RISOPS Legislative News
How to check the status of a bill in RI
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Medicare Conversion Factor Announced
Effective January 1, the Medicare conversion factor for physician services will be $36.0666, which includes a 1.1 percent payment update resulting from the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), according to the 2009 Medicare Physician Fee Schedule final rule.
The AOA provided lengthy comments on the proposed rule on issues such as diagnostic imaging, incentive payment/shared savings programs, hospital acquired conditions (HAC), Physician Quality Reporting Initiative (PQRI) and the MIPPA provisions.
The Centers for Medicare and Medicaid Services (CMS) have decided not to finalize its proposal at the present time to require physicians to enroll as Independent Diagnostic Facility Centers and have reopened its comment period for the incentive payment/shared savings provision for an additional 90 days. CMS is looking to expand its Value-Based Purchasing initiatives and plans to hold a public listening session to discuss the expansion of the HAC payment provision, specifically targeting both the inpatient and hospital outpatient department (HOPD) settings of care.
For the 2009 PQRI, eligible professionals who satisfactorily report data on quality measures for covered professional services furnished between January 1, 2009 and December 31, 2009 will receive an incentive payment. The incentive payment is equal to 2.0 percent of the total estimated allowed charges submitted by no later than February 28, 2010 for all covered professional services furnished between January 1, 2009 and December 31, 2009.
In addition, CMS is establishing an Electronic Prescribing Incentive Program, as authorized under MIPPA. The new program will provide an incentive payment of 2.0 percent if the professional meets the program requirements for being a successful e-prescriber.
Between the 1.1 percent payment update and the two percent incentive payment for PQRI and the two percent incentive payment for e-prescribing, physicians may see a pay boost of 5.1 percent in 2009. For more details on the 2009 Medicare physician fee schedule, go to www.cms.hhs.gov
Carol Monaco
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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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2009 Budget Resolution Adopted
On March 13 and 14, the House and Senate respectively adopted the FY 2009 budget resolution. This resolution is non-binding; but sets aggregate spending and revenue targets for the fiscal year. It offers Congress a way to outline broad policy goals separate from those of the President, who submitted his budget request last month.
The House adopted its resolution (H Con Res 312) by a vote of 212-207. Sixteen Democrats and all Republicans voted against the bill. The Senate adopted its budget resolution (S Con Res 70) by a vote of 51-44. Two Republicans - Sens. Susan Collins(R-ME) and Olympia J. Snowe(R-ME) voted for the proposal, Sen. Evan Bayh, (D-IN)., voted "no."
Both the House and Senate budget resolutions would allot more discretionary spending for the 12 annual appropriations bills than the $991.6 billion proposed by the president. The House plan calls for a $25.4 billion increase above Bush's request, while the Senate version would provide an additional $21.8 billion. Both numbers include funding for advanced appropriations provided in the resolutions but not "emergency" spending, which does not count against budget spending caps.
The House passed measure includes instructions that could be used to facilitate consideration of Medicare legislation, but the Senate measure does not. However, if the chambers agree on a final budget blueprint, it could include the House-approved instructions. That reconciliation language allows legislation to move in the Senate with protection against a filibuster if the measure reduces the federal deficit, needing only a simple majority to pass, not the currently required 60 votes. Conferences will meet when Congress returns on March 31.
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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.
