It was published on 11/15/2011 10:48:34 AM
The AMA advocated for changes to the process of re-enrolling 1.4 million health professionals.
Washington -- Responding to pressure from physician organizations, the agency administering the Medicare program will extend by two years the deadline to re-enroll more than 750,000 physicians.
The move will provide the Centers for Medicare & Medicaid Services with more time as it embarks on the massive enrollment revalidation effort. The latest change to the timeline would allow for a smoother re-enrollment process, CMS said.
The Medicare agency had planned to re-enroll 1.4 million physicians, nonphysician practitioners and other health care professionals by March 2013. Physicians revalidating their enrollment records would be subjected to new screening controls required by the health system reform law.
The new standards are designed to prevent fraud in the Medicare system. But physicians are considered to be low fraud risks and would be subject only to license and identification verifications instead of the more stringent screenings required for device suppliers and home health firms.
The American Medical Association had requested the delay in September. In doing so, the Association asked CMS to re-examine the statute requiring the revalidation and to consider other changes to enrollment.
"We are very pleased that CMS has agreed to the two-year extension on the deadline to revalidate physicians' Medicare status," said AMA President Peter W. Carmel, MD. "This extension, recommended by the AMA, allows physicians to be one of the last groups who will have to face this time-consuming process."
The AMA and other health professional organizations said Medicare contractors would have been hard-pressed to revalidate 1.4 million enrollment records within an 18-month window. Contractors already process about 27,000 new enrollments and more than 30,000 billing reassignments each month. The organizations worried that the new revalidation effort would have led to application backlogs or other unintended consequences, such as doctors being inadvertently banned from the program.
The health system reform law says that by March 23, 2013, no physician or other health professional may be enrolled or re-enrolled in Medicare without going through the enhanced screening procedures. A Sept. 23 letter from the AMA to CMS referenced the law and noted that the section did not require the agency to complete the effort by the 2013 date. The law provided flexibility to implement the new screening methods from that date onward, the Association said.
However, the extra time given to physicians will not affect those doctors and practices who already have received a revalidation notice, CMS said. The physician still must meet the deadlines outlined in the revalidation letter he or she received. Failing to revalidate within the designated timeframe will cause a physician's enrollment record to be deactivated.
The first set of revalidation notices were sent to those who bill for Medicare services but are not in CMS' electronic enrollment record, the agency said. Typically, these recipients are doctors who have not updated their enrollment in several years. Medicare contractors searched enrollment databases to determine which physicians are not in the electronic system.
The Association had recommended that CMS exempt physicians from the revalidation effort altogether because they are low fraud risks to Medicare. The Medicare agency also should allow physicians to revalidate at any time, and not require doctors to print, sign and mail enrollment certification statements when applications are submitted online, the AMA said.
CMS declined to exempt physicians from the process, but it was willing to make other changes. A Nov. 4 CMS email on the revalidation states that physicians who believe they are not in Medicare's Provider, Enrollment, Chain, and Ownership system, or PECOS, can call their administrative contractors about revalidating.
The agency also has told the AMA that it will make improvements to the online enrollment system. New features will include electronic signatures, document upload capabilities, seamless password resets, enhancements for authorized officials, reassignment reports, new "My enrollments page" and "Fast track view" screens, and fewer duplicative document submission requirements.
CMS has said it will introduce these changes by the end of 2012.
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It was published on 11/14/2011 11:08:37 AM
WASHINGTON – The Centers for Medicare and Medicaid Services intends to take a bigger bite out of fraud and abuse by strengthening its monitoring and analytics capabilities to prevent and detect suspicious activities.
CMS will conduct enrollment and medical claims analytics using cutting-edge methods to keep the bad actors out of Medicare, share that information with Medicaid and prevent the payment of fraudulent claims instead of chasing it down afterwards, said Dr. Peter Budetti, CMS deputy administrator for program integrity.
“This is the model for how the system is being put into place for Medicare and where we are going over time in Medicaid,” he said Nov. 9 at the National Medicare RAC Summit.
