Helping Physicians Navigate The Healthcare Industry: March 2011

Thursday, March 31, 2011

“Capped Rental DME: Enforcement of Payment Requirements for Beneficiary-Owned Capped Rental Durable Medical Equipment” Revised

MLN Matters® Special Edition Article #SE1103 – titled “Capped Rental DME: Enforcement of Payment Requirements for Beneficiary-Owned Capped Rental Durable Medical Equipment (DME)” – has been revised to show that oxygen equipment requirements were significantly changed on Thu Jan 1, 2009, as a result of Change Request #6297. For more information, please read the article at http://www.CMS.gov/MLNMattersArticles/downloads/SE1103.pdf.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

“Summary Information Regarding Medicare's Primary Care Incentive Payment Program” Released

MLN Matters® Special Edition Article #SE1109 – titled “Summary Information Regarding Medicare's Primary Care Incentive Payment Program (PCIP)” – has been released to clarify Medicare’s primary care incentive program. This article is based on Section 5501(a) of the Affordable Care Act, which provides for an incentive payment for primary care services furnished on or after Sat Jan 1, 2011, and before Fri Jan 1, 2016, by a primary care physician or non-physician practitioner. For more information, please read the article at http://www.CMS.gov/MLNMattersArticles/downloads/SE1109.pdf.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

HIPAA 101: The Basics of HIPAA Administrative Simplification

Uploaded by PublicResourceOrg on Jun 6, 2009

Health Care Financing Administration

HIPAA 101: The Basics of HIPAA Administrative Simplification
AVA21211VNB1, 2003

HIPAA 101 is a video program designed to inform the health care provider community about the administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996 or HIPAA. In addition to creating consumer protection for health care benefits, HIPAA standardizes financial and administrative health transactions for privacy and security.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Wednesday, March 30, 2011

Miami: Medicare Fraud Summit Preventing Health Care Fraud

Uploaded by USGOVHHS on Jul 19, 2010

Regional Medicare Fraud Prevention Summit - Miami, FL.
July 16, 2010

-Peter Budetti, Deputy Administrator for Program Integrity, CMS, Moderator
-Lewis Morris. Chief Counsel to the Inspector General, HHS
-Peter Weissman, MS, FACP, FACE, Associate Clinical Professor-Medicine and Endocrinology, University of Miami Milller School of Medicine
-Kathy Reep, Vice President/Financial Services, Florida Hospital Association
-Louis Saccoccio, Executive Director, National Health Care Anti-Fraud Association
URL: http://www.stopmedicarefraud.gov/index.html
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
U.S. Department of Health & Human Services (HHS)
http://www.hhs.gov

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

New Information for Compliance Officers and Billing and Coding Professionals

As part of ongoing efforts by CMS to keep Medicare Fee-For-Service providers aware of new and improved products, CMS encourages you to visit the Provider Compliance MLN web page, where you will find FFS provider materials to help you understand – and avoid – common billing errors and other improper activities identified through claim review programs. Be sure to pay particular attention to the listing of Provider Compliance National Educational Products, from which you can quickly link to each available product. Also take a moment to review the first two issues of the Medicare Quarterly Provider Compliance Newsletter (Volume 1, Issue 1 and Volume 1, Issue 2). And like all MLN products, our downloadable compliance materials are available at no cost.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Tuesday, March 29, 2011

The Version 5010 Transaction Standards Deadline Is Approaching. Are You Ready?

There are less than 10 months until all HIPAA-covered entities need to transition from Version 4010/4010A1 to Version 5010 electronic transaction standards. With the January 1, 2012, deadline quickly approaching, have you taken the necessary steps to get ready?
Unlike the current Version 4010/4010A1, Version 5010 accommodates the ICD-10 codes and must be in place first before the changeover to ICD-10 on October 1, 2013. Version 5010 has the ability to tell your practice management or other system that you are using an ICD-10 versus an ICD-9 code.
A key step in preparing your office for this upgrade is testing transactions in the new Version 5010 format. If you have not already done so, you should begin external Version 5010 testing now.
Testing transactions using Version 5010 standards will assure that you are able to send and receive compliant transactions effectively. Testing will also allow you to identify any potential issues and address them in advance of the January 1, 2012, compliance date.
Keep Up to Date on Version 5010 and ICD-10.
CMS has resources to help you prepare. Visit http://links.govdelivery.com/track?type=click&enid=bWFpbGluZ2lkPTEyODMzODEmbWVzc2FnZWlkPVBSRC1CVUwtMTI4MzM4MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY1OTcxOTYmZW1haWxpZD1qdWxpYW5uZS5tdWkyQGNtcy5oaHMuZ292JnVzZXJpZD1qdWxpYW5uZS5tdWkyQGNtcy5oaHMuZ292JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&100&&&http://www.cms.gov/ICD10 and click on "Version 5010."

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us/ or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

"Recovery Audit Program Demonstration High-Risk Medical Necessity Vulnerabilities for Inpatient Hospitals” Podcast Released!

