CMS' message to Trailblazer on July 1, 2010

"On June 25, 2010, President Obama signed into law the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010. This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010. CMS has directed Medicare claims administration contractors to discontinue processing claims at the negative update rates and to temporarily hold all claims for services rendered on or after June 1, 2010, until the new 2.2 percent update rates are tested and loaded into the Medicare contractors’ claims processing systems. Effective testing of the new 2.2 percent update will ensure that claims are correctly paid at the new rates. CMS expects to begin processing claims at the new rates no later than July 1, 2010. Claims for services rendered prior to June 1, 2010, will continue to be processed and paid as usual.

Claims containing June 2010 dates of service that have been paid at the negative update rates will be reprocessed as soon as possible. Under current law, Medicare payments to physicians and other providers paid under the MPFS are based upon the lesser of the submitted charge on the claim or the MPFS amount. Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2 percent update rates will be automatically reprocessed. Affected physicians/providers who submitted claims containing June dates of service with charges less than the 2.2 percent update amount will need to contact their local Medicare contractor to request an adjustment. Submitted charges on claims cannot be altered without a request from the physician/provider."

Six-Month patch in place until November 3, 2010.

Late Thursday evening, June 24, the U.S. House of Representatives approved Senate-passed legislation reversing the 21.3-percent fee cut and implementing a 2.2-percent increase. The legislation extends the fee increase through November 2010.

TCMS President Jim Cox, MD, said, "While this used to be an encouraging event that led physicians to feel as if a permanent fix was on the way, unfortunately the passing of time has proven this to be untrue." He continued, "We can't keeping passing the buck on to the next session hoping they have the guts to fix it. We need a permanent solution as soon as possible."

In a statement of support, the President expressed the need for a long-term fix, saying, "I believe we need to permanently reform the Medicare formula in a way that attacks our fiscal problems without punishing our hard-working doctors or endangering the benefits on which so many of our seniors rely. I look forward to working with Congress to achieve that goal."

CMS' message to Trailblazer on July 1

"On June 25, 2010, President Obama signed into law the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010. This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010. CMS has directed Medicare claims administration contractors to discontinue processing claims at the negative update rates and to temporarily hold all claims for services rendered on or after June 1, 2010, until the new 2.2 percent update rates are tested and loaded into the Medicare contractors’ claims processing systems. Effective testing of the new 2.2 percent update will ensure that claims are correctly paid at the new rates. CMS expects to begin processing claims at the new rates no later than July 1, 2010. Claims for services rendered prior to June 1, 2010, will continue to be processed and paid as usual.

Claims containing June 2010 dates of service that have been paid at the negative update rates will be reprocessed as soon as possible. Under current law, Medicare payments to physicians and other providers paid under the MPFS are based upon the lesser of the submitted charge on the claim or the MPFS amount. Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2 percent update rates will be automatically reprocessed. Affected physicians/providers who submitted claims containing June dates of service with charges less than the 2.2 percent update amount will need to contact their local Medicare contractor to request an adjustment. Submitted charges on claims cannot be altered without a request from the physician/provider."

A Million Signatures to Stop the Medicare Meltdown

To educate patients on Medicare’s problems and engage all Texans in the drive to fix them, TMA, TCMS and county medical societies statewide are embarking on a campaign to gather 1 million signatures to stop the Medicare Meltdown.

We begin with an open letter to Congress, which we will deliver to members of the Texas congressional delegation the last week of March at news conferences across the state. (Please see — and sign — the open letter to Congress below.) The petition drive will include online petitions posted on the TMA and MeAndMyDoctor Web sites, social media petitions for Facebook and Twitter, and other tactics.

• Please add your signature to this letter and forward it to TCMS at 817-732-3033 or email it to agoyer@tcms.org.
  
  
• Encourage your patients, friends and family to sign this petition. Fax the completed page to 817-732-3033 or email it  to agoyer@tcms.org.
  
  • Take it with you to your community meetings and social clubs.
    
    
• Sign and distribute Facebook and other online petitions. 

Medicare Patch Unacceptable
What can you do?

• It is important that we call our Congressmen.  You can find their information on the here. Only you can share how these devastating patches impact your patients and your practice.
  
  • Implore them to act on a permanent solution to the flawed SGR system. 
    
    
• Encourage your patients to contact their Congressmen and share their stories. TMA has created flyers in black and white and color versions as well as English and Spanish.

Resources

Below are helpful resources for you and your patients.

• TMA's Medicare Meltdown Action Center (www.texmed.org/meltdown) has talking points, office flyers, patient letters, and SGR explanation and more.
  
• Meandmydoctor.com is a site for your patients with tools to help them contact their representatives and share the message with their community.
  
• Real Stories of TMA members sharing how this Meltdown is impacting their practice. 

Medicare Options

• Do nothing if you currently participate.
• If you are not currently a Medicare participant, complete the agreement and mail it to TrailBlazer Health Enterprises. The change would be effective Jan. 1, 2010.

• Do nothing if you do not currently participate.
• If you are currently a participant, write to each Medicare contractor to which you submit claims, advising of your termination effective Jan. 1.

• PAR physicians' opt-out affidavit must be submitted 30 days before the next calendar quarter (i.e., Jan. 1, April 1, July 1, and Oct. 1) showing an effective date of the first date in that calendar quarter.
• Non-PAR physicians may opt out at any time.
• Before opting out, refer to TrailBlazer's Medicare Opt-Out Guidelines for Physicians/Practitioners [PDF].

(Source: TMA)