Some of the necessary technology is already deployed, while other systems will be ready the first of the year to keep an eye on program participants and money flows.
CMS is using the latest technologies for a fraud prevention system to scrutinize Medicare claims. This feeds into a risk-scoring solution, which assists in directing priorities for the agency’s anti-fraud recovery audit contractors (RACs) and for CMS to conduct analyses and investigations to determine what action is warranted. Contract awardee Northrop Grumman began operating the fraud prevention system in July, and IBM is developing and testing models that fit into the system.
“We now screen every Medicare claim prior to payment nationally. That integration into the claims processing system will become more sophisticated and agile over time,” said Budetti.
The prepayment review will be used as an investigative technique to follow leads and determine if there is any pattern of a problem. In the past, CMS had access only to post-payment claims information.
“We will revoke provider billing privileges for improper practices,” he said.
CMS will also conduct analyses of providers who enroll in its programs, assign risk levels to them and make its enrollment system more automated to accommodate new data, such as Social Security death files and loss of licensure. The automated provider enrollment screening, which will replace the more manual system, will be operational in January, he said.
A laboratory that CMS is building will examine historical and current data to identify the root causes of vulnerabilities so the agency can change policies as well as prevent future problems.
The agency also shares information broadly with states and law enforcement, including the Justice Department, Office of Inspector General and the FBI, and will move towards being able to do so with private plans, he said.
The agency plans to apply the fraud prevention technology on the Medicaid side also, Budetti said.
“We are embarking on a major initiative to look across all of our auditing activities for areas where we can coordinate and consolidate to make it more efficient and less burdensome from the providers’ perspective,” he said. This effort is included in the Medicaid recovery audit contractors (RACs) final rule, which takes effect Jan. 1.
State-based contractors are designed to recover overpayments and receive a contingency fee. Medicaid RACs will examine different kinds of arrangements than those in Medicare’s fee-for-service system, Budetti said.
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It was published on 11/9/2011 4:30:22 PM
The application fee for providers to enroll in Medicare, Medicaid and the Children’s Health Insurance Program has been set for calendar year 2012. The fee has increased to $523 from $505.
The fee applies to those enrolling in Medicare, Medicaid and CHIP for the first time as well as those revalidating their enrollment or who are adding a new Medicare practice location. The new fee is in effect between Jan. 1, 2012 and Dec. 31, 2012. The $505 fee still applies to applications submitted on or before Dec. 31, 2011.
In the notice published in the Federal Register about the fee, the Centers for Medicare & Medicaid Services noted that the fee is not required for Medicare doctors or non-physician practitioners who submit at CMS-8551 or for first-time or re-enrolling applicants of Medicaid or CHIP who are individual physicians or non-physician practitioners or who have enrolled in Title XVIII or another state’s Title XIX or XXI plan and has paid the application fee to a Medicare contractor or to another state.
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It was published on 9/1/2011 1:52:33 PM
Doctors are concerned that enrollment problems could lead some in good standing to get kicked out of the program.
By Charles Fiegl, amednews staff. Posted Aug. 29, 2011.
Washington -- Roughly 750,000 physicians in the Medicare program soon will be asked to revalidate their individual enrollment records during a massive anti-fraud effort required by the health system reform law. The Centers for Medicare & Medicaid Services hopes to weed out only the people who shouldn't have billing privileges, but physicians are concerned that legitimate health professionals could get caught up in the enrollment sweep by mistake.
CMS gradually will send revalidation requests by mail to more than 1.4 million health professionals -- more than half of whom are doctors -- between now and March 23, 2013, the agency announced on Aug. 10. Physicians who have enrolled since March 25, 2011, will not be required to revalidate, because their applications were scrutinized under new screening criteria, CMS said. Those receiving a request would have 60 days to recertify their enrollment information, which for some doctors will be similar to the process they first used to sign up with the program.
"Failure to submit the enrollment forms as requested may result in the deactivation of your Medicare billing privileges," CMS stated in the notice.