The Medicare Learning Network® has released the first in a series of podcasts designed to educate Fee-For-Service providers about how to avoid common billing errors and other improper activities when dealing with the Medicare Program. This podcast – titled “Recovery Audit Program (RAP) Demonstration High-Risk Medical Necessity Vulnerabilities for Inpatient Hospitals” – is based on MLN Matters Article #SE1027 and discusses some of the 17 findings identified by the RAP in an effort to prevent future improper payment issues. To download this podcast, visit the MLN Multimedia webpage at http://www.CMS.gov/MLNProducts/MLM/list.asp and click on ‘Provider Compliance’ from the list of topics. Stay tuned for future podcasts from the MLN!

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us/ or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Implementation of Provider Enrollment Provisions in CMS-6028-FC” Released

MLN Matters® Article #MM7350 – titled “Implementation of Provider Enrollment Provisions in CMS-6028-FC” – which explains how Medicare will implement certain provisions cited in CMS-6028-FC, as outlined in Change Request #7350, is now available at http://www.CMS.gov/MLNMattersArticles/downloads/MM7350.pdf. These provisions, effective Fri Mar 25, 2011, include [1] establishment of provider enrollment screening categories, [2] submission of application fees, [3] suspensions of payment based on credible allegations of fraud, and [4] authority to impose a temporary moratorium on the enrollment of new Medicare providers and suppliers of a particular type in a geographic area.

To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us/ or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Monday, March 28, 2011

EMR/EHR: Medicare Incentives in the HITECH Act

Uploaded by TheFoxGroup on Oct 19, 2009

Point by point overview for physician practices regarding the incentives, eligibility rules, and deadlines in the HITECH Act.

Medicare Attestation Begins on April 18. Are You Ready?

Attestation for the Medicare Electronic Health Record (EHR) Incentive Program begins on April 18, 2011. In order to receive your Medicare EHR incentive payment, you must attest through CMS' web-based Medicare and Medicaid EHR Incentive Programs Registration and Attestation System.

Today you can preview selected screenshots of the Attestation System to help you understand what the attestation process will involve. Please note that these screenshots are only examples—the final appearance and language may incorporate additional changes.

CMS will release additional information about the Medicare attestation process soon, including User Guides that provide step-by-step instructions for completing attestation, and educational webinars that describe the attestation process in depth.

Here is more information to help you prepare for Medicare attestation:
You need to understand the required meaningful use criteria to successfully attest. Meaningful use requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare EHR Incentive Program are different:
EP Meaningful Use Criteria – Must report on 15 core measures, 5 of 10 menu measures, and 6 clinical quality measures, consisting of 3 required core measures and 3 additional measures.
Go to the Stage 1 EHR Meaningful Use Specification Sheets for EPs for information on core and menu measures for EPs.
Go to the Clinical Quality Measures page for information on the required clinical quality measures for EPs.
Eligible Hospital and CAH Meaningful Use Criteria – Must report on 14 core measures, 5 of 10 menu measures, and 15 clinical quality measures.
Go to the Stage 1 EHR Meaningful Use Specification Sheets for Eligible Hospitals and CAHs for information on core and menu measures for eligible hospitals and CAHs.
Go to the Clinical Quality Measures page for information on the required clinical quality measures for eligible hospitals and CAHs.
You should also make sure that you begin your 90-day reporting period in time to attest and receive a Medicare payment in 2011. The last day to begin your 90-day reporting period for 2011 incentive payments is:
July 3, 2011, for eligible hospitals and CAHs, and
October 1, 2011, for EPs.

Under the Medicaid EHR Incentive Programs, the date when participants can begin attestation for adopting, implementing, upgrading, or demonstrating meaningful use of certified EHR technology varies by state. Go to the Medicaid State EHR Incentive Program web tool for more information about your state's participation in the Medicaid EHR Incentive Program.

Want more information about the EHR Incentive Programs?
Make sure to visit the CMS EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

National Provider Call on Medicare FFS Implementation of HIPAA Version 5010 and D.0 Transactions

Wed Mar 30, 2-3:30pm EDT

The Centers for Medicare & Medicaid Services’ Provider Communications Group will host its fifteenth national education call regarding Medicare Fee-For-Service’s implementation of HIPAA Version 5010 and D.0 transaction standards on Wed Mar 30. This call is primarily intended for vendors, clearinghouses, and providers who need to make Medicare FFS-specific changes in compliance with HIPAA Version 5010 requirements. The presentation will be followed by a Q&A session.

CMS will be making use of a webinar as part of this national conference call (details follow below). This feature will allow participants to follow the presentation online as it is given as well as the opportunity to answer polling questions during the presentation. This will not have any effect on those participants who are only dialing in to the audio portion of the call. Those who are not participating in the webinar should be sure to download the presentation for the call in advance from http://www.CMS.gov/Versions5010andD0/V50/list.asp.

In order to receive the call-in information, you must register for the call. (Note that if you are planning to sit in with a group, only one person needs to register to receive the call-in information. Note also that, if you plan to request continuing education credit from your professional organization and proof of registration is required, you will need to personally register so that you receive a confirmatory email.)

