Revenue Cycle

Important Medicare updates

Medicare Update for CAHs, September 5, 2012

CMS announces Stage 2 final rule for Medicare and Medicaid EHR Incentive Programs 

On August 23, CMS issued a fact sheet which announced a final rule to govern Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The rule specifies the Stage 2 criteria that eligible professionals, eligible hospitals, and critical access hospitals must meet in order to continue to participate in the EHR Incentive Program. 

View the fact sheet.

CMS issues transmittal for October 2012 update of the Hospital Outpatient Prospective Payment System (OPPS)

On August 24, CMS issued a transmittal describing changes to and billing instructions for various payment policies implemented in the October 2012 OPPS update.

Effective date: October 1, 2012

Implementation date: October 1, 2012

View transmittal R2531CP

View MLN Matters article MM8031

CMS issues transmittal regarding the 2013 annual update for the HPSA bonus payments

On August 24, CMS issued a transmittal regarding the 2013 annual update for the Health Professional Shortage Area (HPSA) bonus payments.

Effective date: January 1, 2013

Implementation date: January 7, 2013

View transmittal R2526CP

CMS issues October update to CY 2012 Medicare Physician Fee Schedule Database

On August 24, CMS issued a change request that amends the payment files issued to contractors based upon the CY 2012 Medicare Physician Fee Schedule (MPFS) Final Rule.

Effective date: June 27, 2012

Implementation date: October 1, 2012

View transmittal R2530CP

View MLN Matters article MM8017

CMS issues 2013 HCPCS annual update reminder

On August 24, CMS issued a transmittal regarding the healthcare common procedure coding system (HCPCS) file, which is updated and released annually to the Medicare contractors. The file contains existing, new, revised, and discontinued alpha-numeric codes for 2013.

Effective date: January 1, 2013
Implementation date: January 7, 2013

View transmittal R2529CP

CMS issues transmittal on implementation of fraud prevention predictive modeling prepayment edits for shared systems

On August 24, CMS issued a transmittal regarding the implementation of a national fraud prevention program, which will be effective January 7, 2013. 

Effective date: January 7, 2013

Implementation date: January 7, 2013 for FISS and MCS, analysis and coding for VMS; April 1, 2013 full implementation for VMS

View transmittal R1115OTN

HHS adopts a HIPAA standard for a unique health plan identifier

On August 24, the Department of Health and Human Services (HHS) announced that it adopted the standard for a national unique health plan identifier (HPID) and a data element that will serve as an “other entity” identifier (OEID).

View the fact sheet.

View the press release.

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