Previous revalidation efforts have targeted much smaller segments of physicians, such as those who had not updated their enrollment within the past five years or medical suppliers in areas known to be at high risk for fraud. Medicare administrative contractors across the country process about 27,000 new enrollments and more than 30,000 reassignments, or changes to billing and payment information, each month.
Doctors have described Medicare enrollment as tedious and confusing at times. Attempts to strengthen safeguards in the process have created problems for those caring for Medicare patients in recent years. In March, CMS implemented additional program integrity defenses mandated by the health reform law to prevent fraud. Physician practices have reported long wait times for new applications to be approved since then.
"We have very significant concerns with this revalidation effort in light of the problems physicians have had with enrollment and revalidation efforts in the past," said American Medical Association President Peter W. Carmel, MD. "The AMA is making this a priority and urging CMS to reconsider this action."
Physician practice administrators are being told to watch for the letters requesting revalidation, said Allison Brown, a senior advocacy adviser with the Medical Group Management Assn. in Washington. Practices are urged to begin revalidation as soon as they receive a request, she said. Physicians can revalidate using paper applications or by using CMS' online enrollment system, called PECOS, the Provider Enrollment, Chain and Ownership System, which CMS says is the most efficient way to submit necessary information.
But even if every practice complies with the letters as soon as they receive them, the plans to revalidate all health professionals who enrolled before March 25 would require contractors to process thousands of additional applications a day on top of the ones they already receive. Practices also must wait until their Medicare contractor sends them a request before they can revalidate.
"We may end up with enrollment backlogs just given the scope of the revalidation effort," Brown said.
Bureaucratic brick walls
The Neurology Medical Group of Diablo Valley in Pleasant Hill, Calif., saw the hassles of the Medicare enrollment process when it attempted to change the practice address for a neurologist who was starting at the medical group in September 2009.
The initial enrollment application sent in August 2009 went missing. A second application was denied on a technicality, and a third application was approved in February 2010. But the Medicare contractor would backdate the physician's enrollment status only to late November 2009. The contractor has denied the practice $30,000 in Medicare charges billed by the neurologist between September and November of 2009.
"It was insufferably delayed, so we could not serve Medicare patients," said Steven Holtz, MD, a neurologist at the group.
The practice recently hired another neurologist, who will start on Sept. 1. The practice sent the physician's Medicare enrollment application in July, but the contractor returned the application and noted that it was sent too early, said Nadia George, the practice administrator. Resending it on Aug. 1 resulted in an approval two weeks later, but that was short-lived. "The next day I received an email that said [the application] was rejected," she said.
She followed up with a phone call to the contractor's enrollment department and was told the application appeared to be approved. George is planning to have the new hire treat one Medicare patient before Sept. 1 and have him submit a claim to ensure that the physician is in the Medicare system.
Such an experience is not unique. Physicians tend to find enrolling in the Medicare program an unnecessarily long, complicated and bureaucratic process, said Donald Waters, executive director of the Alameda-Contra Costa (Calif.) Medical Assn. It's a task often left to professional credentialing staff and practice administrators. But even the most experienced staffers encounter problems with confusing language on enrollment forms and vague instructions that cost physician practices time and money, Waters said.
The MGMA's Brown said CMS has planned improvements to the enrollment website. Changes would allow physicians to sign online applications electronically, instead of having to print a certification statement for the application and mail it to a contractor. The improvements could be implemented by January 2012, she said.
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It was published on 9/7/2011 4:15:29 PM
By: Harry Nelson
Increased “screening” of health care providers was among the new anti-fraud “tools” ushered in by Affordable Care Act (ACA). The health care reform bill established new screening procedures and expanded the arsenal of tools to combat fraud and ensure “integrity”.
While those tools are coming soon to the Medicare Program, they are already an increasingly prominent feature of the Medi-Cal Program. If Medicare “screening” looks anything like recent Medi-Cal efforts, physicians have reason to be worried.