Registration will close at 2pm EST on Tue Mar 29 or when available space has been filled; no exceptions will be made, so please register early. To register for the call:
Visit http://www.eventsvc.com/palmettogba/033011.
Fill in all required information and click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Please save this page, in the event that your server blocks the confirmation emails. (If you do not receive the confirmation email, check your spam/junk mail filter as it may have been directed there.)
If assistance for hearing impaired services is needed, the request must be sent to medicare.ttt@palmettogba.com no later than 3 business days before the event.

At the time of the call, you will first dial in for the call audio, then (if you are participating in the webinar) direct your browser to https://webinar.CMS.hhs.gov/MedicareFFS5010 and sign in using your full name (entering as a guest). (No software is necessary to participate in the web-based webinar but, if you have not done so before, please test your computer and connection in advance by visiting https://webinar.CMS.hhs.gov/common/help/en/support/meeting_test.htm.)

If you would like to submit a question related to this topic after registration closes, please email your inquiry to our new 5010 FFS Information resource box at 5010FFSinfo@cms.hhs.gov. Note that this resource box will only accept emails from the close of registration through one business day following the call. Your emailed questions will be answered as soon as possible, and may or may not be answered during the call.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Sign Up for the CMS ICD-10 Industry Update Messages

Did you know that the Centers for Medicare & Medicaid Services has an email update specific to ICD-10 that you can sign up for?

The CMS ICD-10 Industry Email Update provides subscribers with timely information about the upcoming Version 5010 and ICD-10 transitions. Each message is delivered directly to your email inbox, supplying helpful reminders, information on new resources, and other ICD-10 and Version 5010 news. Recent messages have covered important topics, such as:
The partial code freeze prior to ICD-10 implementation,
External testing of Version 5010 transaction standards, and
The General Equivalence Mappings (GEMs).

To sign up for the ICD-10 Industry Email Updates, or to view previous email updates, visit http://www.CMS.gov/ICD10/02d_CMS_ICD-10_Industry_Email_Updates.asp. To keep up to date on Version 5010 and ICD-10, and for the latest news and resources, be sure to keep current with http://www.CMS.gov/ICD10.

Version 5010 and ICD-10 are coming. Will you be ready?

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Sunday, March 27, 2011

Geithner Addresses Social Security and Medicare Issues - Bloomberg

Uploaded by Bloomberg on May 12, 2009

Live! From Washington D.C. - Treasury Secretary Timothy Geithner Holds News Conference (Bloomberg News)

Saturday, March 26, 2011

How Medicare Works with Social Security Disability

Uploaded by CMSHHSgov on Sep 23, 2010

This segment explains how the Medicare program works for people who qualify for Social Security Disability. It describes Medicare coverage under Medicare Parts A, B, C, and D.

Important Information on the Timely Claims Filing Requirement

The Centers for Medicare & Medicaid Services (CMS) would like to remind Medicare Fee-For-Service physicians, providers and suppliers submitting claims to Medicare for payment, as a result of the Patient Protection and Affordable Care Act (PPACA), effective immediately, all claims for services furnished on or after Jan 1, 2010, must be filed with your Medicare contractor no later than one calendar year (12 months) from the date of service – or Medicare will deny them.

In general, the start date for determining the 1-year timely filing period is the date of service or “From” date on the claim. For institutional claims that include span dates of service (i.e., a “From” and “Through” date on the claim), the “Through” date on the claim is used for determining the date of service for claims filing timeliness. For claims submitted by physicians and other suppliers that include span dates of service, the line item “From” date is used for determining the date of service for claims filing timeliness.

For additional information about the new maximum period for claims submission filing dates, contact your Medicare contractor, or review the MLN Matters articles listed below related to this subject:
§ MM6960 – “Systems Changes Necessary to Implement the Patient Protection and Affordable Care Act (PPACA) Section 6404 - Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months” – http://www.cms.gov/MLNMattersArticles/downloads/MM6960.pdf on the CMS website.

§ MM7080 – “Timely Claims Filing: Additional Instructions” – http://www.cms.gov/MLNMattersArticles/downloads/MM7080.pdf on the CMS website.
§ MM7270 – “Changes to the Time Limits for Filing Medicare Fee-for-Service Claims” – http://www.cms.gov/MLNMattersArticles/downloads/MM7270.pdf on the CMS website.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Study and Report on the Development of Home Health Payment Revisions to Ensure Access to Care, and Payment for Severity of Illness

Centers for Medicare & Medicaid ServicesSpecial Open Door Forum: Study and Report on the Development of Home Health Payment Revisions to Ensure Access to Care, and Payment for Severity of IllnessThursday, March 31, 2011 - 1:00 p.m.-2:30 p.m. ET
CMS needs your help identifying beneficiaries who may have difficulty accessing Medicare home health services. We would like to hear about your experiences serving hard to reach populations. Also, we would like you to describe challenges certain beneficiaries may experience in accessing Medicare home health services. This Special Open Door Forum will be dedicated to this very important issue and sharing your first hand experiences. We hope that you will take advantage of this unique and valuable opportunity to help us better define and understand the low-income, underserved and/or high severity beneficiaries for whom the HH PPS may not accurately account and serve. For more information, please download:Home Health Study Literature Reviewhttp://www.cms.gov/HomeHealthPPS/Downloads/HHPPS_LiteratureReview.pdf
Special Open Door Forum Informational Slideshttp://www.cms.gov/HomeHealthPPS/Downloads/HHPPS_StudyODF.pdf

