Friday, December 18, 2009
New Medicare changes continued....
To continue from the previous post. To see if you need to update your Medicare enrollment, it is recommended you call WPS Provider Enrollment Hotline 866.503.7664. They will be able to check if your Physicians are in the PECOS system.
Thursday, December 17, 2009
New Medicare Billing requirements announced
Delay in Implementing Phase 2 of CRs 6417 and 6421
The Centers for Medicare & Medicaid Services (CMS) will delay, until April 5, 2010, the implementation of Phase 2 of Change Request (CR) 6417 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Claims Processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)) and CR 6421 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Claims Processed by Durable Medical Equipment Medicare Administrative Contractors (DME MACs)). CRs 6417 and 6421 are applicable to Part B claims only. The delay in implementing Phase 2 of these CRs will give physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers sufficient time to enroll in Medicare or take the action necessary to establish a current enrollment record in Medicare prior to Phase 2 implementation. Although enrolled in Medicare, many physicians and non-physician practitioners who are eligible to order items or services or refer Medicare beneficiaries to other Medicare providers or suppliers for services do not have current enrollment records in Medicare. A current enrollment record is one that is in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and also contains the physician/non-physician practitioner's National Provider Identifier (NPI). Under Phase 2 of the above referenced CRs, a physician or non-physician practitioner who orders or refers and who does not have a current enrollment record that contains the NPI will cause the claim submitted by the Part B provider/supplier who furnished the ordered or referred item or service to be rejected. CMS continues to urge physicians and non-physician practitioners who are enrolled in Medicare but who have not updated their Medicare enrollment record since November 2003 to update their enrollment record now. If these physicians and non-physician practitioners have no changes to their enrollment data, they need to submit an initial enrollment application which will establish a current enrollment record in PECOS.
http://www.wpsmedicare.com/j5macpartb/publications/news/archived/2009_1125_delay.shtml
The Centers for Medicare & Medicaid Services (CMS) will delay, until April 5, 2010, the implementation of Phase 2 of Change Request (CR) 6417 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Claims Processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)) and CR 6421 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Claims Processed by Durable Medical Equipment Medicare Administrative Contractors (DME MACs)). CRs 6417 and 6421 are applicable to Part B claims only. The delay in implementing Phase 2 of these CRs will give physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers sufficient time to enroll in Medicare or take the action necessary to establish a current enrollment record in Medicare prior to Phase 2 implementation. Although enrolled in Medicare, many physicians and non-physician practitioners who are eligible to order items or services or refer Medicare beneficiaries to other Medicare providers or suppliers for services do not have current enrollment records in Medicare. A current enrollment record is one that is in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and also contains the physician/non-physician practitioner's National Provider Identifier (NPI). Under Phase 2 of the above referenced CRs, a physician or non-physician practitioner who orders or refers and who does not have a current enrollment record that contains the NPI will cause the claim submitted by the Part B provider/supplier who furnished the ordered or referred item or service to be rejected. CMS continues to urge physicians and non-physician practitioners who are enrolled in Medicare but who have not updated their Medicare enrollment record since November 2003 to update their enrollment record now. If these physicians and non-physician practitioners have no changes to their enrollment data, they need to submit an initial enrollment application which will establish a current enrollment record in PECOS.
http://www.wpsmedicare.com/j5macpartb/publications/news/archived/2009_1125_delay.shtml
Wednesday, September 30, 2009
HIPAA Breach Notification Rule- AMA guidance
New resource to help physicians prepare for the HIPAA Breach Notification Rule
New regulations effective Sept. 23, 2009 require all physicians who are covered by HIPAA to notify patients if there are breaches of security involving unsecured patient information. New AMA guidance summarizes these new requirements. These requirements apply in addition to any notification obligations imposed by state law. These requirements also supplement the obligations imposed by the HIPAA Privacy and Security Rules.
Visit www.ama-assn.org/go/hipaa for additional information.
New regulations effective Sept. 23, 2009 require all physicians who are covered by HIPAA to notify patients if there are breaches of security involving unsecured patient information. New AMA guidance summarizes these new requirements. These requirements apply in addition to any notification obligations imposed by state law. These requirements also supplement the obligations imposed by the HIPAA Privacy and Security Rules.
Visit www.ama-assn.org/go/hipaa for additional information.
Friday, September 4, 2009
New Medicaid and HIPAA Changes
There have been changes to Kansas Medicaid program this past month; Due to budget cuts Medicaid has cut out all Provider Representatives for the state of Kansas. I was told we will have to go through Customer Service for all our issues.
Kansas Health Policy Authority (KHPA) changed the Kansas Medical Assistance Program (KMAP) policy meetings for providers, from quarterly to biannual. KHPA also agreed to hold interim meetings to discuss important changes within KMAP. To that end, KHPA will conduct a conference call on Wednesday September 30, 2009 at 1:00 p.m. to provide an update about the reorganization within KHPA and EDS. This call is open to all Medicaid providers.
Phone # to Call: 866.620.7326
Conference code: 2719426287
Reminder: Effective September 15, 2009, covered entities will now be subject to explicit HIPAA breach notification requirements.
What Can You Do Now?
Because of these changes in the law and to ensure compliance with the September 15, 2009, deadline for the breach notification requirements and with the February 17, 2010, deadline set by the HITECH Act for compliance with the other numerous amendments to the HIPAA Privacy and Security Rules, covered entities and business associates should:
(a) update old, and develop new privacy and security policies and procedures to comply with the new requirements and limitations;
(b) amend existing Business Associate Agreements and determine whether new Business Associate Agreements are warranted; and
(c) develop breach notification policies and procedures that comply with the new requirements.
Kansas Health Policy Authority (KHPA) changed the Kansas Medical Assistance Program (KMAP) policy meetings for providers, from quarterly to biannual. KHPA also agreed to hold interim meetings to discuss important changes within KMAP. To that end, KHPA will conduct a conference call on Wednesday September 30, 2009 at 1:00 p.m. to provide an update about the reorganization within KHPA and EDS. This call is open to all Medicaid providers.
Phone # to Call: 866.620.7326
Conference code: 2719426287
Reminder: Effective September 15, 2009, covered entities will now be subject to explicit HIPAA breach notification requirements.
What Can You Do Now?
Because of these changes in the law and to ensure compliance with the September 15, 2009, deadline for the breach notification requirements and with the February 17, 2010, deadline set by the HITECH Act for compliance with the other numerous amendments to the HIPAA Privacy and Security Rules, covered entities and business associates should:
(a) update old, and develop new privacy and security policies and procedures to comply with the new requirements and limitations;
(b) amend existing Business Associate Agreements and determine whether new Business Associate Agreements are warranted; and
(c) develop breach notification policies and procedures that comply with the new requirements.
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