October 19, 2009

NCMS Support for Updated Physician Fee Schedule

In follow-up to a letter sent last week to Senator Richard Burr and Senator Kay Hagan to support Senate Bill 1776, the NCMS sent the attached letter today to both Senators to reaffirm […]

October 16, 2009

Action Needed Now to Support S1776

Monday, October 19th the United States Senate will consider S 1776, known as the Medicare Physicians Fairness Act of 2009, introduced by Senator Debbie Stabenow (D-MI). Without the passage of this important legislation, you will see a 21% cut in Medicare reimbursement as of January 1, 2010. Your action is needed today.

October 9, 2009

New BCBSNC Addendum

BCBSNC has sent out contract addenda to many physician practices in order to comply with Senate Bill 877 Fair Contracting. Senate Bill 877 was a major legislative priority of North Carolina physicians and medical group managers in the 2009 session. NCMS is reviewing the BCBSNC addenda and has concerns related to the contact notice provision, pricing policy disclosure, availability of new fees and other provisions.

October 9, 2009

BCBSA Security Breach

Providers with BCBSNC will receive a letter this week, from the Blue Cross Blue Shield Association (BCBSA), notifying them of a provider data security breach.

October 9, 2009

Medicaid Radiology Preauthorization Orientation

Please be aware that Medsolutions, the vendor for the new Medicaid radiology preauthorization program, will hold numerous on-line orientation sessions from October 7-November 4, 2009.

October 9, 2009

CIGNA Medicare Publishes Checklist for Signatures

In response to questions by NCMS, CIGNA Government Services has created a checklist outlining requirements for physician signatures on claims and other forms of documentation.

October 2, 2009

Medicaid Provider Rate Cut Implemented Oct. 1

Comments from physicians have poured in to the NCMS following the NC Medicaid announcement on Tuesday that it would make a 9% cut to all but 89 specific codes used by physicians and other providers caring for Medicaid patients. NCMS and other physician groups have met with numerous state officials and offered complete accessibility to physicians for a dialogue about the proposed cuts. This level of cut to the provider rate services was not discussed in advance.

September 29, 2009

Medicaid Provider Rate Cut Being Implemented Oct.1

NC Medicaid has announced their proposed State Plan Amendments to save over $200 million from medical services and goods over the next two years. In order to achieve $76 million of this savings this year, NC Medicaid will make a 9% cut to all but 89 specific codes used by physicians and other providers caring for Medicaid patients.

The Medicaid codes that have been protected will continue to be paid at 95% of Medicare. The other codes will be slashed to an average of 86.5% of Medicare rates. Hospitals that are not owned by the State of North Carolina will also be impacted with a 6% cut to their DRG.

September 25, 2009

Medicaid Rate Adjustments Debated

The Department for Health and Human Services (DHHS) is moving quickly to make changes to achieve the $76 million in provider rate savings mandated by the NC General Assembly this year. A number of proposals for how to achieve that target are still being discussed. DHHS is considering multiple proposals that would make adjustments based on a physician’s specialty and other proposals that would that would create variable cuts to individual reimbursement codes. Both of these solutions would cause massive divisions within the physician community that could threaten the stability of NC Medicaid.

September 25, 2009

Compliance Dispute Officer Issues Ruling in Oncology/Rheumatology Dispute

In a disappointing ruling, Compliance Dispute Officer Martin Quinn has determined that the pricing policy and associated actions taken by Blue Cross Blue Shield of North Carolina did not violate key provisions in the BCBS Settlement Agreement.