Special Open Door Forum Participation Instructions:
This forum will be available as a streaming audio webcast over the Internet. To register to hear the call over the Internet, visit: http://www.cms.gov/apps/events/event.asp?id=634.
A limited number of phone lines are available for people who wish to ask a question during the Forum, or have technical problems with the audio stream. You can call 1-800-837-1935 at any time after 12:45 p.m. ET and use Conference ID 51381075. You will be able to hear the Forum while you are on hold.

Note:
You can see live closed captioning from the Federal Relay Center at: http://www.fedrcc.us//Enter.aspx?EventID=1733209&CustomerID=321. You must open a second tab or window and use Internet explorer with Flash enabled to access this service. Participants who use the Federal Relay Center, can download a transcript of the closed captioning. Visit: http://www.fedrcc.us/FedRcc/Default.aspx for more information.
For phone users, TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and a Relay Communications Assistant will help.
An Encore audio recording of this call that can be accessed by dialing 1-800-642-1687 and using Conference ID: 51381075. This recording will be available approximately 2 hours after the conference and will be available for 10 days.

An audio recording and transcript of this Special Forum will be posted to the Special Open Door Forum website at: http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning on or around April 15, 2011. For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website athttp://www.cms.gov/opendoorforums/.

Thank you for your interest in CMS Open Door Forums.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Updated list of answers to Frequently asked EHR questions

The Centers for Medicare & Medicaid Services (CMS) published an updated list of answers to frequently asked EHR questions. These questions are in addition to the more than 100 questions about meaningful use requirements, eligibility for participation, and other aspects of the EHR incentive program. The FAQ section provides information on a range of topics, including patient-education resource requirements, specifications for quality reporting and electronic prescribing.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

2011 Electronic Prescribing (eRx) Incentive Program Reminder - Avoiding the Adjustment!

In November, the Centers for Medicare & Medicaid Services announced that, beginning in calendar year 2012, eligible professionals who are not successful electronic prescribers based on claims submitted between January 1, 2011 – June 30, 2011, may be subject to a payment adjustment on their Medicare Part B Physician Fee Schedule (PFS) covered professional services. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes CMS to apply this payment adjustment whether or not the eligible professional is planning to participate in the eRx Incentive Program.

From 2012 through 2014, the payment adjustment will increase each calendar year. In 2012, the payment adjustment for not being a successful electronic prescriber will result in an eligible professional or group practice receiving 99% of their Medicare Part B PFS amount that would otherwise apply to such services. In 2013, an eligible professional or group practice will receive 98.5% of their Medicare Part B PFS covered professional services for not being a successful electronic prescriber in 2011 or as defined in a future regulation. In 2014, the payment adjustment for not being a successful electronic prescriber is 2%, resulting in an eligible professional or group practice receiving 98% of their Medicare Part B PFS covered professional services.

The payment adjustment does not apply if <10% of an eligible professional’s (or group practice’s) allowed charges for the January 1, 2011 through June 30, 2011 reporting period are comprised of codes in the denominator of the 2011 eRx measure.

Please note that earning an eRx incentive for 2011 will NOT necessarily exempt an eligible professional or group practice from the payment adjustment in 2012.

How to Avoid the 2012 eRx Payment Adjustment

· Eligible professionals – An eligible professional can avoid the 2012 eRx Payment Adjustment if (s)he:¾ Is not a physician (MD, DO, or podiatrist), nurse practitioner, or physician assistant as of Jun 30, 2011 based on primary taxonomy code in NPPES;¾ Does not have prescribing privileges. Note: (S)he must report (G8644) at least one time on an eligible claim prior to June 30, 2011;¾ Does not have at least 100 cases containing an encounter code in the measure denominator;¾ Becomes a successful e-prescriber; and¾ Reports the eRx measure for at least 10 unique eRx events for patients in the denominator of the measure.
· Group Practices - For group practices that are participating in eRx GPRO I or GPRO II during 2011, the group practice MUST become a successful e-prescriber.¾ Depending on the group’s size, the group practice must report the eRx measure for 75-2,500 unique eRx events for patients in the denominator of the measure.For additional information, please visit the “Getting Started” webpage at http://www.cms.gov/erxincentive on the CMS website for more information; or download the Medicare’s Practical Guide to the Electronic Prescribing (eRx) Incentive Program under Educational Resources.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Friday, March 25, 2011

Celebrating 45 Years of Medicare (07/30/2010 Webchat)

Uploaded by USGOVHHS on Aug 2, 2010

Donald Berwick, Director of the Centers for Medicare & Medicaid Services, talks about the role Medicare has had in our health care system since it President Lyndon B. Johnson signed Medicare into law 45 years ago.

