KLA Healthcare Consultants
YOUR PRESCRIPTION FOR A FISCALLY FIT PRACTICE.

Website    About Us     Service    Resources   BLOG    Contact
In This Issue
Obama's Budget & Medicare
RAC's Budget Likely to Increase
Shortcuts for eRx
Join Our Mailing List
Practice Rx 
Is Your Practice Fiscally Fix?
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.

 

 

Remember to check our blog, Keeping Up with KLA, for the news between our newsletters. 
 
Sincerely,


Sharon Lusk, JD, CPA, CMC
KLA Healthcare Consultants
Contact Us
KLA Healthcare Consultants
6890 Hillshire #9
Memphis, Tennessee 38133
Phone: 888.325.1691
Fax: 888.325.1692
[email protected]
Follow Us On Twitter