January 2012
Important Updates/Changes for 2012 The Temporary Payroll Tax Cut Continuation Act of 2011 (TPTCCA) is the new law preventing a scheduled payment cut for physicians and other practitioners who treat Medicare patients from taking effect immediately. The negative update for the 2012 Medicare Physician Fee Schedule is now scheduled to take effect on March 1, 2012. CMS is currently developing the 2012 Medicare Physician Fee Schedule (MPFS) to implement the zero percent update.
As previously advised, Medicare claims administration contractors will be holding new January 2012 claims for up to 10 business days in order to effectively test and implement the new 2012 MPFS. These claims are expected to be released into processing no later than January 18, 2012. Claims with dates of service prior to January 1, 2012, are unaffected.
NEW!! ABN Mandatory Use Date: January 1, 2012 All ABNs with the release date of March 2008 that are used after January 1, 2012, will be considered invalid. Here is the newest version of the ABN and the instructions on appropriate use.
CMS has indicated they will not levy any enforcement actions for the first 3 months of 2012 while HIPAA covered entities continue to work towards compliance. The HIPAA 5010 compliance date was January 1, 2012. Medicare is planning to take the following steps:
Submitters/receivers that have tested and been approved for 5010/D.0 will be notified that they have 30 days to cutover to the 5010/D.0 versions. Submitters/receivers that have not yet tested were notified in December 2011 that they must submit their transition plan and timeline to their MAC in 30 days. MACs will notify the submitters/receivers; submitters/receivers have the responsibility to notify the providers they service. 1