The President has recently signed the Department of Defense Appropriations Act of 2010. The Act provides for a 0% update to the 2010 Medicare Physician Fee Schedule (MPFS) through February 28, 2010, a change from the 21% reduction that was set to take effect January 1, 2010. In light of the change, Medicare contractors will hold claims with 2010 dates of services to allow time for the contractors to receive the new payment files and to perform testing. CMS has instructed contractors to begin processing claims under the new MPFS rates no later than January 19, 2010. CMS expects little effect on provider cash flow because, even without the hold, contractors may not pay an electronic claim sooner than 14 calendar days from its date of receipt. More information is available here at CMS’s website.
von Briesen Health Law Blog
December 31, 2009
December 30, 2009
CMS and ONC Issue Regulations Proposing a Definition of ‘Meaningful Use’ and Setting Standards for Electronic Health Record Incentive Program
The proposed regulations are designed to help implement the electronic health record incentive programs enacted under the American Recovery and Reinvestment Act of 2009. CMS encourages comments and provides a 60-day comment period on the proposed rule. Click here to learn more.
December 28, 2009
OCI posts FAQ Bulletin Concerning Mandated Coverage for Autism Services
Wisconsin’s Office of the Commissioner of Insurance posted today a “Frequently Asked Questions” guide concerning Wisconsin Statute section 632.895(12m), requiring certain insurers to cover certain treatments for individuals with autism spectrum disorders. The bulletin answers questions concerning the applicability and scope of the mandate, including services covered, providers that may be used, and claims issues. The mandate applies to certain policies issued or renewed on or after November 1, 2009. Read the full FAQ guide by clicking here.
December 23, 2009
Year End IRS Advice
The IRS has created a guidance document for leaders in nonprofit organizations. Although long and a bit technical, it is a good “one source” reference for a nonprofits’ operations, reporting and tax filing requirements, including what may jeopardize recognition of the nonprofits’ tax exempt status. For your organization or for those nonprofits you serve, review and discussion of the booklet may be a good New Year’s discussion topic, or at least worth sending this document out to the board. We have provided a link so you can download a copy of the document here.
Instructions for Submitting Notice of a Breach to the Secretary
HHS has published instructions for submitting notices of breach of unsecured health information to the Secretary. Nothing unexpected, but here are the specifics:
http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/brinstruction.html
December 18, 2009
The Joint Commission Standard MS01.01.01
Beginning December 17, 2009, The Joint Commission has posted MS.01.01.01 (formerly MS.1.20) for field review. The field review will last six weeks, and the proposed standard is identical to the standard drafted in March 2009 with the help of the AHA, AMA and others. To view the standard and other related TJC information, click here.
December 10, 2009
IRS Develops Examination Materials to Study Exempt Organization Governance
As noted in a previous post, the IRS has developed a two-page check sheet to be used by IRS Exempt Organizations agents to gather data about the governance practices and the related internal controls of tax-exempt organizations under examination. The check sheet contains several questions from the governance section of the revised Form 990. The data will be included in a long-term study that the IRS hopes will create a better understanding of the relationship between governance practices and tax compliance. The check sheet and other governance-related materials are now available on the IRS website.
December 7, 2009
CMS Modifies RAC Document Request Limit
In response to comments from RACs, providers/suppliers and various health care associations, CMS has modified its limit for document requests from the RAC program for FY 2010. To view this modification, see http://www.cms.hhs.gov/RAC/Downloads/DRGvalidationADRlimitforFY2010.pdf.
December 3, 2009
CMS Grants Continued Deeming Authority for The Joint Commission
The Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) has approved the continuation of deeming authority for The Joint Commission’s hospital accreditation program through July 15, 2014.
The CMS designation means that hospitals accredited by The Joint Commission may choose to be “deemed” as meeting Medicare and Medicaid certification requirements. For years, The Joint Commission had automatic deemed status to survey hospitals on behalf of CMS, but in 2008 CMS required The Joint Commission to reapply for this status. As a result, the commission needed to update some of its requirements to more closely align with the Medicare Conditions of Participation. (For example, see our recent article “Medical Staff Update: October 2009” for examples of changes affecting the medical staff.)
Accreditation by The Joint Commission is voluntary and seeking deemed status through accreditation is an option, not a requirement. Hospitals seeking Medicare approval may choose to be surveyed either by an accrediting body, such as The Joint Commission, or by state surveyors on behalf of CMS. All deemed status surveys are unannounced, a policy The Joint Commission instituted into its accreditation process in 2006.