Red Flag Rules Moved to 12/31/10

FTC Red Flag Rules pushed back again

New enforcement date is December 31, 2010

The American Osteopathic Association, American Medical Association and the Medical Society of the District of Columbia filed a lawsuit in federal court last week seeking to prevent the Federal Trade Commission (FTC) from extending identity theft regulations to physicians.

The complaint, prepared by the Litigation Center of the AMA and State Medical Societies, targets the contentious "Red Flags" Rule, which requires creditors to implement safeguards against identity theft. The medical societies charge that the FTC's rule exceeds the powers delegated to it by Congress and that its application to physicians is "arbitrary, capricious and contrary to the law."

At the request of Congress, the FTC has announced that it will delay the enforcement of the "Red Flags" Rule until Dec. 31, 2010. Prior to this announcement, the "Red Flags" Rule was scheduled to go into effect on June 1. For more information on the delay, visit the FTC website.

Medicare to hold payments....again!

Here we go again...Medicare will hold claims for DOS June 1, 2010.....

The Continuing Extension Act of 2010, enacted on April 15, 2010, extended the zero percent (0%) update to the 2010 Medicare Physician Fee Schedule (MPFS) through May 31, 2010. The Centers for Medicare & Medicaid Services (CMS) believes Congress is working to avert the negative update scheduled to take effect June 1, 2010. To avoid disruption in the delivery of health care services to beneficiaries and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the MPFS, CMS has instructed its contractors to hold claims containing services paid under the MPFS (including anesthesia services) for the first 10 business days of June. This hold will only affect MPFS claims with dates of service June 1, 2010, and later.

CMS states that this hold should have minimum impact on provider cash flow because, under the current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt. but we all know, there will be some cash flow issues.

PECOS - Are you Enrolled?

IMPORTANT NOTICE ABOUT MEDICARE ENROLLMENT AND PECOS:
PROVIDERS BE WARNED.....

Since last October, CMS has been recommending that offices check to make sure that their providers are enrolled in PECOS. The date for PECOS enrollment has been moved several times, with the last date, by printed document from CMS, being January 3, 2011.

I am writing to WARN Iowa Providers that there is rumbling going on at CMS indicating that the PECOS compliance date may be moved forward to July 6, 2010.

This information was presented on a CMS teleconference last week, however, the presenters were not quite clear about the new rules and kept referring those asking questions to consult the Federal Register....where clarity doesn’t necessarily prevail.

Bottom line.....if you have a provider that has no enrollment activity since November of 2003, address change, name change, change in work history, change in employment, etc. then that provider is most likely NOT in the PECOS system. If you have had activity, you should call and check just to be safe!

You can call the WPS enrollment hotline to verify if your provider is or isn’t in PECOS. The number is 866-503-7664. Callers will have to provide one of the following: Provider PTAN, Social Security Number, or Federal Tax ID number.

If your provider is enrolled in PECOS – perfect – you’re done.
If your provider is NOT enrolled in PECOS, ask the enrollment specialist what needs to be done. Keep in mind that enrollment takes a minimum of 30 and 60 days to process, so don’t delay.

PLEASE UNDERSTAND THAT THIS IS VERY IMPORTANT AND REGARDLESS OF THE NEW COMPLIANCE DATE – DO IT TODAY!