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The TMGMA Legislative Page is the home to past legislative updates from National and State resources, as well as policy updates from CMS. Check back regularly to see what is happening legislatively in the medical community. Want to see more or different information? Send your thoughts to LEGISLATIVE CONTENT.
TMGMA has a Legislative Committee, chaired by Gabi Brockelsby, that meets on a regular basis via conference call. For more information about this committee, please contact Gabi at gbrockelsby@dermclinics.com.
TMA Legistat (weekly legislative update provided by the Tennessee Medical Association)
Friday April 23, 2010
Friday April 16, 2010
Friday April 9, 2010
Special Alert: April 15, 2010 (8:00 pm)
House approves Medicare physician payment freeze through May 31; President to sign
By a vote of 289 to 112, the House of Representatives just approved H.R. 4851, the Continuing Extension Act of 2010. This legislation continues the Medicare physician payment freeze through May 31. Earlier today, the Senate approved identical legislation by a vote of 59 to 38. The president is expected to sign the bill shortly.
As we reported earlier today, the Centers for Medicare & Medicaid Services (CMS) will instruct its contractors to retroactively reprocess any claims that were paid at the lower rate. Claims with dates of service prior to April 1, 2010, are not affected and will continue to be processed under normal procedures at the rates in effect on the date of service.
We will continue to keep members apprised via email and on the website of any further CMS announcements regarding reprocessing of claims.
Special Alert: April 15, 2010 (4:46 pm)
Official CMS announcement regarding April claims processing
The Centers for Medicare and Medicaid Services (CMS) just released an official announcement regarding the processing of claims in light of Congress’ failure to extend the freeze on Medicare physician payments. Please find the full text of the announcement below.
The Senate continues to debate an amended version of H.R. 4851, the Continuing Extension Act of 2010, legislation which would continue the payment freeze at its current level through May 31. Once the Senate completes action on this bill, it will return it to the House for their consideration. Since this version of the extension legislation is different than the version passed by the House on March 17, the House must approve this Senate-passed version before sending it to the president for his signature. Yesterday, the House Rules Committee approved a rule allowing for swift consideration of this amended version of H.R. 4851. The House is expected to act on this legislation this week.
CMS Statement on processing of claims:
CMS continues to work with Congress towards possible legislative action to extend the zero percent update for the Medicare Physician Fee Schedule. The zero percent update expired on March 31, 2010. We are hopeful that Congress will take action in the next few days. Until now, CMS has been holding April 2010 date-of-service claims, anticipating congressional action. But that has not occurred. Therefore, under current law, Medicare contractors will begin processing claims with dates of service April 1 and later at the negative update rates. This will begin as soon as systems are fully tested to ensure proper claims payment. And, Medicare contractors will pay these claims on a first in - first out basis.
If subsequent congressional action extends the zero percent update retroactive to April 1, 2010, Medicare will reprocess those claims at the higher rates. Claims with submitted charges at or above the higher rates will be able to be automatically reprocessed without further action. Providers have the option of holding their affected claims until the legislative landscape becomes clearer. Claims with dates of service prior to April 1, 2010, are not affected and will continue to be processed under normal procedures at the rates in effect on the date of service.
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