Q. With Congress unable to agree on a freeze of the cuts in the Medicare Physician Fee Schedule, I’m wondering if there’s anything I need to do at the office level?

A. We rely on Dr. Ron Short, Heartland Consulting Group, to keep his finger on the pulse of the latest developments in Medicare.  Yesterday afternoon Ron passed along an urgent alert so your question is very timely.

Many DCs have been paying close attention to the pending legislation regarding the Medicare Physician Fee Schedule (MPFS) “negative adjustment” (Washington-speak for “drastic cut”).  At this point it doesn’t look likely the issue will be resolved before the end of the session and before the cuts go into effect.

This happened once before.  According to Ron:

“In 2010 Congress enacted a retroactive 2% increase to the MPFS.  Those providers that were Participating Providers and were billing Medicare their full fee were automatically paid this 2% increase.  Those providers that were not participating or did not bill their full fee to Medicare did not receive the retroactive portion of the increase.  If you are a non-participating provider you have until the end of December to change your participation status.”

And that’s precisely what Ron is recommending you do:

“I recommend that you become a participating provider with Medicare if you are not already.  Participation means that you will accept assignment on all Medicare claims for the year.  Non-participation does not provide you with any protection from audits or reviews or from refunding overpayments.”

Ron was kind enough to include the form needed to become a participating provider (CMS-460 Participation Agreement) and we’ve added a link to the form for your convenience.

If you are not a participating provider, you’ll want to take action on this quickly.  If you have questions, we recommend contacting Dr. Ron Short directly by phone at 217-285-2300 or by email at ChiroMedicare@gmail.com.

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