dates of service of April 1, 2014, and later. The hold should have minimal impact on provider cash flow, because under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 days for paper claims) after the date of receipt. All claims for services delivered on or before March 31, 2014, will be processed and paid under normal procedures, regardless of any Congressional actions. Please share this important information with your colleagues and encourage them to subscribe to the eNews.  Previous issues are available in the archive.

Administrative Simplification News: EFT/ERA Options for Providers to Receive Payments

Electronic Funds Transfer: What Providers Need to Know With Administrative Simplification operating rules in place, the Centers for Medicare & Medicaid Services (CMS) encourages providers to consider their option to receive electronic funds transfer (EFT) payments through the Automated Clearing House (ACH) Network. The ACH Network is the standard format for EFT and electronic remittance advice (ERA) transactions. This standard format allows providers to fill out a single enrollment form for participation in EFT and ERA across different health plans. As of January 1, 2014, health plans are required to comply with provider requests to use the ACH Network to conduct EFT and ERA transactions. Providers need to know that health plans may not: Delay or reject an EFT or ERA transaction because it is a standard Charge an excessive fee or otherwise give providers incentives to use an alternative payment method to EFT via the ACH Network Providers who choose not to use the ACH Network may continue to receive payments by check, Fedwire, and other payment networks. For any payment method, CMS recommends that providers carefully review the agreements for any added fees. To find out more about operating rules and EFT and ERA, see the: Newly posted FAQ 9778 on www.cms.gov The Administrative Simplification Online Guide available as part of the CMS eHealth University Administrative Simplification resources from the American Medical Association, including theElectronic Funds Transfer Toolkit and Electronic Remittance Advice Toolkit Subscriber Services: Manage Preferences | Unsubscribe

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.

CMS MLN Connects™ Weekly Provider eNews: Registration for the PQRS Group Practice Reporting Option, Important EHR Incentive Program Deadlines, & More

Thursday March 27, 2014                                     Get the latest information on registration for the PQRS Group Reporting Option, EHR Incentive Program deadlines, and more in this week's eNews. Click to view the complete issue of the MLN Connects™ Provider eNews for March 27, 2014.     Is the eNews Meeting Your Needs? Give Us Your Feedback!

Please share this important information with your colleagues and encourage them to subscribe to the eNews.              Previous issues are available in the archive.

ICD-10 Update: Register Today for the CMS/HIMSS Webinar on ICD-10

News Updates | March 27, 2014
Join the ICD-10 Webinar on April 2nd Are you ready for ICD-10? To help you prepare, CMS and the Healthcare Information and Management Systems Society (HIMSS) will present a webinar on Wednesday, April 2, from 1:00 p.m. to 2:00 p.m. ET. This webinar will feature CMS representatives who will discuss: What you need to do to get ready for the October 1, 2014, ICD-10 compliance date Key steps to ensure a successful transition Resources to help with a smooth implementation CMS will also demonstrate the new “Road to 10” tool, available on the Provider Resources page of the CMS ICD-10 website. Developed in collaboration with physicians, the tool helps clinical practices create a customized action plan for ICD-10. A portion of the webinar will be dedicated to Q&A. How to Register Register through HIMSS to participate in the ICD-10 Webinar. Once registration is complete, you will receive a follow-up email with instructions on how to log-in to the webinar. Space is limited so register today! Keep Up to Date on ICD-10 Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, compliance date. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
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CMS MLN Connects™ Weekly Provider eNews: Medicare Shared Savings Program, ICD-10, & More

Thursday March 20, 2014                                                               Get the latest information on the Medicare Shared Savings Program, ICD-10 and more in this week's eNews.                    Click to view the complete issue of the MLN Connects™ Provider eNews for March 20, 2014.     Is the eNews Meeting Your Needs? Give Us Your Feedback!

Please share this important information with your colleagues and encourage them to subscribe to the eNews.              Previous issues are available in the archive.

Administrative Simplification News: Health Plan Certification of Compliance Comment Period Extended

Health Plan Certification of Compliance Comment Period Extended toApril 3 The Department of Health and Human Services (HHS) has extended the comment period for the proposed rule, “Administrative Simplification: Health Plan Certification of Compliance.” HHS is specifically looking to receive additional comments from third party administrators (TPAs) and self-insured plans. HHS is now accepting public comments on the proposed rule through April 3, 2014. The Certification of Compliance for Health Plans proposed rule is different from previous Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification regulations because it affects more and different types of entities. For example, many third party administrators, self-funded health plans, and group health plans that have not been impacted by previous HIPAA Administrative Simplification requirements will be affected by this rule, even if they do not directly conduct HIPAA covered transactions. The proposed rule would require controlling health plans to submit documentation on or before December 31, 2015. It would also establish penalty fees for a controlling health plan that fails to comply with the Certification of Compliance requirements. The goal of the extension of the comment period is to provide these entities with time to understand and offer feedback on the business impacts of the Certification of Compliance proposed rule. HHS encourages these entities to submit feedback so that their comments and suggestions can be considered during the policy-making process. Subscriber Services: Manage Preferences | Unsubscribe

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.

 

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ICD-10 News: Road to 10 Provider Tool

News Updates | March 17, 2014
Road to 10: The Small Physician Practice's Route to ICD-10 The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the  release of the Road to 10, a free online resource built with the help of physicians in small practices. Available on the Provider Resources page at cms.gov/ICD10, this tool is intended to help small medical practices jumpstart their ICD-10 transition. The Road to 10 gives providers the capability to build ICD-10 action plans tailored for their practice needs. The customized action plans break down the transition into concrete steps: Plan Your Journey – Look at the codes you use, prepare a budget, and  build a team; Train Your Team – Find options and resources to help your team get ready for the transition; Update Your Processes – Check  your clinical documentation and update policies, procedures, systems, and forms; Engage Your Partners – Talk to your software vendors, clearinghouses, and billing services; and Test Your Systems and Processes – Test within your practice and with your partners. The tool is designed for use by small practices in primary care as well as all specialties. The Road to 10’s resources include common ICD-9 and ICD-10 codes, clinical documentation primers, and clinical scenarios for: Family practice Internal medicine Pediatrics OB/GYN Cardiology Orthopedics Keep Up to Date on ICD-10 Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, compliance date. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
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ICD-10 News: MLN Matters Article on End-to-End Testing

News Updates | March 14, 2014
MLN Matters Article on End-to-End Testing The Centers for Medicare & Medicaid Services (CMS) is committed to supporting health care organizations across the country as they prepare for the ICD-10 transition on October 1, 2014. As part of these efforts, CMS has planned several testing initiatives, including acknowledgment testing and end-to-end testing. The Medicare Learning Network has released MLN Matters Number MM8602 with information on the ICD-10 end-to-end testing process. The article includes detailed instructions for providers and clearinghouses on how to volunteer to be chosen for end-to-end testing with Medicare in July 2014. If you are interested in participating, contact your Medicare Administrative Contractor (MAC). You can find your MAC by selecting your state on the MAC website. You must complete the ICD-10 end-to-end testing volunteer form by March 24, 2014. If you have any questions, contact your MAC through their website or at their toll-free number. Keep Up to Date on ICD-10 Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, compliance date. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
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