css strategies april 2012

eNews April 2012

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Parker University President Dr. Fabrizio Mancini, D.C., appears on "The Dr. Phil" show
March 14, 2012, Dr. Mancini and Dr. Phil discussed how chiropractic care fits into a generally healthy lifestyles and the principles in Dr. Mancini's new book, The Power of Self-Healing: Unlock Your Natural Healing Potential in 21 Days. Watch the film clip.

Former Navy SEAL-Turned DC, Dr. Howard Wasdin, DC shares his stories at National Chiropractic Legislative Conference
Dr. Howard Wasdin, DC, who is spokesperson for the Foundation for Chiropractic Progress, discussed his former career as a member of the Navy's elite SEAL-Team 6, and the events that led him to become a chiropractor. Watch all three parts.


Additional Way to Submit Medical Record Documentation: Update
Effective January 15, 2012 Palmetto GBA providers will be able to submit medical records via MD. In order to send medical documentation electronically to review contractors, Medicare providers, including physicians, hospitals, and suppliers, must obtain access to a CONNECT-compatible gateway.

Certain larger providers, such as hospital chains, may choose to build their own gateway. Many providers may choose to obtain gateway services by entering into a contract or other arrangement with a Health Information Handler (HIH) that offers MD gateway services.

The following are tentative schedules of when HIHs will be ready to offer MD services: LEARN MORE


HHS Announces Delay in ICD-10 Implementation
As part of President Obama's commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).

The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 - a delay of two years from the compliance date initially specified in the 2008 proposed rule. HHS will announce a new compliance date moving forward. LEARN MORE

Extension of Enforcement Discretion Period for Updated HIPAA transaction standards through June 30, 2012
March 15, 2012 Contact: CMS Media Relations Group (202) 690-6145
The Centers for Medicare & Medicaid Services' Office of E-Health Standards and Services (OESS) is announcing that it will not initiate enforcement action for an additional three (3) months, through June 30, 2012, against any covered entity that is required to comply with the updated transactions standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA): ASC X12 Version 5010 and NCPDP Versions D.0 and 3.0.

On November 17, 2011, OESS announced that, for a 90-day period, it would not initiate enforcement action against any covered entity that was not compliant with the updated versions of the standards by the January 1, 2012 compliance date. This was referred to as enforcement discretion, and during this period, covered entities were encouraged to complete outstanding implementation activities including software installation, testing and training. LEARN MORE

Secretary Sebelius announces next stage for providers adopting electronic health records
News Release February 24, 2012 Contact: HHS Press Office (202) 690-6343 Health and Human Services Secretary Kathleen Sebelius today announced the next steps for providers who are using electronic health record (EHR) technology and receiving incentive payments from Medicare and Medicaid. These proposed rules, from the Centers for Medicaid & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), will govern stage 2 of the Medicare and Medicaid Electronic Health Record Incentive Programs.

A technical fact sheet on CMS's proposed rule is available at http://www.cms.gov/apps/media/fact_sheets.asp.
A technical fact sheet on ONC's standards and certification criteria proposed rule is available at http://www.healthit.gov/policy-research.
The proposed rules announced today may be viewed at www.ofr.gov/inspection.aspx. Comments are due 60 days after publication in the Federal Register. LEARN MORE

The Affordable Care Act Became Law March 23, 2010
If you or your patients are still confused about what changes have already taken place Healthcare.gov has a timeline which will help you to learn about what's changing and when. Some of the topics covered are:
50% discount for name-brand drugs in the Medicare "donut hole"
Expanded coverage for young adults
Small business tax credits
Pre-Existing Condition Insurance Plans


DIR Announces Additional Sessions for Workers' Compensation Forums
"Because we have received a great response from the public we are adding two additional public sessions to allow people the opportunity to provide feedback on improvements to the workers' compensation system," said DIR Director Christine Baker. "The forums are intended to discuss current issues in the workers' compensation system and to gather information from stakeholders and members of the public on suggestions for improvements." DIR Director Christine Baker and DWC Administrative Director Rosa Moran will host the forums Topics include: Provision of appropriate medical treatment without unnecessary delay, the medical provider network (MPN), utilization review (UR) or other issues
Enabling injured workers to return to work as quickly as medically feasible
Adequate compensation for permanent disabilities
Reducing the burden of liens on the system
Identification of appropriate fee schedules
Reducing unnecessary litigation costs
Assessing appropriate use of opiates and other care
Any other improvements needed

DWC changing some e-filing rules to allow more flexibility
The Division of Workers' Compensation (DWC) is changing the rules of its e-forms trial to open the electronic filing method to more participants.

