CMS Clarifies Bad Debt Policy Related to Accounts at a Collection Agency
A MedLearn Matters article released June 27 specifies that, in order for providers to properly claim a bad debt and be reimbursed under the Medicare Program, providers must follow all of the Criteria for Allowable Bad Debt and sections 308 and 310 of the Provider Reimbursement Manual (CMS Publication 15-1), available on the CMS website.
Pursuant to these criteria, a provider must establish that reasonable collection efforts were made. A provider must establish that the debt is uncollectible when claimed as worthless and use sound business judgment to establish that there is no likelihood of recovery at any time in the future.
View the related MedLearn Matters article.
CMS Releases Medicare Provider Satisfaction Survey Results
The Centers for Medicare and Medicaid Services (CMS) has released the results of its second annual provider satisfaction survey of Medicare fee-for-service contractors who pay more than $280 billion in Medicare claims each year. View the results.
View the MedLearn Matters article to learn more.
Neurology Medicare Carrier Advisory Committee (NeuroCAC)
CMS mandates that each Medicare carrier have a Carrier Advisory Committee (CAC) in every state to help with payment and policy issues.
CAC representatives assist in drafting Medicare Local Coverage Determinations (LCDs). To search and view carrier LCDs, visit the CMS website.
Read a question-and-answer document about the NeuroCAC in the May 1, 2007, issue of Neurology Today.Compliance Program Guidance
Neurologists interested in the typical regulatory requirements that their offices must meet can review the compliance program laid out by the Office of Inspector General. The guidance (PDF) is targeted at solo and small group physician practices.
Consequences for Failure to Maintain Opt-Out Apply, New CMS Updates Say
Effective September 29, 2008, CMS updates take effect that clarify the consequences for the failure to maintain opt-out on the part of a physician or practitioner. The added sections to the Medicare Benefit Policy Manual?contained in Chapter 15, sections 40.5, 40.6, 40.9, 40.11, 40.13, 40.20, 40.26, and 40.35?clarify that the consequences for failure to maintain opt-out apply regardless of whether or when a carrier/MAC notifies a physician or practitioner of the failure to maintain opt-out.
A new paragraph was also added to clarify situations where a violation is not discovered by the carrier/MAC during the two-year opt-out period when the violation actually occurred. In such a case, the requirements are applicable from the date that the first violation for failure to maintain opt-out occurred until the end of the opt-out period during which the violation occurred. The exception to this rule is when the physician or practitioner makes a good faith effort to restore opt-out conditions; for example, by refunding the amounts in excess of the charge limits to beneficiaries with whom he or she did not sign a private contract.