Corporate Compliance

Transmittals and MLN Matters articles: CMS posts special RAC article, implements annual wellness visit benefit, and more

Medicare Insider, December 7, 2010

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CMS posts special article on physician vulnerabilities under the RAC program

On December 2, CMS issued the latest in a series of RAC program special MLN Matters articles. The current article aims to provide education to physicians on two vulnerabilities uncovered by the RAC demonstration program - services billed with excessive units and duplicate claims.

View the special edition MLN Matters article.

CMS implements annual wellness visit benefit

On December 3, CMS issued two transmittals to implement expanded coverage of preventive services under the Patient Protection and Affordable Care Act. Subject to certain eligibility and other limitations, Medicare will cover an annual wellness visit, including personalized prevention plan services, for an individual who is no longer within 12 months after the effective date of his or her first Medicare Part B coverage period, and has not received either an initial preventive physical examination or an annual wellness visit providing PPPS within the past 12 months. Medicare coinsurance and Part B deductibles do not apply.

Effective date: January 1, 2011
Implementation date: April 4, 2011

View the Benefit Policy Manual transmittal.

View the Claims Processing Manual transmittal.

CMS updates 2010 travel allowance under lab fee schedule

CMS has posted a revision to the travel allowances for 2010 under the clinical laboratory fee schedule.

Effective date: January 1, 2010
Implementation date: January 3, 2011

View the transmittal.

CMS makes PPS manual updates

On December 3, CMS implemented revisions to the Claims Processing Manual to account for changes to the IPPS, OPPS, IRF PPS, IPF PPS, and LTCH PPS.

Effective date: April 1, 2011
Implementation date: April 4, 2011

View the transmittal.

CMS implements primary care incentive payments, CAH provisions

On December 3, CMS implemented the 10% primary care incentive bonus pursuant to the Patient Protection and Affordable Care Act. The transmittal also discusses the incentive in relation to CAHs biling under the optional method.

Effective date: April 1, 2011
Implementation date: April 4, 2011

View the transmittal.

MLN Matters article

CMS issued several MLN Matters articles related to transmittals previously outlined in Medicare Weekly Update.



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