News from the AOA's Blog

It is not too late to participate in Medicare’s 2011 Physician Quality Reporting System (PQRS) program and qualify to receive incentive payments, according to the U.S. Centers for Medicare & Medicaid Services (CMS). A new six-month reporting period begins July 1.   

Again this year, Medicare’s PQRS [formerly known as the Physician Quality Reporting Initiative (PQRI)] program has two reporting periods: a 12-month reporting period that extends from Jan. 1 to Dec. 31 and a six-month reporting period that extends from July 1 to Dec. 31.

Eligible health care professionals (EPs) who satisfactorily report PQRS measures during the six-month reporting period will be eligible to receive a PQRS incentive payment equal to 1 percent of their total Medicare Part B allowed charges for services performed during the reporting period. Read the rest of this entry ?

‘Fast Facts’ spotlight key Medicare issues

The U.S. Centers for Medicare & Medicaid Services (CMS) is now posting a series of “Fast Facts” on its Medicare Learning Network® (MLN) Provider Compliance Web page to offer simple answers to common questions on Medicare’s often complex rules and regulations. 

The first briefly explains Medicare requirements regarding signatures on physician orders. Additional Fast Facts features will be posted each month, according the CMS. Read the rest of this entry ?

Legislation that would provide full recognition for doctors of optometry under the Medicaid program has received a boost in Capitol Hill support as a result of outreach conducted by hundreds of AOA doctors and students during the 2011 AOA Congressional Advocacy Conference.

Through many in-depth meetings held with their elected representatives, AOA doctors and students urged lawmakers to co-sponsor the AOA-backed Optometric Equity in Medicaid Act (H.R. 1219) and made clear that the situation facing working men and women, children and seniors in need of primary eye care services has grown more urgent. Read the rest of this entry ?

AOA President Joe Ellis, O.D., recently welcomed key congressional leaders to Kentucky. Joined by leading OD volunteers, Dr. Ellis met with U.S. House Speaker John Boehner (R-Ohio), Sen. David Vitter (R-La.) and Rep. Hal Rogers (R-Ky.), the chairman of the Appropriations Committee, at events surrounding the Kentucky Derby. The AOA delegation also included AOA Federal Keypersons Bill Reynolds, O.D., of Richmond, Ky., and Charles Nassauer, O.D., of Bogalusa, La. 

Shown in the first photo, from left, are Dr. Reynolds, Sen. Vitter, Dr. Ellis and Dr. Nassauer. In the second photo, from left, are Dr. Reynolds, Speaker Boehner and Dr. Ellis. In the last photo, from left, are Dr. Ellis, Rep. Rogers, and Dr. Reynolds.

In the weeks since the record-breaking AOA Congressional Advocacy Conference in Washington, D.C., Dr. Ellis and other AOA leaders and Federal Keypersons have been seeking out opportunities to continue to educate and inform members of Congress about optometry and build further support for the Optometric Equity in Medicaid Act (H.R. 1219) and other AOA-backed legislation. For more information on the AOA’s top legislative and regulatory priorities or to join the Federal Keyperson program and serve as a direct link to your elected representatives, contact Adam Weiss of the AOA Washington office at 800-365-2219 or aweiss@aoa.org.

Quarterly updates to the Medicare Correct Coding Initiative (CCI) edits, Version 17.2, take effect on July 1, 2011.

The U.S. Centers for Medicare & Medicaid Services (CMS) developed the CCI to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment for Medicare Part B claims.

Under the CCI, the CMS compiles lists of billing code combinations that describe duplicative or mutually exclusive services.

Medicare payment contractors use the lists to “edit” claims for improper billing. Health practice billing staff can use the lists to review claims, prior to filing, as a means of preventing unnecessary claim rejections.

For additional information or to access the updated CCI edits, see the CMS Web site National Correct Coding Initiative page (www.cms.gov/NationalCorrectCodInitEd).

Medicare releases guidelines on enrollment for ordering/referring providers fact sheet

 A new publication titled “Medicare Enrollment Guidelines for Ordering/Referring Providers” is designed to provide education on the Medicare enrollment requirements for eligible ordering/referring providers and includes information on the three basic requirements for ordering and referring and who may order and refer for Medicare Part A Home Health Agency, Part B, and DMEPOS beneficiary services. Read the rest of this entry ?