Related blog post: http://www.healthcare.gov/news/blog/45yrs.html

http://www.healthcare.gov

We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html

U.S. Department of Health & Human Services (HHS)
http://www.hhs.gov

Thursday, March 24, 2011

Medicine Dish: Medicare Part D and Program Updates

Uploaded by CMSHHSgov on Jan 14, 2011

Experts from IHS and CMS discuss Medicare Part D and recent Medicare program changes. Topics include: creditable coverage letters, plan changes for 2011, LIS; redeeming and reassignment, Medicare Plan Enrollment, Medicare program updates, and a demonstration of the new Medicare Plan Finder on www.medicare.gov.

We would like to hear from you. Please send all comments to TribalAffairs@cms.hhs.gov. Thank you.

Wednesday, March 23, 2011

The Medicare Learning Network (MLN): Official CMS Information for Fee-For-Service Providers

CMSHHSgov | Date: Mar 22, 2010

The Medicare Learning Network video contains quick and basic information about CMS Medicare Learning Network and its benefits to providers. The video is suitable for self instruction, as well as exhibits and training events. National and local provider associations are encouraged to post this product on their websites and/or distribute via electronic newsletters or mailing lists.

To order the video on DVD, visit http://www.cms.hhs.gov/MLNGenInfo, scroll down to Related Links Inside CMS and select MLN Product Ordering Page.

New EHR Incentive Program Frequently Asked Questions (FAQs) Posted Online

CMS wants to help you find the answers you need about the Electronic Health Record (EHR) Incentive Programs. Take a minute and review the new FAQs about topics including eligibility, registration, meaningful use and attestation that have been posted to the FAQ section of the EHR Incentive Programs website.

A few of the new FAQs include:

What is the definition of "reasonable cost" for critical access hospitals (CAHs) under the Medicare and Medicaid EHR Incentive Programs?
The reasonable costs for which a CAH may receive an EHR incentive payment are the reasonable acquisition costs for the purchase of certified EHR technology to which purchase depreciation (excluding interest) would otherwise apply. Read the full answer.

How is hospital-based status determined for eligible professionals (EPs) in the Medicare and Medicaid EHR Incentive Programs?
A hospital-based eligible professional (EP) is defined as an EP who furnishes 90% or more of their covered professional services in either the inpatient (Place of Service 21) or emergency department (Place of Service 23) of a hospital. Read the full answer.

For large practices, will there be a method to register all of the EPs at one time for the Medicare or Medicaid EHR Incentive Programs? Can EPs allow another person to register or attest for them?
At this time there is no method available for a third party to register multiple EPs for the Medicare and Medicaid EHR Incentive Programs. Read the full answer.

FAQ Highlights: Registration Questions
To help ensure that your registration process goes smoothly and for your easy reference, we have provided answers below to two of the most common registration questions from our FAQs found on the CMS website.

How will EPs and eligible hospitals apply for incentives under the Medicare and Medicaid EHR Incentive Program?
Registration for the Medicare and Medicaid EHR Incentive Programs began on January 3, 2011. However, the Medicaid Incentive Program is rolled out on a state-by-state basis. An updated schedule of state-planned Medicaid Incentive Program start dates can be found on the CMS website.

If a hospital is eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, how should they register?
If a hospital meets all of the following qualifications, it is dually-eligible for the Medicare and Medicaid EHR Incentive Programs:
It is a subsection(d) hospital in the 50 U.S. States or the District of Columbia, or you are a Critical Access Hospital (CAH), and
It has a CMS Certification Number ending in 0001-0879 or 1300-1399, and
It has 10% of patient volume derived from Medicaid encounters.

Any hospitals that meet these three qualifications, must register for "Both Medicare & Medicaid" when registering for the programs.

Want more information about the EHR Incentive Programs? Keep up to date! Click here to join the CMS EHR Incentive Programs listserv. Make sure to visit the CMS EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Tuesday, March 22, 2011

Medicare physician payments cut 29.5 percent in 2012; MedPAC recommends a 1 percent update

In a letter to the Medicare Payment Advisory Commission (MedPAC), the Centers for Medicare & Medicaid Services (CMS) estimated that Medicare physician payments will be cut by 29.5 percent in 2012, unless Congress intervenes. As required by Congress, each March MedPAC reviews Medicare payment policies and makes recommendations to Congress. The 2011 report includes a payment policy recommendation for a 1 percent increase in physician reimbursements for 2012. The commission has previously stated its opposition to physician payment cuts, and determined the 1 percent increase for 2012 to be fiscally disciplined while preserving beneficiaries’ access to physician and health professional services.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

New York: Medicare Fraud Summit Civil Law Panel

USGOVHHS | Nov. 5, 2010

HHS Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder host the third in a series of Health Care Fraud Prevention Summits in Brooklyn, NY.

More info at: http://www.stopmedicarefraud.gov/index.html

We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html

U.S. Department of Health & Human Services (HHS)
http://www.hhs.gov

To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555 begin_of_the_skype_highlighting 1 888-428-2555 end_of_the_skype_highlighting, Ext. 200.

