Resource-based relative value scale (RBRVS) is a method used to determine how much money medical providers should be paid by Medicare and health plans. Medicare, under the Reagan administration, initiated in 1985 the development of a new, fair and a more transparent fee schedule. This led to a large study, jointly conducted by researchers at [...]
On February 2, 2012, the state of California announced that it would apply short-term payment delays for Medi-Cal institutional providers due to a severe cash flow shortage. The effective date of the delays is March 1, 2012. Reimbursement to Medi-Cal institutional providers, except for clinics, designated public hospitals and local educational agencies, will be held [...]
In the event you would like to contact people at a higher level at Palmetto GBA, we have their contact information listed below: PROVIDER NAME: Palmetto GBA, LLC – A/B MAC JURISDICTION 1 PROVIDER SERVICE AREA: California, Hawaii, Nevada, American Samoa, Guam, and Northern Mariana Islands J1 MAC PROJECT OFFICER: Jim Massa, 303-844-7053 J1 MAC [...]
The Pioneer ACO Model is one of CMS’s initiatives. It is designed to support organizations with experience operating as Accountable Care Organizations (ACOs). Medicare offers several ACO programs, including: Medicare Shared Savings Program – a fee-for-service program Advance Payment Initiative – for certain eligible providers in the Shared Savings Program Pioneer ACO Model – population-based [...]
Don Berwick is out and Marilyn Tavenner is in. The Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Donald Berwick said he’ll step down from his post now that Republicans have successfully blocked his Senate confirmation, the Associated Press reports today. After he steps down Dec. 2, Deputy Administrator Marilyn Tavenner will take over. When Berkwick [...]
Consumers do not need to register cell phone or wireless numbers on the National Do Not Call Registry to be protected from most telemarketing calls to those numbers, despite viral email messages saying otherwise. Consumers may place their cell phone number on the Do Not Call Registry to notify marketers that they don’t want to [...]
A 21.3% Medicare physician payment cut takes effect on June 1, unless Congress comes up with a solution. ACOG, the AMA, and other medical groups are pushing for a permanent fix through repeal of the flawed SGR formula for setting payment rates. But Members of Congress, many of them squeamish about increasing the federal deficit [...]
With Medicare’s 21.2% cut looming, many physicians are frustrated with the whole process. Since 2001, Medicare payments have only increased by 1%, whereas physician costs have risen by 22%! To help physicians make informed decision on their participation, we have listed the available options about Medicare participation. Participation (PAR): PAR physicians agree to take assignment on all Medicare [...]
The Centers for Medicare & Medicaid Services (CMS) will delay until January 3, 2011, the implementation of Phase 2 of Change Request (CR). This change is only applicable to Part B claims only. Phase 2 of these CRs relates to the Medicare enrollment status of physicians and non-physician practitioners who order items or services for Medicare [...]
CMA has put together the following sample letter to the Senate for the current Healthcare reform issues that is going to be in effect on March 1, 2010: Dear Senator: As a physician and member of the California Medical Association, I am a strong, longtime supporter of health care reform that provides universal access to care for the [...]
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