Starting this month, Medicare rules got tougher for physician practices--in a way that could not only deny the practices revenue, but even get them kicked out of the program completely.
The rules, which became effective April 1, cut the time-frame under which physicians can bill retroactively for services after a successful enrollment or re-enrollment. The window plummeted from 27 months to a mere 30 days. At the same time, practices must alert contractors of any changes in practice locations within 30 days, or risk expulsion from Medicare for as much as two years. In other words, we're talking about serious stuff here.
These changes, which appeared in the final 2009 Medicare physician fee schedule, were set to go into effect Jan. 1, but the AMA and the Medical Group Management Association convinced CMS to put things on hold for a few months and sort through the groups' concerns.
CMS, for its part, is telling doctors that it's not trying to punish practices that are doing their best to comply. CMS also notes that there's a workaround for the enrollment problem that can extend the retroactive billing window. Still, physicians are still gun-shy after coping with the transition to the National Provider Identifier number.
To learn more about the rules:
- read this American Medical News piece