November 22, 2016

CMS Releases Medicare Physician Fee Schedule for Calendar Year 2017

When the Centers for Medicare and Medicaid Services (CMS) recently released the final rule of the Medicare Physician Fee Schedule (MPFS), this was the first year in a while that industry insiders weren’t scouring for guidelines related to the Physician Quality Reporting System or the Value-Based Payment Modifier. With those programs being replaced through the MACRA Quality Payment Program, the MPFS dealt primarily with payment policies. READ MORE

April 26, 2016

New Anthem Credentialing Guidelines Beginning July 1, 2016

Effective July 1, 2016, Anthem will start requiring credentialing for several additional practitioner and health delivery organization (HDO) provider types. READ MORE

March 10, 2016

Medicare Begins Round 2 Revalidations

New enrollment screening criteria under the Affordable Care Act requires regular revalidations for all providers enrolled in the Medicare program. The Centers for Medicare and Medicaid Services has begun notifying providers of round two revalidation deadlines. READ MORE

March 10, 2016

CMS Proposes Updates to Medicare Enrollment Process

In late February, the Center for Medicare and Medicaid Services proposed several new regulations to further screen entities and individuals who pose a risk to the Medicare program. READ MORE

March 10, 2016

Indiana Medicaid Wrapping Up Round 1 Revalidations

New enrollment screening criteria under the Affordable Care Act requires regular revalidations for all providers enrolled in the Medicare and Medicaid programs. Indiana providers face a March 26, 2016, deadline for the first round of revalidations with the Indiana Health Coverage Programs. READ MORE

February 26, 2016

CMS Strengthens Provider and Supplier Enrollment Screening

Using several new strategies, including tools provided by the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) is strengthening its screening process for providers and suppliers enrolling in the Medicare program. READ MORE

February 11, 2016

PECOS Primer: Medicare Enrollment Made Simple

In December 2015, Medicare updated their PECOS Frequently Asked Questions Fact Sheet to help make the Medicare enrollment process more transparent for providers. Whether you already are a PECOS user or are wondering why you should be, here are a few other things to know about PECOS. READ MORE

December 22, 2015

10 Things to Know about Medicare in 2016

As we prepare to turn our calendars to 2016, the Centers for Medicare and Medicaid Services (CMS) will begin to implement new policies and procedures for a new calendar year of claims submission. Here are ten things you need to know if you plan to submit claims for Medicare services in 2016. READ MORE

January 16, 2015

Medicare Revalidation Coming to a Close; Now What?

The Patient Protection and Affordable Care Act required a revalidation, or a re-enrollment, for all Medicare providers enrolled prior to March 25, 2011. Medicare Administrative Contractors have been contacting providers, and once they receive their revalidation notice, providers have 60 days to respond. The massive special revalidation is expected to be completed by March 2015. READ MORE

December 18, 2014

New Provider Enrollment Provisions to Reduce Medicare Fraud

On December 3, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that will improve CMS’ ability to deny or revoke the enrollment of entities and individuals that pose a program integrity risk to Medicare. READ MORE

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