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CMS may want your opinion
Check your mail. You may have the opportunity to tell the Centers for Medicare and Medicaid Services (CMS) your opinion about the performance of Medicare fee-for-service contractors.
About 35,000 randomly selected physicians, suppliers and institutional facilities across the country should have received the survey the first week of January.
The evaluation helps CMS set 2009 performance targets for Medicare administrative contractors. It is designed to gather information on key services such as provider inquiries, outreach and education, claims processing, appeals and reimbursement.
“The Medicare Contractor Provider Satisfaction Survey (MCPSS) provides contractors with greater insight into their provider communities, and allows them to make process improvements based on provider feedback,” said CMS Acting Administrator Kerry Weems.
Survey results will be published in July 2008. Information about the MCPSS and a sample questionnaire>> |
CMS delays new anti-markup rule implementation
The Centers for Medicare & Medicaid Services (CMS) has issued a delay in application of the expanded anti-markup rule published in the 2008 final physician fee schedule.
The action came in response to advocacy efforts by the AMA, the Medical Group Management Association and others, including a letter signed by 47 national physician organizations.
CMS posted a notice in the Jan. 3 Federal Register postponing implementation of the rule until Jan. 1, 2009, instead of Jan. 1, 2008. CMS intends to use the one-year delay to clarify application of the rule, issue an additional proposed rule or both.
In its current form, the anti-markup rule limits physician payments for the technical component (TC) of services purchased from an outside supplier.
The expanded rule would have applied the same payment limitation to the professional component (PC) of purchased diagnostic tests, as well as the technical and professional components of services performed by employees of physicians or group practices – for services performed outside the “office” of the physician or group practice.
The new provision defines “office” as substantially where the full range of patient care services is generally provided.
An exception
The delay is not that straightforward, however. It postpones application of this new rule except in the case of anatomic pathology diagnostic testing services furnished in space used by a physician group practice as a “centralized building.”
That means this postponement only applies to diagnostic pathology services when the group provides other patient care services at the site as well. This is intended to close a perceived loophole in the self-referral regulations that had allowed operation of off-site “pod labs.”
The AMA will continue efforts to ensure the new rules do not have unintended negative consequences for patient access to diagnostic tests.
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