Obama's Budget and Your Medicare Payments
HBMA (the Health Billing and Management Association) has a presence in Washington and keeps its members informed as to items that might impact your reimbursement. The following is an excerpt from a recent newsletter to its membership. Note how much of the federal budget is for patient care and how much is for other costs. Especially note the amount proposed to monitor physicians.
The President's budget proposes a $663 million increase, or about 17%, in CMS' discretionary budget which reflects money needed to implement the health care reform law enacted last year.
A little bit of good news: In addition, President Obama is proposing a 2 year SGR fix as part of his FY 2012 Budget proposal. In essence, he is proposing a 2 year freeze of physician payments covering CY 2012 and CY 2013. His budget then assumes that Congress will find a permanent fix for the SGR problem beginning in 2014.
Of course, better news would be that the problem was permanently fixed, but it will be a relief not to worry about pay cuts multiple times each year.
Below is a chart that highlights various key proposed funding levels for CMS. The line-item identified as "Program Operations" funds such activities as claims processing, provider enrollment and other administrative activities carried out by Medicare's contractors. We would also direct your attention to the line-item for the Recovery Audit Contractor program. The Obama Administration proposes to more than double the amount of money available for RAC audits, dramatically expanding this program in 2012. Below is a chart that highlights various key proposed funding levels for CMS. The line-item identified as "Program Operations" funds such activities as claims processing, provider enrollment and other administrative activities carried out by Medicare's contractors. We would also direct your attention to the line-item for the Recovery Audit Contractor program. The Obama Administration proposes to more than double the amount of money available for RAC audits, dramatically expanding this program in 2012. Dollars are in Millions 2010 Actual 2012 estimate Program operations 2,404 3,245 Federal administration 697 925 State survey & certification 366 417 Research, demonstrations 39 90 High-risk pool grants 55 44 ARRA Medicare/Medicaid HIT 88 201 Consumer Assistance Grants 1 0
Recovery audit contractors 26 500 CLIA 54 43 Data Sales 8 2 Coordination of Benefits 42 59
(Our apologies if your system font is different from ours. We thought it more important to get you this information even knowing it may not always "line up" correctly.) |
RAC Budget Proposal Shows Increase to 500 Million If you aren't worried about RAC auditors, it's time to get worried.
The Obama administration is proposing a massive increase in the funding of the program.
Will your charting withstand the audits? Are you signing off on all your labs, xrays, etc. Do you include a written report on each?
Do you have a written Medicare compliance plan in place; and ensure your staff gets at least annual training? Many of the hospitals offer classes on these subjects.
KLA staff is attending auditing workshops in the near future. Check our blog and resources for tips on staying compliant.
At least annually, consider having an external chart audit done by a professional service. (See our website for a list of some we recommend.) |
Electronic Prescribing
Not ready for a full ERA, but don't want your Medicare reimbursement cut next year?
Here's our link that will allow you to set up a free Practice Fusion account without worries of being contacted by other consultants. We promise we won't call you either; but you are welcome to call us with questions.
http://www.practicefusion.com/ccn/kla
There are a few simple questions to set up your account. To access the free electronic prescribing feature, you will need to complete and fax a form and include proof of license, dea, etc. Within a few days you will be set up and ready to go. Remember to "bill for" you electronic subscribing with the related claim form.
iPhone and Android accessiblity are available; but beware HIPAA concerns. Use these over secure connections only.
If you are a KLA client, please contact our office so we can assist you in set up.
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