Red Flags Rule update: court rules on definition of “creditor”

In the latest development in the long debate over enforcement of the Red Flags Rule, the D.C. Circuit Court has ruled that the Federal Trade Commission’s (FTC’s) definition of a creditor as any entity that defers payment is no longer valid. The Red Flags Rule, established after the Fair and Accurate Credit Transactions Act, requires creditors that maintain covered accounts to adopt an identity theft prevention program. After release of the rule, the FTC maintained that it applied to any entity that defers payment, including healthcare providers, who bill monthly or defer billing their patients until after submitting claims to insurers.

This ruling came after the American Bar Association (ABA) sued the FTC in an effort to exclude lawyers from the rule. In December, Congress intervened by passing the Red Flag Program Clarification Act, which changed the definition of a creditor. Because of this, the Court found that the ABA’s lawsuit was moot since Congress’s definition of a creditor supersedes the FTC’s.

Under the act, creditors subject to the rule are those that use information from or report information to consumer reporting agencies as well as those who advance funds. The act also allows the FTC to develop a new regulation aimed at creditors that offer or maintain accounts where there is a foreseeable risk of identity theft. Based on the recent court decision, the FTC will need to go through a formal notice-and-comment rulemaking process in order to include healthcare providers in the definition of a “creditor” subject to the rule.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Monday, March 21, 2011

Health Insurance & Medicare : Who Must Comply With HIPAA?

Uploaded by eHow on Jul 5, 2009

HIPAA is the Health Insurance Portability and Accountability Act, and any health provider or health clearinghouse is covered by the HIPAA. Discover how HIPAA was designed to protect personal health information with help from a financial services specialist in this free video on the Health Insurance Portability and Accountability Act.

Expert: William Rae
Contact: www.hbwfl.com
Bio: William Rae has been licensed in the insurance and financial fields for over 30 years.
Filmmaker: Christopher Rokosz

Saturday, March 19, 2011

2011 Electronic Prescribing (eRx) Incentive Program Reminder - Avoiding the Adjustment!

In November, the Centers for Medicare & Medicaid Services announced that, beginning in calendar year 2012, eligible professionals who are not successful electronic prescribers based on claims submitted between January 1, 2011 – June 30, 2011, may be subject to a payment adjustment on their Medicare Part B Physician Fee Schedule (PFS) covered professional services. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes CMS to apply this payment adjustment whether or not the eligible professional is planning to participate in the eRx Incentive Program.

From 2012 through 2014, the payment adjustment will increase each calendar year. In 2012, the payment adjustment for not being a successful electronic prescriber will result in an eligible professional or group practice receiving 99% of their Medicare Part B PFS amount that would otherwise apply to such services. In 2013, an eligible professional or group practice will receive 98.5% of their Medicare Part B PFS covered professional services for not being a successful electronic prescriber in 2011 or as defined in a future regulation. In 2014, the payment adjustment for not being a successful electronic prescriber is 2%, resulting in an eligible professional or group practice receiving 98% of their Medicare Part B PFS covered professional services.

The payment adjustment does not apply if <10% of an eligible professional’s (or group practice’s) allowed charges for the January 1, 2011 through June 30, 2011 reporting period are comprised of codes in the denominator of the 2011 eRx measure.

Please note that earning an eRx incentive for 2011 will NOT necessarily exempt an eligible professional or group practice from the payment adjustment in 2012.

How to Avoid the 2012 eRx Payment Adjustment

· Eligible professionals – An eligible professional can avoid the 2012 eRx Payment Adjustment if (s)he: Is not a physician (MD, DO, or podiatrist), nurse practitioner, or physician assistant as of Jun 30, 2011 based on primary taxonomy code in NPPES;¾ Does not have prescribing privileges. Note: (S)he must report (G8644) at least one time on an eligible claim prior to June 30, 2011; Does not have at least 100 cases containing an encounter code in the measure denominator; Becomes a successful e-prescriber; and Reports the eRx measure for at least 10 unique eRx events for patients in the denominator of the measure.
· Group Practices - For group practices that are participating in eRx GPRO I or GPRO II during 2011, the group practice MUST become a successful e-prescriber. Depending on the group’s size, the group practice must report the eRx measure for 75-2,500 unique eRx events for patients in the denominator of the measure.For additional information, please visit the “Getting Started” webpage at http://www.cms.gov/erxincentive on the CMS website for more information; or download the Medicare’s Practical Guide to the Electronic Prescribing (eRx) Incentive Program under Educational Resources.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

What is Medicare, What is Medicaid and What is the Difference?

