Q. It’s all over Facebook and on the news. What the heck is going on with Medicare these days?
A. Oh yes, Medicare is in a bit of flux these day. Congress voted just before Christmas to delay the Medicare Physician Fee Schedule (MPFS) cut until March 1. The stage is set for a repeat of 2010 when Congress voted five separate times to delay the MPFS cut and in the middle of the year voted a 2% retroactive increase.
Things could get confusing. Here are a few key Medicare points you should be aware of (and keep a watchful eye on):
- For 2012, Medicare has a $140 deductible with the same 80/20% co-insurance for allowable services. (Interesting note: That’s LESS than last year’s deductible!).
- The latest version of the Advanced Beneficiary Notice of Noncoverage (ABN), with the release date of 3/2011 printed in the lower left hand corner, should now be in use at your office. Mandatory use of this version began on January 1, 2012. All ABNs with the release date of 3/2008 that are issued on or after January 1, 2012 will be considered invalid. If you need the new version, you can find it here.
- At this time any fee schedule reductions have been put on hold until March 1, 2012 and you should continue to bill as normal. Per a special email announcement from us, and various posts to our Facebook page, we passed along the advice of Ron Short, Heartland Consulting Group, who advised that the best way to protect yourself from the uncertainty and a repeat of 2010′s chaos was to become a participating provider (if you were not one already). Ron says…
“As a par provider you can bill Medicare your full fee. They will reduce it to the allowed amount, whatever that may be at the time, and you write off the rest. You will also receive any retroactive fee increases. Due to the uncertainty, Medicare has extended the deadline for changing your participation status to February 16. Act now to protect yourself in these uncertain times.”
To become a participating provider, you will want to submit a CMS-460 Participation Agreement form, which you can download here. 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.
Above all, keep your eye on your email’s inbox and on our Facebook page for continued updates.