The first new “tool” that Medi-Cal has put to use in recent years is the Form 6207 Medi-Cal Disclosure Statement. Over the past several years, this form has led to the unexpected disenrollment and deactivation of a growing number of providers, based on minor mistakes made by physicians and their administrators.
The Disclosure Statement is one of several documents required to enroll or re-enroll in the Medi-Cal Program. It requires physicians to disclose an assortment of information, including their ownership and control in other organizations, and their business relationships with other parties. The danger is that any omission of any kind on the Disclosure Statement – or even a failure to submit an updated form within 35 days of any change of information – is grounds for the California Department of Health Care Services to deactivate a provider number for 36 months.
The problem is that the Disclosure Statement is extremely confusing. Many providers, for example, assume – incorrectly – that it is not necessary to “disclose” relationships with entities that are already enrolled in Medi-Cal, because the Department plainly already knows about them. Still other providers have made the mistake of thinking that a business co-owned by a husband and wife (or a contract between them), constitutes community property, and does not require disclosure. The form itself is exceptionally confusing: one question asks physicians to distinguish between a “contract” and an “agreement” – something that leaves legal experts scratching their heads.
After applications and updates are submitted, the Department’s Provider Enrollment division scrutinizes the forms, looking for any way to “catch” providers in mistakes. Resorting to Internet searches and other aggressive tactics, Provider Enrollment has gone from processing applications rationally to searching for any argument to impose a 36-month deactivation on the applicant. The result has been that many physicians and other healthcare providers have submitted enrollment and reenrollment applications with minor inadvertent errors, only to find themselves barred from the Program for three years.
Unfortunately, California law authorizes the Medi-Cal Program to take its severe approach. (Welfare & Institutions Code ?? 14043.26, 14043.28) In the Lieblein v. Shewry decision (137 Cal.App.4th 700 (2006)), the Court of Appeal ruled that even when a provider’s error is inadvertent and harmless, the law entitles the Department to impose this draconian penalty.
The other “anti-fraud” tool that growing numbers of physicians are encountering in recent years is the “temporary” suspension. The use of the word “temporary” is misleading, as these suspensions are often indefinite. But far more troubling than their duration is the fact is that California law permits the Medi-Cal Program to impose temporary suspensions based on an unsupported claim to have “discovered” that a provider is under investigation by some law enforcement agency. (Welfare & Institutions Code ?? 14043.36.)
Like the statutes establishing deactivation for even harmless errors, the temporary suspension law is heavy on penalty and light on procedural protections. The Department is not required to offer proof of what it has “discovered.” Nor are providers entitled to any sort of hearing to contest the claimed “discovery.” In many cases, physicians have no idea they are under “investigation,” let alone what they are under investigation for, and yet they find themselves indefinitely unable to participate in the Medi-Cal Program.
From a physician perspective, these anti-fraud tools are a troubling sign of what is ahead: an increasingly arbitrary system, that is long on draconian sanctions and short on due process, for anyone who wishes to treat beneficiaries of Medicare and Medi-Cal. In the current Medi-Cal and coming Medicare environment, physicians are well advised to ensure that their practices are sufficiently diverse to not be overly dependent on federal health program beneficiaries to the extent possible. Physicians should also recognize the existing and growing level of risk: being “screened out” of the Program increasingly has nothing to do with misconduct, and is linked to inadvertent error. Entering into a new lease, for example, without updating the Medi-Cal Disclosure Statement within 35 days, is an invitation for a 36-month deactivation. Physicians should consider the need for attorney review of Medi-Cal enrollment documents to avoid problems. And physicians may wish to consider the need for political action to amend these measures to include a measure of fair procedure.
Harry Nelson is the managing partner of Fenton Nelson, LLP, a law firm that specializes in representing physicians in matters involving the Medicare and Medi-Cal Programs.
