Next week is expected to be a "super" ... The special congressional Super Committee designated to identify recommendations for further reducing the U.S. budget deficit is required to release its recommendations and hold a vote by Nov. 23. There is currently no indication of what will be in the recommendations, particularly as they relate to the College's priorities of fixing the Sustainable Growth Rate formula, protecting medical imaging and addressing medical liability reform. A special Advocate will be sent as soon as any recommendations are released. A final vote count will also be included on CardioSource.org/Advocacy as soon as it is available. In addition, the ACC's PINNACLE Network and Advocacy staff are holding a special webinar on Dec. 1 from 7-8 pm (ET) to discuss the Super Committee outcome and answer any member questions. Registration for the webinar is available at CardioSource.org/Webinars.
Update from the Hill: Legislation to eliminate the 3 percent tax withholding on Medicare payments was approved by Congress and is expected to be signed into law by the President. Without this action by Congress, the Internal Revenue Service would have required Medicare contractors to withhold 3 percent of Medicare payments to physicians and other health care providers until the following tax year.
HOPP on over to CardioSource ... The Centers for Medicare and Medicaid Services (CMS) has released the 2012 Hospital Outpatient Prospective Payment System (HOPPS)final rule. Your ACC has prepared a high-level overview of the provisions within the rule of importance to cardiovascular professionals. Get the details.
A focus on fraud and abuse: CMS recently announced two new demonstration programs designed to root out fraud and abuse that may impact cardiovascular specialists.
The Recovery Audit Prepayment Review program will rely on Recovery Audit Contractors (RACs) to conduct prepayment claims reviews to assist in lowering the improper payment rate and to identify potential fraud and abuse in Medicare. Initially, the demonstration will focus on inpatient hospital claims, particularly short stays, based on CMS data illustrating a high improper payment rate. Eleven states (CA, FL, IL, LA, MI, MO, NY, NC, OH, PA and TX) will be included in this program.
The Part A to Part B Rebilling Demonstration program will focus on inpatient billing for services that should have been performed in the outpatient setting and billed under Medicare Part B, rather than Part A. Under the demonstration program, providers will be able to resubmit claims denied under Part A for wrong place of service, provided the service would have been considered reasonable and necessary had it been billed properly initially. Medicare will pay the provider 90 percent of the Medicare Part B allowable in exchange for agreeing to waive appeal rights.
Both of these programs are slated to last three years, beginning on Jan. 1, 2012. A third program requiring prior authorization for power mobility devices, was also announced but is expected to have little to no impact on cardiology practices. Your ACC is very concerned about the limited information available, as well as the implications of these programs, and has reached out to CMS to discuss these concerns. Stay tuned to the Advocate for updates and more information as it becomes available.
What do you want to know about Meaningful Use? Your ACC is working with CMS and the Office of the National Coordinator for Health Information Technology (ONC) to develop two webinars devoted exclusively to how cardiologists can participate in the Electronic Health Record (EHR) Incentive Program. While the details and logistics are still being finalized, we need your help in identifying any questions or concerns you would like to have answered related to the EHR program. Please send your questions to advocate@acc.org. More details on dates will be included in the next Advocate.
Mark your calendars! Don't miss the final webinar in the PINNACLE Network/Paragon Health series on Nov. 29 at 4 pm (ET) focused on aligning incentives through co-management models. In addition, archived versions of the five previous webinars are available on the PINNACLE Network webpage. In addition, the PINNACLE Network and ACC Advocacy are holding a special webinar focused on preparing cardiovascular professionals for new 2012 coding changes, which will take place on Nov. 30 at 3:30 pm (ET).
Questions/Comments contact advocate@acc.org.