News Updates

SGR Deal Done; Passage Expected the Week of 2/15/2012

February 21, 2012 / Posted by NPCC

A possible deal to freeze Medicare payments to doctors for 10 months was being discussed by Congress, the week of 2/15/2012.  There is talk from the Affordable Care Act (ACA) that payments will hold steady at the 2011 levels until the end of 2012.  A 27.4% reduction in Medicare payments to doctors would take place on March 1, if there is no legislative action.  The bipartisan House-Senate conference committee has been trying to figure out three things for over a month now, which is a yearlong payroll cut extensi

Health Care Fraud Prevention and Enforcement Efforts Result in Record-Breaking Recoveries Totaling Nearly $4.1 Billion

February 21, 2012 / Posted by NPCC

The Department of Health and Human Services (HHS) Secretary Kathleen Sebelius and Attorney General Eric Holder released a new report showing that the government's health care fraud prevention and enforcement efforts recovered nearly $4.1 billion in taxpayers monies in the 2011 year.  These monies were recovered from individuals and companies who tried to defraud seniors and taxpayers who were trying to get payments that they were not entitled.

2012 Medicare and Patient Responsibility

January 23, 2012 / Posted by NPCC

The Centers for Medicare & Medicaid Services (CMS) has  implemented several important changes for Medicare providers and beneficiaries.  For many of your patients, Medicare costs will go down.  And for the first time the Part B deductible will decrease to $140.00. 

CMS has increased the paym

2012 Outpatient Therapy Caps and Exclusions

January 23, 2012 / Posted by NPCC

The cap for outpatient physical therapy and speech language pathology limit has increased to an incurred limit expense of $1,880.00. The outpatient occupational therapy limit is limited to $1,880.00 as well.

Temporary Payroll Tax Cut Continuation Act of 2011 (TPTCCA)

January 23, 2012 / Posted by NPCC

This new law prevents a scheduled payment cut for physicians and other practitioners who treat Medicare patients from taking effect until March 1, 2012, giving Congress two additional months to agree to the fee schedule and providers two additional months without a substantial decrease. The Administration remains strongly opposed to letting this cut take effect. 

Medicare Expanding Competitive Bidding Program to Save Billions-Program Expanded by Affordable Care Act

December 2, 2011 / Posted by NPCC

The Centers for Medicare & Medicaid Services (CMS) today announced operational details for the next stage in a program that sets new, lower payment rates for certain medical equipment and supplies – such as oxygen equipment, walkers, and some types of power wheelchairs – while maintaining patient access to them.

Affordable Care Act Helping Consumers Get Better Value for Their Health Care Dollars

December 2, 2011 / Posted by NPCC

New Proposal Makes Rebates To Consumers Tax Free, Increases Transparency

Today, the Centers for Medicare & Medicaid Services (CMS) issued a final regulation that will ensure health insurance companies spend at least 80 percent of consumers’ health insurance premiums on medical care, not income, overhead and marketing. Insurance companies that fail to meet the new standard are required to provide a rebate to consumers.

CMS Announces Version 5010, D.0 And 3.0 Standard Enforcement Discretion Period

November 17, 2011 / Posted by NPCC

The Centers for Medicare & Medicaid Services' Office of E-Health Standards and Services (OESS), has announced that it would not initiate enforcement action with respect to any HIPAA covered entity non-compliant with the ASC X12 Version 5010 (Version 5010), NCPDP Telecom D.0 (NCPDP D.0) and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards until 90 days after their January 1, 2012 compliance date, or until March 31, 2012. The compliance date for implementation of these updated standards remains January 1, 2012.

Doctor's Mother Also Convicted of Healthcare Fraud

November 15, 2011 / Posted by NPCC

Antoine Johnson, 40, a former resident of Aberdeen, Washington, and his mother, Lawanda Johnson, were convicted today in U.S.

Final Rule Issued for 2012 Medicare Physician Fee Schedule

November 3, 2011 / Posted by NPCC

The Centers for Medicare & Medicaid Services (CMS) today issued a final rule with comment period that updates payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY) 2012.  More than 1 million providers of vital health services to Medicare beneficiaries – including physicians, limited license practitioners such as podiatrists, and NPPs such as nurse practitioners and physical therapists – are paid under the MPFS.  CMS projects that total payments und