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It was published on 8/17/2011 8:34:56 AM
Valley Stream, NY – Newport Credentialing Solutions, LLC, the nation’s leading provider of patent pending, cloud based reporting, decision support software and back office credentialing solutions for physicians and allied health providers, today announced that Michael Hobbs has joined the firm as Vice President of Business Development. Hobbs works with multi-facility health systems, hospitals, academic medical centers, and physician group practices to create significant, sustainable value.
“As health systems, academic medical centers, and physician group practices manage their revenue cycles in preparation for the roll out of the ACO delivery model, physician alignment and linking those providers to the appropriate insurance plans through a pro-active provider enrollment initiative has never been more important,” said Scott Friesen, CEO, Newport.
“Mike’s deep knowledge of the revenue cycle will help our clients develop a robust provider enrollment solution by partnering with them to meet their IT and back office needs.”
Hobbs has more than 20 years of healthcare GPO and revenue cycle experience. At Newport, he will be responsible for developing comprehensive provider enrollment IT and back office solutions as well as managing the business development team.
Previously, Hobbs worked at VHA/Novation and most recently at Amerinet where he developed innovative software driven supply chain and revenue cycle solutions. Prior to Amerinet, Hobbs worked at Owens and Minor. Hobbs proudly served in Dessert Storm as a Nuclear Biological Chemical Warfare officer. He is a graduate of the University of North Carolina at Chapel, majoring in Radiologic Science. Hobbs also has a Master’s Degree in Business Management from Amber University. Mike resides in Richmond, VA with his wife and daughter.
Newport Credentialing Solutions partners with clients to provide industry defining, cloud based reporting, decision support software and back office credentialing solutions for physicians and allied health providers. Newport works with some of the nation’s largest multi-facility health systems, academic medical centers, hospitals and group practices to help them increase revenue and manage their provider enrollment departments in a more efficient and pro-active manner.
Learn more at www.newportcredentialing.com.
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It was published on 8/15/2011 11:16:01 AM
Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. This revalidation effort applies to those providers and suppliers that were enrolled prior to March 25, 2011. Newly enrolled providers and suppliers that submitted their enrollment applications to CMS on or after March 25, 2011, are not impacted. Between now and March 23, 2013, MACs will send out notices on a regular basis to begin the revalidation process for each - provider and supplier. Providers and suppliers must wait to submit the revalidation only after being asked by their MAC to do so. Please note that 42 CFR 424.515(d) provides CMS the authority to conduct these off-cycle revalidations.
Please visit the CMS website to learn more
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It was published on 8/8/2011 8:16:30 AM
North Shore-LIJ extends agreement with credentialing firm to deliver revenue while meeting growth demands
Valley Stream, NY (June 1, 2011) Newport Credentialing Solutions, LLC, a premier provider of cloud based reporting, decision support software and back office credentialing solutions for physicians and allied health providers, announced today that North Shore-LIJ Health System’s Physician and Ambulatory Network Services group agreed to extend their agreement with Newport through 2013.
By combining Newport’s provider credentialing expertise, payer knowledge, and technology solutions with North Shore–LIJ’s rapidly growing Provider Enrollment Department, North Shore–LIJ has been able to meet the demands of its growing organization.“
As a complex and growing organization, we were interested in finding a vendor who could serve as an extension to our Department of Provider Enrollment. Newport was selected to help us continue to meet the needs of our growing organization while providing the highest levels of service,” said Felix Aviles, North Shore-LIJ’s Vice President of Practice Management. “Leveraging Newport’s expertise and technology, we’re decreasing the credentialing processing time and realizing revenue faster than before.”
“The reality is that academic medical centers and health systems are growing at unprecedented rates,” said Newport CEO Scott Friesen. “In order to meet their growth needs, these organizations are looking for innovative ways to both manage their growth and generate faster, incremental revenue. By providing comprehensive credentialing services and revenue focused credentialing technology solutions, Newport is able to meet our client’s needs. We are excited to continue our successful alliance with North Shore–LIJ.”