Uploaded by DudeckLawFirm on Dec 22, 2010

If you are on social security you probably have Medicare Part B premiums taken out of your social security check each month. This is just like other health insurance where you pay a monthly premium and when you go to the doctor you have Medicare deductibles and co-pays. This covers most of a retired person's medical bills but not prescription drugs. Therefore many people purchase a Medicare Supplement which pays the Medicare deductibles and co-pays. Blue-Cross Blue-Shield, AARP and Humana, among others are companies who sell this type of Medicare Supplemental Insurance. In addition many retired persons have purchased a Medicare Part D insurance which covers the expenses of prescription drugs. Again Medicare Part D insurance has deductibles and co-pays which you pay out of pocket. In summary Medicare is a health insurance with monthly insurance premiums. Medicaid is different. Medicaid is an entitlement program. You must apply for and qualify for Medicaid. There are income limitations and asset limitations so your qualification is not automatic. Most people qualify income wise but do not qualify asset wise. If you are single and want to qualify for Medicaid to pay for your nursing home costs you can own a home, a car and $2,000 in money and other assets. Most people have more money than this. Most will need to do some planning and get some advice to help them arrange their affairs so they qualify as quickly as possible. Taking just two or three months to figure all this Medicaid stuff out can cost a person $4,000 to $5,000 per month in nursing home bills. Therefore a mistake in applying for Medicaid can cost a person $8,000 or $12,000 or more because they had one asset too many and now they have to start the application process all over. In the mean time they must continue to pay the Nursing Home $4,000 to $5,000 per month. The learning curve can get very expensive which can make hiring an Elder Law Firm look very economical.

Physician Compare Initiative Web Page is Now Available

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that the Physician Compare Initiative Web page is now available.

The Physician Compare Initiative Web page is a resource related to the Physician Compare Website specifically for physicians and eligible professionals. The web page will contain information that is deemed of interest to the healthcare professional community, including CMS sponsored forums and links to other applicable resources.

The Physician Compare Website was launched December 30, 2010, to meet requirements set forth by Section 10331 of the Patient Protection and Affordable Care Act of 2010. For more information on the Physician Compare Website visit http://www.medicare.gov/find-a-doctor/provider-search.aspx on the internet.

For more information on the Physician Compare Initiative, visit http://www.cms.gov/physician-compare-initiative/01_overview.asp on the CMS website.
This newly established web page will be updated regularly, so check it often for timely and reliable information from CMS.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

REMINDER: Important Information on the Timely Claims Filing Requirement

The Centers for Medicare & Medicaid Services (CMS) would like to remind Medicare Fee-For-Service physicians, providers and suppliers submitting claims to Medicare for payment, as a result of the Patient Protection and Affordable Care Act (PPACA), effective immediately, all claims for services furnished on or after Jan 1, 2010, must be filed with your Medicare contractor no later than one calendar year (12 months) from the date of service – or Medicare will deny them.
In general, the start date for determining the 1-year timely filing period is the date of service or “From” date on the claim. For institutional claims that include span dates of service (i.e., a “From” and “Through” date on the claim), the “Through” date on the claim is used for determining the date of service for claims filing timeliness. For claims submitted by physicians and other suppliers that include span dates of service, the line item “From” date is used for determining the date of service for claims filing timeliness.
For additional information about the new maximum period for claims submission filing dates, contact your Medicare contractor, or review the MLN Matters articles listed below related to this subject:
§ MM6960 – “Systems Changes Necessary to Implement the Patient Protection and Affordable Care Act (PPACA) Section 6404 - Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months” – http://www.cms.gov/MLNMattersArticles/downloads/MM6960.pdf on the CMS website.

§ MM7080 – “Timely Claims Filing: Additional Instructions” – http://www.cms.gov/MLNMattersArticles/downloads/MM7080.pdf on the CMS website.
§ MM7270 – “Changes to the Time Limits for Filing Medicare Fee-for-Service Claims – http://www.cms.gov/MLNMattersArticles/downloads/MM7270.pdf on the CMS website.

You can also listen to a podcast on this subject by visiting http://www.cms.gov/CMSFeeds/02_listofpodcasts.asp on the CMS website.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Register for National Call on Medicare EHR Incentive Program Registration for Eligible Professionals

(Fri Apr 1, 1:30-3pm EST)

On Fri Apr 1, from 1:30 – 3 PM , the CMS Provider Communications Group will host a national provider education call for eligible professionals about registration for the Medicare Electronic Health Records (EHR) Incentive Program, which will cover the following topics and have a question and answer session.

Eligibility for Incentives
Switching between the Medicare and Medicaid Incentive Programs
Reassigning Payments
Pre-Registration
Registration
Helpful Resources

In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation.

Registration will close at 1:30 p.m. ET on March 31, 2011, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.

To register for the call participants need to go to: http://www.eventsvc.com/palmettogba/040111
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation e-mail shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation e-mails. If you do not receive the confirmation e-mail, please check your spam/junk mail filter as it may have been directed there.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business days before the event.

Prior to each call, presentation materials will be available in the Upcoming Events section of the Spotlight Page on the CMS EHR website.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Friday, March 18, 2011

Joint Budget Hearing on Health & Medicaid - March 3, 2011

Uploaded by nysenateuncut on Mar 3, 2011

Joint Budget Hearing on Health & Medicaid - March 3, 2011

Grassley speaks out about Medicare and Medicaid fraud

Uploaded by SenChuckGrassley on Mar 2, 2011

Senator Chuck Grassley speaks out about Medicare and Medicaid fraud during his speech on the U.S. Senate floor on Wednesday, March 2, 2011.

