WASHINGTON, DC – Crucial decisions loom for providers pondering whether or not to grandfather their patients in Round 1 bidding areas. Just over a week remains to meet the grandfathering letter requirement.
Round one Recompete contracts start on January 1, 2014, and the requirement to send letters out is 30 business days prior to the beginning of the contract period. Since there are many holidays throughout the remainder of the year, the 30-day window closes on November 18. Look for more information from the CBIC soon. In the meantime, AAHomecare’s Kim Brummett can be reached at (202) 372-0750.
Full Implementation of PECOS Phase II Edits Announced
Last week, CMS announced that full implementation of PECOS Phase II edits on ordering/referring HME providers in Medicare Part B will be in place effective January 6, 2014. AAHomecare worked closely with CMS on the original delay of Phase II seven months ago, which was due to a lack of guidance on the operational effects of the edits.
Recently, the Association has received additional clarification from CMS on issues such as whether or not advanced beneficiary notices (ABNs) may be used, and if services are statutorily non-covered if the ordering practitioner is not enrolled in PECOS. For more details on the announcement, click here for MLN Matters.
HR 1717 Fight is Still On
Tom Ryan, president and CEO of AAHomecare warned members that there is a short window to stop the current CMS bidding program. Ryan wrote: “We must focus on the immediate objective of attaching legislation to a broader bill that Congress is likely to approve to address other Medicare issues. AAHomecare is aggressively working to achieve this goal. Your boots on the ground, pressing your local lawmakers so that we can gain more cosponsors for our legislation, are essential for preventing this precious opportunity from slipping away.
“The voices that matter most on Capitol Hill are Medicare patients whose health and quality of life are threatened by this badly flawed bidding program. Their voices and yours must be heard. Across the country, providers need to work with patient advocates and the patients themselves to rally support for our legislation.
“Call your Representative and Senators, write to them, email them, and ask them questions at public events. They need to know that their constituents care about this issue and are being negatively impacted by it.”