Provider Partnership Email Archive

CMS asks that you share this important information with all of your association members and State and local chapters.  Thanks!

Happy Fall everyone!  E-mail problems prevented me from sending you this information on Friday, so here it is on this fine Monday morning, including information on:

Your Medicare Payments Being Reduced If the IRS Needs to Collect Overdue Taxes That You Owe

Medicare Premiums, Deductibles for 2009New Rules to Enforce Marketing Requirements During Upcoming Health and Drug Plan Enrollment Period

CMS Selection of First Coast Service Options, Inc. to Administer Medicare Claims Payment in Florida, Puerto Rico, and U.S. Virgin Islands

Update of the Hospital-Acquired Conditions (HAC) & Present on Admission (POA) Indicator Reporting Website

A New CMS Initiative That Helps to Assist and Identify Individuals Who Care for Medicare Beneficiaries as Caregivers

THIS IS A REMINDER: Beginning October 1, 2008 Your Medicare Payments Could Be Reduced If The Internal Revenue Service (IRS) Needs To Collect Overdue Taxes That You Owe

The Taxpayer Relief Act of 1997, Section 1024, authorizes the IRS to reduce certain federal payments, including Medicare payments, to allow collection of overdue taxes. Should you owe such taxes and your payments are reduced, your remittance advice will reflect a provider level adjustment code (PLB) of "WU" in the PLB03-1 data field.  For more information, please see MLN Matters Article #MM6125 available at: 

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6125.pdf

CMS Announces Medicare Premiums, Deductibles for 2009

The standard Medicare Part B monthly premium will be $96.40 in 2009, the same as the Part B premium for 2008. This is the first year since 2000 that there was no increase in the standard premium over the prior year.

The 2009 Part B premium of $96.40 is the same as the amount projected in the 2008 Medicare Trustees Report issued in March. This monthly premium paid by beneficiaries enrolled in Medicare Part B covers a portion of the cost of physicians' services, outpatient hospital services, certain home health services, durable medical equipment, and other items.

By law, the standard premium is set to cover approximately one-fourth of the average cost of Part B services incurred by beneficiaries aged 65 and over.  The remaining Part B costs are financed by Federal general revenues.  The income to the program from premiums and general revenues are paid into the Part B account of the Supplementary Medical Insurance trust fund, and Part B expenditures are drawn from this account.

To view this Fact Sheet in its entirety go to:  http://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=3272&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

Medicare Issues New Rules to Enforce Marketing Requirements During Upcoming Health and Drug Plan Enrollment Period

The two regulations issued today include prohibitions on telemarketing and other unsolicited sales contacts.  The new rules also prohibit financial incentives that could encourage agents and brokers to maximize commissions by inappropriately moving, or churning, beneficiaries from one plan to another each year.  Plans must be in compliance with these provisions when they begin their marketing activities on October 1.

The final rule implementing MIPPA marketing requirements may be viewed at http://www.cms.hhs.gov/HealthPlansGenInfo/.

The Interim Final Rule dealing with agent commissions and other MIPPA provisions may be viewed at http://www.cms.hhs.gov/HealthPlansGenInfo/.

Comments are due at 5:00 p.m. Eastern time on November 15, 2008.

Guidance for MA plans under Part C and PDPs under Part D plans may be viewed at http://www.cms.hhs.gov/HealthPlansGenInfo/Downloads/MIPPA_Imp_memo091208Final.pdf

Fact Sheets with more information on each rule may be viewed at http://www.cms.hhs.gov/apps/media/fact_sheets.asp.

To read more of the CMS press release issued 9/15/08 click here: http://www.cms.hhs.gov/apps/media/press_releases.asp

CMS SELECTS FIRST COAST SERVICE OPTIONS, INC.

TO ADMINISTER MEDICARE CLAIMS PAYMENT IN

FLORIDA, PUERTO RICO, AND U.S. VIRGIN ISLANDS

The Centers for Medicare & Medicaid Services (CMS) recently announced that First Coast Service Options, Inc. (FCSO) has been awarded a contract of up to five years for the combined administration of Part A and Part B Medicare claims payment in Florida, Puerto Rico, and U.S. Virgin Islands. 

"With this award, CMS continues its progress in reengineering the way in which the government contracts for claims administration for the largest part of the Medicare program.  CMS is seeking the best value, from a cost and technical perspective for this critical function," said Acting CMS Administrator Kerry Weems. "This is another step toward improving services to beneficiaries and providers who are in the Medicare fee-for-service benefit plan."   

FCSO will serve as the first point of contact for the processing and payment of Medicare fee-for-service claims from hospitals, skilled nursing facilities, physicians and other health care practitioners in Florida, Puerto Rico and the U.S. Virgin Islands.  The new Part A/Part B Medicare Administrative Contractor (A/B MAC) was selected using competitive procedures in accordance with federal procurement rules.  The entire press release may be viewed at:  http://www.cms.hhs.gov/apps/media/press_releases.asp

Update of the HAC/POA Reporting Website

The Centers for Medicare & Medicaid Services (CMS) has recently updated all sections of the Hospital-Acquired Conditions (HAC) & Present on Admission (POA) Indicator Reporting website to describe the changes published in CMS' Inpatient Prospective Payment System (IPPS) Fiscal Year (FY) 2009 Final Rule.  The HAC & POA Indicator information is available at http://www.cms.hhs.gov/HospitalAcqCond/ on the CMS website. 

New CMS Initiative Helps to Assist and Identify Individuals

Who Care For Medicare Beneficiaries as Caregivers

Ask Medicare provides online information, tools, and materials for caregivers

The Centers for Medicare & Medicaid Services (CMS) recently launched Ask Medicare, a new initiative to help family caregivers--those who are family members or friends who help people with Medicare access and use valuable healthcare information, services and resources. 

More than 44 million Americans, more than one in five adults, provide care to a loved one, friend or neighbor, valued in economic terms at $350 billion annually, according to a recent report by AARP.  The new initiative will provide a one-stop Web page for caregivers http://www.medicare.gov/caregivers that provides easy access to useful information about Medicare and other essential resources to help with caregiving.  Most caregivers do not think of or identify themselves as caregivers; yet so many of the resources available to them use that term.              

The Ask Medicare Website will provide links to key partner organizations that assist caregivers and beneficiaries, and present personal stories from caregivers in the community.  Support information and tools to help caregivers address common problems will also be available.  As part of the initiative, CMS will launch an e-newsletter for caregivers that will deliver information into subscribers' email boxes. 

For more information about Medicare's new caregiver initiative, please visit: http://www.medicare.gov/caregivers.

To read the CMS press release issued on September 18, 2008, click here: http://www.cms.hhs.gov/apps/media/press_releases.asp

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