RISOPS Legislative News
How to check the status of a bill in RI
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EHR Incentive Payments
Incentive payments for the Medicare Electronic Health Records (EHR) Incentive Program will be made approximately four to eight weeks after physicians successfully attest that they have demonstrated meaningful use of certified EHR technology. For more information about the attestation process, go to http://www.cms.gov/EHRIncentivePrograms.
However, physicians will not receive incentive payments within that timeframe if they have not yet met the threshold for allowed charges for covered professional services furnished by the physician during the year. Payments will be held until the physician meets the $24,000 threshold in allowed charges for calendar year 2011 in order to maximize the amount of the EHR incentive payment they receive, according to the Centers for Medicare and Medicaid Services (CMS).
If the physician has not met the $24,000 threshold in allowed charges by the end of calendar year 2011, CMS expects to issue an incentive payment for the physician in March 2012 (allowing 60 days after the end of the 2011 calendar year for all pending claims to be processed). Payments to Medicare physicians will be made to the taxpayer identification number (TIN) selected at the time of registration, through the same channels their claims payments are made. The form of payment (electronic funds transfer or check) will be the same as claims payments.
Bonus payments for physicians who practice predominantly in a geographic Health Professional Shortage Area (HPSA) will be made as separate lump-sum payments no later than 120 days after the end of the calendar year for which the physician was eligible for the bonus payment.
The Medicare EHR incentive payments to physicians are based on 75% of the estimated allowed charges for covered professional services furnished by the physicians during the entire payment year. Again, if the physician has not met the $24,000 threshold in allowed charges at the time of attestation, CMS will hold the incentive payment until the Eligible Professional (EP) meets the threshold.
NOTE: Medicare Administration Contractors (MACs), carriers, and Fiscal Intermediaries (FIs) will not be making Medicare EHR incentive payments. CMS has contracted with a Payment File Development Contractor to make these payments. For questions about your EHR incentive payment, call the EHR Information Center:
* Hours of Operation: 7:30 a.m. -- 6:30 p.m. (Central Time) Monday through Friday, except federal holidays.
* 1-888-734-6433 (primary number) or 888-734-6563 (TTY number).
For more information about the Medicare and Medicaid EHR Incentive Program, please visit http://www.cms.gov/EHRIncentivePrograms.
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Recovery Audit Contractors on Hold
The Centers for Medicare and Medicaid Services (CMS) plan to expand its Recovery Audit Contractor (RAC) program nationwide are temporarily on hold. CMS recently announced four contractors for the RACs, but the contracts are being protested by two unsuccessful bidders. Due to the protests filed, an automatic stay will stop work for all four RAC regional awards until a determination is made by the General Accountability Office (GAO). The GAO has 100 days to issue its decision, after which the program will go forward.
The agency has made several changes to the RAC to make the program less burdensome to the provider community and to assure more accuracy. For example, to minimize burden CMS is limiting the number of medical record requests and the RAC "look-back period." For accuracy, each RAC must have a physician medical director and certified coders. CMS also calls for a new issue review board (greater oversight), an independent validation contractor, and annual accuracy rates for each RAC.
CMS gave some advice on how to prepare for a RAC audit: 1) know where previous improper payments have been found (OIG, CERT, Demo RAC Reports); 2) know if you are submitting claims with improper payments; 3) get ready to respond to RAC medical record requests fully and promptly; 4) appeal when necessary; 5) keep track of overpayments and underpayments the RAC finds in claims.
Carol Monaco
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Recent Medicare Legislation & its Impact on e-Prescribing
We would like to make you aware of recent changes and amendments to Medicare law that promotes the use of electronic prescribing. These changes are important whether you already use e-prescribing technology or are looking for more information on getting started. 1. New incentives to promote use of e-prescribing
The Medicare Improvements for Patients and Providers Act of 2008 contains incentives to encourage the adoption of electronic prescribing technology by prescribers.
The Act provides positive Medicare payment incentive of up to 2% for practitioners who use e-prescribing systems in 2009 through 2013, and a reduction in payments of up to 2% for providers who do not e-prescribe by 2012.
Note – more details are to come from the Centers for Medicare and Medicaid Services on what process prescribers will engage in to receive their reimbursements.
2. New Rules Surrounding Computer-Generated Fax Based Prescription Transmissions to Pharmacies
Starting January 1, 2009, all computer-generated new prescriptions for Medicare Part D must comply with the NCPDP SCRIPT standard, and thus be transmitted electronically and not by computer-generated fax.
This change is particularly relevant for practices that use electronic medical record (EMR) or e-prescribing technology. Many of these systems are currently set up to transmit prescriptions only by fax. This type of transmission will no longer be allowed after January 1, for Part D prescriptions. Practices must either print the prescription and hand them to the patient or manually fax them to the pharmacy.
However some of these same systems can be enabled to exchange prescription information with pharmacies electronically. It is important for practices to know if their technologies have this ability, and to take steps to secure it.
Members are invited to find out more about securing e-prescribing connectivity by visiting a special resource site: www.GetRxConnected.com.
The site contains:
1) A special E-Prescribing Readiness Assessment that can determine if your practice EMR or prescribing technology is compatible with the NCPDP Script Standard, and thus able to send prescriptions to pharmacies electronically, not by fax.
2) A free guide and other resources detailing how to best adopt and implement electronic prescribing technology. This includes listings of state and national programs that can provide e-prescribing software at a reduced rate or for free.
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How to check the status of a bill in Rhode Island
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Double click “Bill Status/History” in the left-hand column. You will be on the “General Assembly Bill Status System” page. Double click on “Bill Status/ History” at the top.
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In the box entitled “Bills” enter the Bill Number. Bills are 4 digits in length, 0-4999 for Senate bills and bills starting with 5 or getter are house bills.
