Client Alerts
February 2012
CMS Has Updated the EHR Information Center
with New Self-Service Options
Following months of review and collective input, the Electronic Health Record (EHR) Information Center Interactive Voice Response (IVR) system has been enhanced to provide users with an increased number of options and services to make accessing and reviewing data easier than ever before.
For eligible professionals (EPs), eligible hospitals or critical access hospitals (CAHs), the revised functionality vastly improves the efficiency in obtaining the desired information, while also offering a more varied amount of information and options for callers.
CMS is proud to announce that providers can now obtain information through an extensive IVR Self-Service option. Included in this option is a reinforced privacy protection module that requires your individual National Provider Identifier (NPI), the last five digits of your Tax Identification Number (TIN) and your EHR registration ID. Once accepted, this newly enhanced Self-Service tool allows you to:
- Obtain registration status
- Acquire attestation status
- Review payment information
- Check progress towards meeting the $24,000 threshold amount
Users may access these new options by following the steps outlined below:
- Begin by dialing (888) 734-6433
- Press 3 for Self Service
- Enter the authentication elements
These options will be available on the IVR effective February 16, 2012. Supplementary information on the program may also be viewed by visiting the FAQs section of the EHR Incentive.
EHR Information Center Hours of Operation:
7:30 a.m. - 6:30 p.m. (Central Time) Monday through Friday, except federal holidays.
(Please note that General Information and Self-Service options may be reached via IVR 24 hours a day, except during periods of planned system maintenance or upgrades).
Free Online Compliance Training
The Office of the Inspector General (OIG), the agency that oversees the Center for Medicare and Medicaid Services, recently released a series of compliance training videos related to healthcare specific issues.
CLICK HERE for these free online videos and audio podcasts that cover major healthcare fraud and abuse laws, the basics of healthcare compliance programs, and what to do when a compliance issue arises.
Recovery Audit Program: Medicare Administrative Contractor (MAC)-issued Demand Letters
As of January 3, 2012, the Centers for Medicare & Medicaid Services (CMS) is transferring the responsibility for issuing demand letters to providers from its Recovery Auditors to its claims processing contractors. This change was made to avoid any delays in demand letter issuance. As a result, when a Recovery Auditor finds that improper payments have been made to you, they will submit claim adjustments to your Medicare (claims processing) contractor. Your Medicare contractor will then establish receivables and issue automated demand letters for any Recovery Auditor identified overpayment. The Medicare contractor will follow the same process as is used to recover any other overpayment from you.
The Medicare contractor will then be responsible for fielding any administrative concerns you may have such as time frames for payment recovery and the appeals process. However, the Medicare contractor will include the name of the initiating Recovery Auditor and his/her contact information in the related demand letter. You should contact that Recovery Auditor for any audit specific questions, such as their rationale for identifying the potential improper payment.
The RAC Tsunami on the Horizon
If you think the RACs are gone, think again. The next wave is about to hit like a tsunami. We believe that the RAC auditors have been taking the easy path to money and flying under providers' radars with automated reviews. As you read this article, we hope you will understand why we believe the worst is yet to come.
Recently we have spoken to hospitals, physicians and cost report consultants who erroneously believe the Recovery Audit Contractor (RAC) program is not a threat and that the risk of recoupment basically has gone away. In one case we were told that RAC activity is not an issue because CMS is only looking at providers committing blatant fraud, not those making errors.
In truth, however, even simple errors are considered improper payments and could be considered fraud. In the past we have used the example of a faulty chargemaster creating a pattern of imbalance because inherent coding errors occur over and over. These types of simple provider errors are easily detectable during a RAC automated review.
READ FULL ARTICLE
HHS Announces Intent to Delay ICD-10 Compliance Date
As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services (HHS) Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain healthcare 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.
"ICD-10 codes are important to many positive improvements in our healthcare system," said HHS Secretary Kathleen Sebelius. "We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead. We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our healthcare system." ICD-10 codes provide more robust and specific data that will help improve patient care and enable the exchange of our healthcare data with that of the rest of the world that has long been using ICD-10. Entities covered under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will be required to use the ICD-10 diagnostic and procedure codes.
Learn more About ICD-10 Implementation
