Centers for Medicare & Medicaid Services Accounces Plan to Address Inaccurate Payments
Posted: Feb 10, 2011
CMS announces process to address inaccurate payments for some 2010 claims

Retroactive provisions in the Patient Protection and Affordable Care Act, coupled with technical corrections to the 2010 Medicare physician fee schedule, resulted in overpayments and underpayments on millions of Medicare fee-for-service claims during the first five months of 2010. To address the inaccurate claims, the Centers for Medicare & Medicaid Services (CMS) announced yesterday that it would begin reprocessing some of them over the next few weeks – a process CMS says will take “some time.”
According to CMS’s instructions, claims that were underpaid will not be automatically reprocessed at higher rates. However, providers should not resubmit these claims. Instead, they should request a manual reopening and adjustment of the claims from the Medicare contractor. Additionally, contractors will send requests for repayment of overpayments to providers. CMS will waive beneficiary cost-sharing and claim adjustment time limits for claims affected by these changes.

CMS to modify meaningful use group practice registration process

The Centers for Medicare & Medicaid Services (CMS) announced that it will implement protocols in May that allow eligible professionals (EPs) to designate a third-party, such as a practice administrator, to register and attest for them as part of the EHR meaningful use incentive program . EPs are not currently allowed to designate a practice manager or any other person to register in their place. However, until CMS implements this new group practice “functionality,” each EP should register himself or herself separately for the Medicare and Medicaid EHR Incentive Programs.

EPs may qualify for either $44,000 under the Medicare EHR program or up to $63,750 under the Medicaid EHR incentive program. CMS has posted information about when your state will launch its program. You may also contact your state Medicaid agency for more information about the program and or visit your state EHR Incentive Program and HIT Web site.

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