As of Jan. 15, parties are no longer required to file all of their forms electronically as a condition of being in the e-forms trial. In the past, parties who joined the trial agreed not to file fillable Optical Character Resolution (OCR) paper forms in order to receive a logon and password to file directly into EAMS, the court system's electronic case management system.

This rule change means that parties have access to all of the available filing methods electronically via the e-forms trial or JET File, or through OCR paper forms. However, parties using e-forms must still attend a training session before receiving a login and password.

"Now parties have their choice of filing by OCR paper, JET File or e-forms, depending on the situation," said Mark Fudem, acting associate chief judge for EAMS. "We want to give filers more flexibility and at the same time, we want to demonstrate to them that electronic filing through e-forms and JET File is the preferred method --and it is easier and more efficient than ever. Electronic filers are happier with EAMS because they know their documents will get filed on time." LEARN MORE

Standardized medical billing form regulations not applicable to medical-legal bills
The Division of Workers' Compensations has received complaints from qualified medical evaluators (QMEs) that bills are being rejected by claims administrators because they are not on the standardized forms. By statute, medical providers are required to bill using standardized paper billing forms effective Oct. 15, 2011. This is a new requirement for medical treatment bills only. It does not apply to medical-legal bills.

The "Medical Billing and Payment Guide 2011" specifically states: "The following forms [which include the Centers for Medicare & Medicaid Services, (CMS) 1500] are the only forms to be used for paper billing of California workers' compensation medical treatment services and goods unless there is a written contract agreed by the parties specifying something different." (Medical Billing and Payment Guide, page 11, Appendix A Standard Paper Forms.) LEARN MORE


The Board is proposing to make the following changes:
This proposal would prohibit a duly licensed chiropractor and any person under their direct or indirect supervision from using any laser in the practice of chiropractic which has not been properly approved or cleared by the United States Department of Food and Drug Administration. LEARN MORE


2012 Medicare Fee Schedule-Temporary Payroll Tax Cut Continuation Act of 2011
On December 23, 2011, President Obama signed into law the Temporary Payroll Tax Cut Continuation Act of 2011 (TPTCCA). This law contains a number of Medicare provisions, which extend current Medicare fee-for-service program policies, and prevents a scheduled payment cut for physicians and other practitioners who treat Medicare patients from taking effect immediately. LEARN MORE LEARN MORE

Video Slideshow Presentation of the November 8, 2011 Physician Quality Reporting System & Electronic Prescribing Incentive Program National Provider Call
The Centers for Medicare & Medicaid Services (CMS) has released a YouTube video slideshow presentation from the November 8, 2011, National Provider Call on 'Overview of the Medicare Physician Fee Schedule to Address the 2012 Physician Quality Reporting System & Electronic Prescribing Incentive Program. Watch the video

Medicare Participating Physicians Directory (MEDPARD) which contains the listing of names, addresses, phone number and specialties of all participating has been updated. If you are not sure if your name is in the directory or if you are a "non-participating provider" or a "participating provider" you may find the answers here LEARN MORE: LEARN MORE

Now Available Online: List of Providers sent a Revalidation Request CMS has posted a listing of providers who have been sent a request to revalidate their Medicare enrollment information. The listing contains the name and national provider identifier (NPI) of each provider sent a letter, as well as the date the letter was sent. Lists of providers sent notices to revalidate their Medicare enrollment may be found on the CMS Website LEARN MORE


Why would a chiropractor risk their practice? Is it really worth the risk?
In the past few years, many offices have had their patients records reviewed by third party insurance carriers, state boards, and Medicare. In some cases, the chiropractors were required to reimburse the carriers substantial amounts of money because their documentation did not support the codes and services and/or the services were not accurately reflected in the patient's records. In other cases, they lost their licenses or were placed on probation with the state board.

You should not have to lose sleep or worry about whether your policies and practices are bullet proof. If you think it will never happen to you, or you can do it as long as you don't get caught, think again. Ask yourself, is it worth the risk? Take the time to do due diligence and review your financial policies and practices to determine if they are in compliance with both state and federal laws.

Keeping a Watchful Eye on the Chiropractic Industry

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