Physicians who furnish services to Medicare beneficiaries in federally designated health professional shortage areas (HPSA) are eligible for a 10 percent bonus payment for services furnished from Jan. 1, 2012, to Dec. 31, 2012. Read the rest of this entry ?
Archive for the ‘Eye on Washington’ Category
CMS offers Medicare revalidation Q&As
February 22, 2012The U.S. Centers for Medicare & Medicaid Services (CMS) is proceeding with plans to revalidate all Medicare providers and suppliers who have not revalidated since March 25, 2011, so that all Medicare providers and suppliers are scrutinized under new screening requirements of the Affordable Care Act. Read the rest of this entry ?
New standards move insurers toward electronic payment
February 21, 2012The Centers for Medicare & Medicaid Services (CMS), announced new standards for the use of electronic funds transfers (EFT) and the electronic issuance of remittance advice (RA) by health insurance plans on Jan. 5.
The new standards, to be implemented by insurers between now and 2014, will effectively prompt more private health plans to pay doctors via electronic funds transfer, according to AOA Advocacy Group Director Jon Hymes. Read the rest of this entry ?
AOA helps over 600 ODs earn Medicare EHR incentives
February 19, 2012U.S. Department of Health & Human Services (HHS) data shows optometrists are quickly establishing themselves as leaders in the implementation of electronic health records (EHRs), according to the AOA Advocacy Group.
Some 614 optometrists qualified for bonus payments during the first 11 months of the department’s Medicare EHR Incentive Program, according to data posted online by the HHS. Read the rest of this entry ?
Congress Approves Measure to Avert Massive Medicare Pay Cut
February 17, 2012Facing increased pressure from AOA and other physician organizations, U.S. House and Senate leaders came together earlier today to approve yet another measure to prevent enactment of a massive cut to Medicare payments made to optometrists and other Medicare physicians.
Part of a larger deal aimed at continuing a payroll tax break for most workers and extending unemployment insurance for many jobless Americans, the compromise bill now heads to the White House for President Obama’s signature.
Without today’s bipartisan action, Medicare physician reimbursement rates were scheduled to be cut by more than 27 percent starting Mar. 1. As a result of this latest deal, under Medicare’s sustainable growth rate formula (SGR), a nearly 30 percent cut is now scheduled for Jan. 1, 2013. Read the rest of this entry ?
Straight talk on the new national health care law and vision plans: A message to optometry from Dr. Mike Kriedler, optometrist, former member of Congress, and Washington Insurance Commissioner
February 9, 2012
Dear Fellow Optometrist:
As an optometrist, a former Member of Congress and, today, the longest-serving elected state insurance commissioner in the nation, I am especially pleased that the 2010 national health care overhaul law recognizes the full scope of optometric eye health care, including the medical services we deliver, and takes specific and much-needed steps to stop stand-alone insurers from isolating and trying to define our profession.
Under the new law, stand-alone vision plans, including VSP, may participate in health insurance exchanges in every state, but they must do so by contracting with qualified health plans which must offer coverage that is seamless for patients and doctors. That this means these companies will no longer be able to limit optometric care only to vision services is a major victory for optometry, though I understand these companies are irresponsibly and selfishly claiming otherwise. Read the rest of this entry ?
Watch carefully for Medicare CERT audit notices
February 9, 2012
The AOA Advocacy Group urges optometrists and practice staff members to watch their mail carefully for Medicare CERT audit record requests that will arrive in brown window envelopes, not unlike those used for many more-routine notices or commercial mailings. The AOA Advocacy Group is concerned the record requests may be mistaken for “junk mail” in some practices.
The nation’s four durable medical equipment Medicare administrative contractors (DME-MAC) are cooperating in a new, joint effort to determine error billing rates for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) as part of the Medicare Comprehensive Error Rate Testing (CERT) Audit Program.
Optometrists are among those who may receive requests for claims documentation under the CERT program, the AOA Advocacy Group notes.
Practitioners should always watch their mail carefully for CERT record requests and respond to any such requests promptly, the AOA Advocacy Group emphasizes.
Failure to respond promptly could result in claim denial and demand for repayment, the CMS warns. Read the rest of this entry ?
Adapt to the Reality of Today’s Health Care – Advocate for Optometrists as Primary Eye Care Providers
February 8, 2012Vision plans can continue to play an important role in the health care market after health care reform. Conflicting messages about how vision plans are able to function after reform are circulating, causing considerable confusion and anxiety among optometrists and vision plan operators.
We believe that the facts about health care reform will clarify how plans can successfully adapt to the changes being demanded of all insurers by the Affordable Care Act. Vision plans hold the power to choose a proactive solution to benefit practicing optometrists who elect to participate as vision plan network providers. Unfortunately, for now, some vision plan companies resist the need to modernize and seek to keep vision care separate from medical care. We regret that these insurance companies are fighting any efforts to better integrate optometrists into the mainstream of care delivery and payment. Read the rest of this entry ?
AOA backs health care error prevention effort
February 7, 2012The Department of Health & Human Services (HHS) last month announced that hospitals across the country will have new resources and support to make health care safer and less costly by targeting and reducing the millions of preventable injuries and complications from health care-acquired conditions. Read the rest of this entry ?
Medicare extends 2012 Annual Participation Enrollment Program
February 7, 2012The U.S. Centers for Medicare & Medicare Services (CMS) is extending the Medicare 2012 Annual Participation Enrollment Period through Tuesday, Feb. 14, 2012.
The effective date for any participation status change during the extension, however, remains Sunday, Jan. 1, 2012, and will be in force for the entire year. Read the rest of this entry ?
