Medicare e-prescribing payment

Starting with the new year, payment reductions set in for eligible physicians who have not become “successful” electronic prescribers in Medicare’s eRx Incentive Program and have not applied for the hardship exemption. The 1% payment reduction is for Part B-covered professional services.

Eligible doctors and practices will see further reductions in 2013 (98.5%) and 2014 (2%) if they have not met the electronic prescribing requirement.

For additional information, please visit http:/ /www.cms.gov/erxincentive

Revised ABN form

The revised Advanced Beneficiary Notice (ABN) of Non-coverage goes into effect Jan. 1, 2012.  The ABN, which is required whenever Medicare is expected to deny payment, is available for immediate use and can be accessed via the link below. Medicare will consider the old forms invalid.

For more information, and details on mandatory and voluntary use, go to http://www.cms.gov

HIPAA 5010 standards compliance

Enforcement of the updated HIPAA 5010 electronic transmission standards begins March 31, 2012, according to the Centers for Medicare & Medicaid Services (CMS).

The Jan. 1 compliance date remains in effect, however.

Nonetheless, the federal agency encourages physicians to continue their version 5010 implementation programs as planned.

CMS announced the delay in enforcement after determining that some covered entities and their trading partners will not be compliant by Jan. 1.  Many are still awaiting software upgrades, according to CMS.

The following organizations offer resources to help with the 5010 transition and future ICD-10 adoption.

Centers for Medicare and Medicaid Services
Electronic Billing & EDI Transactions

Illinois Department of Healthcare and Family Services
Companion Guide Updates for HIPAA 5010 - Transactions

CDC’s National Center for Health Statistics
ICD-10-CM Guidelines, List of Codes & Descriptions, and General Equivalency Mappings