Archive | March 2014

Hold on Medicare Claims until April 14

CMS has asked that Medicare Administrative Contractors (MACs) hold claims from April 1, 2014 through April 14, 2014, in hopes that Congress will act quickly to prevent the fee cut. This only affects MPFS claims with dates of service of April 1, 2014 and later. All claims for services delivered on or before March 31, 2014 will be processed and paid under normal procedures. Read more.

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Doctors’ Day 2014

Governor Christie has filed a resolution passed by both houses of the Legislature institutionalizing an annual commemoration of Doctors Day in New Jersey. We are thrilled and thankful that the Administration and Legislature recognize the important contributions that physicians make. The Governor has also signed a proclamation commemorating Doctors’ Day 2014.

House Votes to Pass Bill with One Year Medicare Payment Patch, No SGR Repeal

Wednesday evening, March 26, MSNJ wrote to the New Jersey congressional delegation urging them to vote NO on a bill that would provide  another Medicare payment patch, instead of permanently repealing the SGR. Yesterday morning, MSNJ joined the AMA in a similar letter to the House opposing the “Protecting Access to Medicare Act of 2014”  and advocating that the House enact the physician payment and delivery system reform policy contained in H.R. 4015/ S. 2000, the SGR Repeal and Medicare Provider Payment Modernization Act. These bills have bipartisan support and provide a framework for sustainability for the Medicare program. The endless congressional cycle of short-term remedies that serve to support a failed policy are no longer acceptable.

Thursday, March 27, the House of Representatives debated H.R. 4302, the “Protecting Access to Medicare Act of 2014,” which would postpone the imminent 24 percent Medicare physician payment cut for 12 months.  The debate took place under suspension of the rules, meaning that a two-thirds majority would be required for the bill to pass.  At the conclusion of the debate, an objection was raised about the absence of a quorum, and the vote was suspended. 

Then, shortly after noon, the House of Representatives quickly recommended and passed H.R. 4302, the “Protecting Access to Medicare Act of 2014,” on a voice vote.

The Senate could follow suit very quickly; the process for action there is still to be determined.

Read the statement of Senate Majority Leader Harry Reid made on the floor shortly after the House vote.

MSNJ is disappointed that the House has passed a bill with yet another temporary patch instead of repealing the SGR with legislation that has bicameral and bipartisan support.  We will continue to advocate for a permanent repeal of the SGR. Read AMA’s statement.

House Votes to Pass Bill with One Year Medicare Payment Patch, No SGR Repeal

        Last night MSNJ wrote to the New Jersey congressional delegation urging them to vote NO on a bill that would provide  another Medicare payment patch, instead of repealing the SGR. This morning, MSNJ joined the AMA in a similar letter to the House opposing the “Protecting Access to Medicare Act of 2014”  and advocating that the House enact the physician payment and delivery system reform policy contained in H.R. 4015/ S. 2000, the SGR Repeal and Medicare Provider Payment Modernization Act. These bills have bipartisan support and provide a framework for sustainability for the Medicare program. The endless congressional cycle of short-term remedies that serve to support a failed policy are no longer acceptable.

       This morning, the House of Representatives debated H.R. 4302, the “Protecting Access to Medicare Act of 2014,” which would postpone the imminent 24 percent Medicare physician payment cut for 12 months.  The debate took place under suspension of the rules, meaning that a two-thirds majority would be required for the bill to pass.  At the conclusion of the debate, an objection was raised about the absence of a quorum, and the vote was suspended.

       Shortly after noon, the House of Representatives quickly passed H.R. 4302, the “Protecting Access to Medicare Act of 2014,” on a voice vote.  The bill would postpone the imminent 24 percent Medicare physician payment cut for 12 months.

        The Senate could follow suit very quickly; the process for action there is still to be determined.

        Read the statement of Senate Majority Leader Harry Reid made on the floor shortly after the House vote.

        MSNJ is disappointed that the House has passed a bill with yet another temporary patch instead of repealing the SGR with legislation that has bicameral and bipartisan support. Read AMA’s statement.

March 28 Deadline to File Claims Under Aetna Class-Action Settlement will be Extended; Court Evaluates Whether to Terminate the Settlement Agreement

Aetna is seeking to terminate a proposed class-action settlement agreement that would pay physicians and patient/subscribers $120 million. At issue is Aetna’s use of the Ingenix data base to calculate usual, customary, and reasonable fees over the past decade. The settlement was reached last year and was to be the subject of a federal district court hearing for final approval on March 18. Ahead of the hearing, Aetna notified the court it was invoking a provision of the settlement that gave the insurer the right to terminate the agreement if the settlement claims of providers and subscribers opting out of the settlement exceeded $20 million. Aetna told the court, “Based on the list of Opt-Outs provided by the Settlement Administrator to Aetna and Class Counsel, the Opt-Out levels exceed the threshold.” While the termination issue is being adjudicated Aetna has agreed to toll the time for physicians/subscribers to file their claims. Therefore, physicians who planned to file a claim by the end of this week are no longer required to meet that deadline. We will keep members apprised of developments on the termination proceedings. If the settlement is terminated, then the matter will proceed to trial. Read more. Keep up to date by visiting the Aetna UCR settlement website.