Sunday, February 05, 2012
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NOW IS THE TIME TO REPEAL THE SGR BEFORE THE MARCH 1 DEADLINE

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MSD leadership has communicated with our Congressional Delegation letting them know the urgency of repealing the SGR before the March 1 deadline.
(Please note the same letter was sent to Senators Carper and Coons and to Congressman Carney.) 

We have also shared the results of the Medicare Participation -- Delaware Physicians 2012 membership survey with the Delegation.


Contact information for Delaware's U.S. Senators and Representative

Talking points on the SGR issue

Medicare Reimbursements

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Medicare Fee Schedule Update for 2012

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Legislation necessary to temporarily prevent the scheduled Medicare SGR related payment cut for physicians and other practitioners from taking effect on January 1, 2012 was signed December 23. The negative update for the 2012 Medicare Physician Fee Schedule is now scheduled to take effect on March 1, 2012.

While the physician fee schedule update will be zero percent, other changes to the relative value units (RVUs) must be budget neutral. CMS is currently developing the 2012 Medicare Physician Fee Schedule (MPFS) to implement the zero percent update.  

CMS previously announced that it was directing its contractors to hold new, January 2012 claims, for up to 10 business days.  CMS expects these claims to be released into processing no later than January 18, 2012.  Medicare contractors will post the new rates on their websites no later than January 11, 2012.  

In addition, CMS and Congress implemented several other changes and/or postponement of policies scheduled to take effect on January 1, 2012. 

Read more.

Attention Part B Providers in the District of Columbia and Delaware

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Claims Processing Issue for Preventive Care Services - Procedure Codes 77078, 77079, 77080, and 77081
ISSUED: (01/09/2012 @ 4:42 PM) by Highmark Medicare Services

Highmark Medicare Services (HMS) has identified a Part B claims processing issue in the District of Columbia and Delaware contract areas involving claims for preventive care bone mass measurement studies, procedure codes 77078, 77079, 77080, and 77081. CMS Change Request 7012 advised that effective for dates of service on or after January 1, 2011, Medicare will provide 100 percent payment (deductible and coinsurance would be waived) for certain preventive services. Procedure codes 77078, 77079, 77080, and 77081 are four of the preventive service codes for which 100 percent payment should have been approved. The deductible was appropriately waived. However, due to a system problem, coinsurance was erroneously applied. The system problem was corrected on January 6, 2012. HMS will automatically reprocess any claims for procedure codes 77078, 77079, 77080, and 77081, which were paid incorrectly. For further information on the waiver of coinsurance and deductible for preventive services, please see MLN Matters Article MM7012 issued on March 2, 2011. We apologize for any inconvenience this issue has caused.
Copyright 2011 by Medical Society of Delaware