North Shore-LIJ is the second-largest, not-for-profit, secular healthcare system in the United States. It consists of 15 hospitals, 18 long-term care facilities and approximately 200 outpatient centers with a service area of more than 7 million people in Long Island, Manhattan, Queens and Staten Island, NY.
Newport Credentialing Solutions provides cloud based reporting, decision support software and back office credentialing solutions for physicians and allied health providers. Newport provides these services to the nation’s top academic medical centers, health systems, and large group practices. For more information, visit info@newportcredentialing.com
Please visit Fierce Healthcare for more industry news.
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It was published on 7/25/2011 11:59:59 AM
Newport launches their new ROI Calculator.This addition to our site allows users to quickly and easily calculate how Newport can assist your institution by reducing costs and increasing revenue. Click Download Now to launch the ROI calculator.
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It was published on 6/11/2011 7:36:00 AM
Scott Friesen, CEO of Newport Credentialing Solutions, is proud of the exponential growth that his company has experienced since it was founded in 2009.
Newport Credentialing Solutions is a technology and services company which provides decision support software and back office services for physicians and allied health providers in the medical credentialing and provider enrollment industry. Using cloud-based technology, Newport works with physicians and healthcare senior leadership teams to identify and manage un-tapped revenue. Newport Credentialing Solution's patent-pending solution is an unrivaled product in today's marketplace.
Newport Credentialing Solution's cloud based tools, The CAREreport, provides users with an institution wide understanding of how their credentialing departments are performing, links un-tapped revenue opportunities to the department's performance, and establishes key benchmarks that departments can use to track and trend performance.
Friesen commented: "Prior to our entrance in the market, credentialing was never viewed as an integral part of the revenue cycle. We sought to change that view. Our combined cloud based software and back office services places credentialing squarely in the middle of the revenue cycle by enabling our clients to identify operational and financial breakdowns and implement rapid corrective actions. The end result is increased revenue and operational efficiency." Friesen continued, "The goal of healthcare, as we see it, is to improve clinical outcomes through the collection, encryption, and use of critical clinical, operational and financial data. Our goal is to lead the market through our innovative software and service offerings."
Newport Credentialing can be contacted through the website located at the top of the screen or at 516-593-1380.
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It was published on 6/1/2011 5:32:00 PM
Valley Stream, NY (June 1, 2011) – Newport Credentialing Solutions, LLC, the nation’s leading provider of patent pending, cloud based reporting, decision support software and back office credentialing solutions for physicians and allied health providers, announced today that they have released their cloud based reporting and decision support software – CAREreport and CAREanalytics.
Newport’s innovative CAREreport and CAREanalytics provide an online suite of easy to use, executive dashboards which combine revenue cycle and provider enrollment metrics into unified dashboards.
“After working with some of the nation’s largest academic medical centers, health systems, hospitals, and large group practices, we identified a tremendous need for value added, easy to use, cloud based reporting and decision support software,” said Scott Friesen, CEO of Newport. “What we realized was that very few organizations viewed provider enrollment as an integral part of the revenue cycle and that many clients were losing revenue due to poor enrollment processes.”
Scott Friesen continues, “In order to help our clients identify and capture the revenue that they were losing due to poor enrollment processes, we developed CAREreport and CAREanalytics.”
CAREreport and CAREanalytics provide three novel concepts in the provider enrollment industry:
1. Online, easy to use, executive dashboards that depict current credentialing department performance
2. Links “in-process” provider enrollment applications with daily charge figures so as to present the financial impact of poor performance
3. Standardized metrics which are used to benchmark and trend performance. Further, added metrics can be used to compare a department’s performance against a piers.
“The outcome is increased awareness of your credentialing department’s operational and financial performance while being able to trend your performance against a set of standardized metrics.”
To compliment their cloud based reporting and decision support software, Newport also provides comprehensive provider enrollment, re-enrollment solutions, and expirables management solutions for physician and allied health providers.
Newport Credentialing Solutions provides cloud based reporting, decision support software and back office credentialing solutions for physicians and allied health providers. For more information, email info@newportcredentialing.com .
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