The Obama administration recently launched HealthCare.gov to promote new programs and insurance reforms in the Affordable Care Act (ACA), commonly known as the health reform law.

The site provides a breakdown of the law and gives physicians, patients and insurers a practical understanding of the reforms. After that - I couldn't find much utility for physician practices. I clicked on the "Health Care Providers" link to get the "new resources and support" that the ACA promises to provide, but the site offered only short summaries of the law. The landing page for providers was a dead end. Overall, the information was nice to have, but the info won't directly help a practice today.

For example, under "Talking to Your Patients About Health Reform" section of the providers page it mentions the annual wellness exam and preventative care without copays starting in 2011. Again, there's just a summary of the provision, there is not enough detail or explanation to help practices get ready for the initiatives or explain the new coverage to patients.

You've got the usual 60 days to comment on all the provisions in CMS's proposed 2011 Medicare Physician Fee Schedule (PFS). Just visit www.regulations.gov or click our direct link to the comment page for the proposed rule. The official deadline to file your comment is 11:59 p.m., Eastern Time, on Aug. 24.

Part B News subscribers can download a special supplement to our proposed 2011 Medicare Physician Fee Schedule coverage in the latest edition of the newsletter. We've compiled seven charts impacting physician reimbursements into one document. The charts are:

• CPT codes subject to 90% equipment utilization rate assumption that will be subject to 75% assumption in 2011;
• Codes proposed to be added to the 75% equipment utilization rate assumption list;
• Separately payable "Always Therapy" Services subject to the proposed MPPR policy;
• Proposed Cost Share Weights for GPCI update;
• Primary care services eligible for primary care incentive payments in 2011;
• Total allowed charge estimated impact for RVU, MPPR, and MEI rebasing changes; and,
• Impact of proposed rule and estimated physician update on payment for selected codes.

The document is labeled "2011_Proposed_MPFS_charts.pdf" in the Hot Documents section of the PBN Library.

CMS is giving physicians and non-physician practitioners (NPPs) an extra chance to switch their Medicare status from non-participating to participating between now and July 16. This extra window is being provided because of the 2.2% medicare payment increase under the pay-fix bill that passed June 24, the agency says. If you're currently non-par, you must complete the usual CMS-460 form and mail it by July 16, 2010 ... (read more).

Rumors on the release date for CMS's final meaningful use rule have been circulating for the last few weeks, with most educated guesses coalescing around July 16 as the latest date. These guesses are coming from some very well-informed folks who will speak at our live conference on electronic health records (EHRs), so I decided to see if they were on target. Earlier this week, I fired off an email to some folks I know at the HHS Office of the National Coordinator (ONC) to see what they were willing to say ... (read more)

A massive surge in traffic to CMS's online Provider Enrollment, Chain and Ownership System (PECOS) website is causing significant performance problems. It seems a huge number of practices are signing on to update their providers' PECOS information as the July 6 deadline for the ordering/referring rule nears. A technician at the EUS Help Desk acknowledged the issue and said it was being caused by "lots of people signing and accessing their accounts." Nothing can be done to mitigate the sudden burden on the server, and she suggested users try signing off and accessing the system in the late afternoon or evening, when traffic is usually lower ... (read full post)

The Senate's six-month Medicare pay patch proposal has received a chilly reception in the House of Representatives, so far. House Speaker Nancy Pelosi (D-Calif.) has panned the bill as "inadequate" and called on the Senate to pass an expansive package of tax provisions, extenders and the House Democrats' 19-month doc fix.

"The inadequate legislation on physicians' fees that Senate Republicans allowed to pass today is a great disappointment," Pelosi stated in a press release on Friday. "The House has approved long-term reform that ensures that Medicare patients will have access to quality physicians' services."

The House's American Jobs and Closing Tax Loopholes Act failed to gain enough support to pass procedural hurdles in the Senate last week. The Senate only passed the six month fix - which retroactively raises Medicare reimbursements by 2.2% from June 1 through Nov. 30 - by unanimous consent after CMS began processing physician claims with the 21.3% sustainable growth rate (SGR) cut on Friday. The SGR cut only effects claims with dates of service on or after June 1. 

The Senate passed a six-month Medicare payment fix just hours after CMS ordered carriers to begin processing claims with the scheduled 21.3% reimbursement cut. The pay fix bill needs to pass the House of Representatives, which is in recess until Tuesday June 22, before it can go to the president for his signature.

The temporary pay fix includes a 2.2% boost to Medicare reimbursements retroactive to June 1.

The House initially voted for a 19-month pay fix, but the legislation failed to gain enough support to pass procedural hurdles in the Senate. It remains to be seen how House leaders will react to the reduced Senate measure.  

CMS sent a memo advising lawmakers that it has begun to pay June 1 claims with the 21.3% cut after delaying claims processing for 17 days.  "We continue to monitor Congressional actions, and if Congress changes the negative update that is currently in effect, we are prepared to act expeditiously to make the appropriate changes to Medicare claims processing systems," the memo stated.

One out of every five private payer claims are processed incorrectly by insurance carriers, according to the AMA's 2010 National Health Insurer Report Card, released June 14. The results were based on the AMA's benchmarks of seven major private insurers: Aetna, Anthem BCBS, CIGNA, Coventry, HCSC, Humana and UHG. NOTE: The AMA's analysis did not include any Medicare or Medicaid contractors (read the full post for a breakdown of error rates by insurer).

CMS will hold claims for an extra three days after President Barack Obama pleaded with Congress to delay the 21.3% cut to Medicare payments during his weekly presidential address.

"We cannot allow this to happen," Obama said on Saturday. "We have to fix this problem so that our doctors can get paid for the life-saving services they provide and keep their doors open. We have to fix this problem to keep the promise of Medicare for our seniors so that they get the health care they deserve.  So I urge Republicans in the Senate to at least allow a majority of Senators and Congressmen to stop this pay cut.  I urge them to stand with America's seniors and America's doctors."

The Obama administration followed the president's remarks by buying lawmakers extra time to pass a fix.

more on Medicare pay fix