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Advocacy
Once again, Congress failed to act
Congress failed to act to stop the 21.2 percent Medicare physician payment cut related to the flawed sustainable growth rate formula (SGR) before the scheduled deadline. As a result, the cuts officially took effect on June 1. The Centers for Medicare and Medicaid Services (CMS) is holding claims for 10 business days to allow time for Congress to act when members return from the Memorial Day recess on June 7. The House on May 28 did pass a measure to stop the 21.2 percent SGR cut for 19 months, but the Senate adjourned without taking action and it's unclear whether there are enough votes in the Senate to move the House legislation forward.
Your ACC -- along with the entire House of Medicine -- continues to fight for a permanent repeal of this flawed payment formula.
In fact, the ACC was quoted in the "National Journal" last week urging Congress to get past this nightmare issue so we can begin to work on legitimate payment reform and quality improvement nationally. This year alone, Congress has passed three short-term freezes in Medicare payment without addressing the growing problem. ACC members are encouraged to call their lawmakers and once again urge them to enact a permanent replacement of the flawed SGR formula. Call your members of Congress at (800) 210-7193 or via email using the ACC's grassroots website.
Good News!
The Federal Trade Commission (FTC) announced on May 28 that it will once again delay enforcement of its "red flags" rule through Dec. 31 while Congress considers legislation that would exempt physician, attorney and accounting offices with fewer than 20 employees from having to comply. The FTC rule requires banks and creditors (including health care providers) to have written plans in place to prevent, identify and mitigate identity theft. The ACC, the American Medical Association (AMA) and other medical associations have strongly opposed the inclusion of physicians as creditors and have repeatedly been able to delay the rule's implementation date. Most recently, the AMA, the American Osteopathic Association and the Medical Society of the District of Columbia also filed a lawsuit on this point. The ACC continues to monitor this situation. In the meantime, practices are encouraged to read through the AMA's sample guidance documents and policies regarding this issue.
Are you ready for new NPI requirements?
As a result of the new health reform law, all practitioners enrolled in the Medicare or Medicaid programs must include their National Provider Identifier (NPI) in their enrollment application materials effective July 6. NPIs must also be included on all Medicare and Medicaid claims, along with the ordering or referring practitioner's legal name. Your ACC recommends ensuring that your Medicare provider enrollment information is current and accurate. Practitioners that enrolled in Medicare prior to 2003 and who have not updated enrollment records since that time are likely not to have an enrollment record in the Medicare provider enrollment database. To ensure that one is created, a Medicare provider enrollment application (CMS-855 form) must be completed. This can also be done via the Internet-based Provider Enrollment, Chain and Ownership System (PECOS). Medicare contractors are reported to be experiencing higher than normal volumes of Medicare provider enrollment application submissions as a result of the new changes. Please contact the ACC if you experience sustained delays of six months or m
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