Corporate Compliance

Transmittals/MLN Matters articles: CMS issues emergency March 2012 update to the CY 2012 MPFS database and more

Medicare Update for Physician Services, April 5, 2012

CMS issues emergency March 2012 update (MCTRJCA) to the CY 2012 Medicare physician fee schedule (MPFS) database

On Wednesday, February 22, President Obama signed into law the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA), extending the zero percent update to the end of the calendar year, December 31. This new legislation contains a number of Medicare provisions which change or extend Medicare fee-for-service policies. This One-Time Notification addresses the specific changes to the payment files resulting from the MCTRJCA effective March 1. 

Effective Date: March 1, 2012
Implementation Date: March 15, 2012
View the transmittal

CMS replaces automated tracking and reporting of Recovery Audit or reopenings and appeals transmittal

On March 1, CMS rescinded Transmittal 1021, which directs implementation of the automated tracking/reporting of directs implementation of the automated tracking/reporting solutions. CMS replaced it with Transmittal 1050 to clarify the Legacy Provider/Supplier ID in the attached content file.

Effective Date: April 1, 2012 FISS and MCS (Analysis and Design for VMS- July 1, 2012, coding and implementation for VMS)
Implementation Date: April 2, 2012 FISS and MCS (Analysis and Design for VMS- July 2, 2012 coding and implementation for VMS) 

View the transmittal


CMS replaces intensive behavioral therapy for obesity transmittal

On March 7, CMS rescinded Transmittal 2409, which addresses Medicare coverage for intensive behavioral therapy for obesity, and replaced it with Transmittal 2421 to correct the ICD-10 code range in BR 7641-04.1.3 All other information remains the same.  

Effective Date: November 29, 2011
Implementation Date: March 6, 2012 for non-shared system edits, July 2, 2012 for shared system edits, CWF provider screen, HICR, and MCSDT changes
View the transmittal
CMS revises screening and counseling transmittals

Last week, CMS rescinded and replaced three transmittals related to screening and behavioral counseling in the primary care setting. CMS revised the transmittals in order to remove fiscal intermediary responsibility and the common working file override.   

View the Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse transmittal  

View the Screening for Depression in Adults transmittal 

View the Intensive Behavioral Therapy for Cardiovascular Disease transmittal

CMS revises Medicare Managed Care Manual

On March 23, CMS issued a transmittal that revises Chapter 13 of the Medicare Managed Care Manual. The changes include language to clarify the role of representatives and provider interaction with representatives.  

Effective Date: March 23, 2012
Implementation Date: March 23, 2012 
View the transmittal

CMS issues article about questionable billing for lower limb prosthesis

On March 26, CMS issued a special edition MLN Matters article highlighting the August 2011 OIG report titled “Questionable Billing By Suppliers of Lower Limb Prostheses.” It also discusses Medicare policy regarding the coverage of lower limb prostheses under its Part B Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) benefit.  

View the special edition MLN Matters article

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