MSDC leadership has developed a program to educate District physicians on Medicare and Medicaid fraud prevention.  The program draws from the resources of FBI and HHS investigative agents with expertise in identifying potential fraud risks and removing those risk factors from your practice.

     Medicare/Medicaid fraud has been estimated to cost the District of Columbia $110 million annually.  Those funds could be better used to raise Medicaid rates to expand access to medical care for District patients, and improve the services offered by the District's Medicaid program.

     MSDC has reached out to the DC Department of Health Care Finance to collaborate on expanding the Fraud Prevention program.  Currently, the program is being included in medical staff meetings hosted at hospitals across the city.  Once a formal program schedule is finalized, an invitation to attend the program will be sent to all members.

     To view the materials used in the program, please click the following links:

     FBI Fraud Examples

     Medicare Fraud Prevention for Physicians 

Fair Health Database: Fairness and transparency in out-of-network reimbursement, how it may impact the practice 

Prepare for Jan. 1 HIPAA compliance with new AMA toolkit 

     Are you on track to meet the Jan. 1, 2012 compliance deadline for using Version 5010 of the HIPAA electronic standard transactions? If you or your vendor submit claims electronically, you must comply with this deadline. Physician practices who aren't prepared risk rejected claims and cash flow interruptions.
     With the deadline less than six months away, now is the time to make sure your practice is ready to use the Version 5010 electronic standard transactions. Learn the steps you need to take with the new 5010 toolkit  from the AMA. This toolkit also explains the differences you should expect in Version 5010, how to test your readiness for the Version 5010 transactions, and steps you can take to prevent interruptions to your cash flow.
     Access this toolkit and additional AMA resources to make sure your practice is ready.

Repeal the flawed SGR, Medicare's Physician Payment Formula

     Work is on-going with the US Congress during the current debt talks to fully repeal the SGR.  As a part of AMA's education efforts, they have created a short video.

It's Time for Congress to Repeal Medicare's SGR

ICD-10-CM Instructional Workshops for Practice Managers, Staff and Physicians; One will be held in Baltimore, MD

     The AMA is hosting CPT Changes Workshops in six convenient locations: Atlanta, Baltimore, Dallas, New Jersey, San Diego and Las Vegas this December, 2011. The Workshops will cover the 2012 CPT Changes and transition to ICD-10-CM. The linked PDF will give you more information, as will the links below.   

MSDC Continues to Fight for Needed Changes to the Medicare eRx Incentive Program to Protect Member Physician Practices

     CMS has issued a proposed rule on the Availability of Medicare Data for Performance Measurement, mandated by Sec. 10332 of the Affordable Care Act.  MSDC has signed on to a letter urging CMS to carefully develop a final rule in which qualified entities:

1. meet each of the requirements in section 10332;

2. produce public reports that are valid, meaningful, actionable, and user-friendly; and 

3. participate in a reporting program that is standardized and streamlined to minimize administrative burden and allow comparable results.

     The letter also addresses the need for CMS to move toward standardization of many elements qualified entities will use in developing and releasing public reports, including standardization of: measure specifications; the content of public reports; formatting of the reports; risk-adjustment and attribution methodologies; and appeal processes. The letter also encourages CMS to apply the standardization process across all payers, including Medicare and private payers. 

HHS Has Established the Preexisting Condition Insurance Program; DC is a Participating Jurisdiction 

     Thank you in advance for your time and participation.

DC Cancer Consortium Hosts Annual National Meeting