At Manage My Practice we like to keep our posts informative and actionable – and not political. I’ve tried to provide the facts about the reforms, and how they could affect your patients and staff in an unbiased and professional manner – exactly how you would present them as an administrator. I hope you find it useful. – Abe
The process of passing and implementing a law is a long and winding road, but President Obama’s Healthcare Reforms cleared a significant hurdle on Thursday when the Supreme Court upheld most of the law as constitutional against challenges from many of the states as well as business organizations. You have probably been getting a lot of questions from employees, patients, friends and relatives, and even your providers and colleagues, and they all basically boil down to this: How does the law affect me?
Two milestone Acts were approved by Congress this week and both will be presented to President Obama for his signature shortly.
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What he will be signing:
The “Medicare and Medicaid Extenders Act of 2010” This legislation freezes Medicare physician payments at current rates through the end of 2011. The Act also includes funds for Medicare contractors to pay claims for physician services affected by provisions of the Patient Protection and Affordable Care Act passed last spring. The bill, estimated to cost $19.3 billion over 10 years, will be paid for by changing a provision of the health reform act that provides tax credits for people who buy coverage. President Obama released a statement saying: “It’s time for a permanent solution that seniors and their doctors can depend on and I look forward to working with Congress to address this matter once and for all in the coming year.
“Red Flag Program Clarification Act of 2010” changes the Red Flags Rule’s definition of “creditor” and relieves doctors from complying with the Federal Trade Commission’s identity theft prevention law.
The Center for Healthcare Transformation may not be my organization of choice, but they’ve put together an excellent timeline of the PPAC (Patient Protection and Affordable Care Act), also called the ACA or Affordable Care Act.
The timeline shows what’s happening in regards to Medicare, Medicaid, public health, insurance, Indian health, taxes and government programs. You can slide the timeline forward or backward and jump around in hourly, daily, weekly, monthly, quarterly, yearly, etc. increments. It gives you a wonderful sense of the Big Picture. It is also being constantly updated.
And, for a quick look at the ACA changes happening as of September 23, 2010, you can watch a short video that I made for the “? of the Day” tab above. I thought this tab was getting just a bit boring, so I thought I would post short animations there that readers could share with staff or whomever for infotainment. I posted the first video under the “? of the Day” tab and also here for your convenience.
Providers have the opportunity to participate with Medicare once annually. This period called “Open Enrollment” is usually from mid-November to the end of the calendar year. Providers who may have declined to participate with Medicare for the 2010 calendar year due to the anticipated deep cuts in the physician Medicare fee schedule now have a special opportunity to jump on board between now and July 16, 2010. Here is the announcement:
Dear Medicare Part A and Part B Providers,
Opportunity for Nonparticipating Physicians/Practitioners to Become Participating
In consideration of the recent enactment of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which established a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS), the Centers for Medicare & Medicare Services (CMS) is offering physicians and other practitioners, whose current participation status is non-participating, the opportunity to become participating (PAR). This opportunity is being offered only to those physicians/practitioners whose current PAR status is non-participating. This opportunity is available through July 16, 2010.
Non-participating physicians/practitioners who would like to become a participating physician/practitioner should download and complete the Medicare Participating Physician or Supplier Agreement (Form CMS-460). The form can be obtained by using the following CMS web site link: http://www.cms.gov/cmsforms/downloads/cms460.pdf.
Any new CMS-460 form received during this limited enrollment period will be retroactive for claims with dates of service of January 1, 2010, and later. However, the change in participation status will only apply to new MPFS claims submitted after your new status as a participating physician/practitioner is processed. Claims previously submitted and processed will not be adjusted for only a change in participation status.
Medicare claims administration contractors (Medicare Administrative Contractors and carriers) will accept and process requests to become a participating physician/practitioner that are submitted on the CMS-460 form and are post-marked on or before July 16, 2010.