New Information Now Available on the ICD-10 MS-DRG Conversion Project Website

The ICD-10 Medicare Code Editor v27 and a text version of the ICD-10-CM/PCS MS-DRGv28 Definitions Manual are now posted on the Centers for Medicare & Medicaid Services (CMS) website at http://www.cms.gov/ICD10/17_ICD10_MS_DRG_Conversion_Project.asp in the “Downloads” section. There are also links to order the MS Grouper with Medicare Code Editor ICD-10 Pilot Software Version 28 on CD-ROM from National Technical Information Service (NTIS) in the “Related Links Outside CMS” section of the web page.

This update is part of the ICD-10 MS-DRG Conversion Project. In the Conversion Project, CMS is using the General Equivalence Mappings (GEMs) to convert CMS payment systems. CMS is sharing information learned from this project with other organizations facing similar conversion projects. Please note that the final ICD-10 MS-DRGs will be subject to formal rulemaking.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Thursday, March 17, 2011

Provider Compliance Group National Outreach

Centers for Medicare & Medicaid Services
Listening Session Series:
March 22-24, 2011

The Centers for Medicare & Medicare Services (CMS) would like to announce three national outreach listening sessions, called the Provider Compliance Group (PCG) Outreach Calls that will focus on several Office of the Inspector General (OIG) released reports. Also, there will be an Outreach and Education session for Chiropractic Care. The purpose of the calls is to educate providers and suppliers on specific vulnerabilities that exist in Durable Medical Equipment (DME), Part A, Part B, and Home Health and Hospice settings related to the reports. These reports can be found on the OIG website at http://oig.hhs.gov/reports.asp .

CMS Contractor, Medical Directors, will identify common topics and themes along with identified billing errors seen to educate on ways provider and supplier behaviors can be changed to ensure full compliance with Medicare policy, billing instructions and medical review guidance.

Based on your understanding of the OIG reports, the PCG Outreach Calls and your real life experience, questions and suggestions of policy, procedure, or practice improvements to prevent improper payments are welcomed. Submit questions and suggestions to the email boxes listed after each call day schedule.

Questions should be submitted to the designated emails below and CMS will provide answers after the series of calls via email. No questions will be taken on the call as these calls are listening sessions. The calls will be broadcasted over the internet with a specific web-link for each call is listed below. See below for the schedule of calls and OIG and Audit reports to be discussed.

A notice regarding how to access the rebroadcast of the calls will soon follow.

Day One - Tuesday, March 22, 2011, 1:00pm to 4:00pm ET

Audience Web-Link: http://webcast.acrobat.com/r.htm?e=296561&s=1&k=BE936C7435C1F82BEB7DE8A67A75DDC8;

Email questions: PCGOUTREACHCALLS.DAYONE@CMS.HHS.GOV;

1.    OEI-05-09-00030 - Inappropriate Medicare Payments for Transforaminal Epidural Injections Services;

2.    OEI-06-06-00580 - Medicare Part B Services During a Non-Part A Nursing Home Stays: Mental Health;

3.    OEI-06-07-00090 - Medicare Part B Services during Non-Part A Nursing Home Stays: Enteral Nutrition Therapy;

4.    A-01-09-00503 - Review of Point Of Service (POS) Coding for Physician Services Processed by Part B Carriers During Calendar Year 2007.

Day Two - Wednesday, March 23, 2011, 1:00pm to 4:00pm ET

Audience Web-Link: http://webcast.acrobat.com/r.htm?e=296567&s=1&k=686C277EEA298133D4767DB9D4A3B708;

Email: PCGOUTREACHCALLS.DAYTWO@CMS.HHS.GOV;

1.    A-01-04-00513 - Medicare Part B Payments for Ambulance Services Rendered to Beneficiaries During Inpatient Stays: 2001 Through 2003;

2.    A-04-09-00059 - Review of Inpatient Rehabilitation Facilities (IRF) Compliance with Medicare Transfer Regulation During Fiscal Year 2004 through 2007;

3.    A-01-09-00504 - Part A ER Department Adjust Nationwide Review of Medicare Part A Emergency Dept Adjustments for Inpatient Psychiatric Facilities During CY 2006 and 2007;

4.    A-01-09-00507 - Nationwide Review of IRF Transmission of Patients’ Assessment Instruments for CY 2006 and 2007.

Day Three - Thursday, March 24, 2011, 1:00pm to 4:00pm ET

Audience Web-Link: http://webcast.acrobat.com/r.htm?e=296629&s=1&k=39F8A595DB5092CD6641D3C0942CB138;

Email: PCGOUTREACHCALLS.DAYTHREE@CMS.HHS.GOV;

1.    OEI-07-08-00550 - A Review of Claims for Capped Rental Durable Medical Equipment;

2.    OEI-02-06-00224 - Questionable Billing for Physicians Services for Hospice Beneficiaries;

3.    OEI-04-09-00540 - Questionable Billing for Medicare Outpatient Therapy Services

4.    Chiropractor Outreach and Education.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

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