Winter - Indiana Academy of Family Physicians

service on or after January 1, 2007, Medicarewill waive the annual Medicare Part Bdeductible for colorectal cancer screeningtests billed with the HCPCS codes listedbelow. While the deductible will be waivedand will not apply for colorectal cancerscreening test services furnished on or afterJanuary 1, 2007, the Medicare beneficiary isstill financially responsible for the MedicarePart B 20 percent coinsurance.Unfortunately, the DRA did not amend§1834(d)(3)(D) of the Social Security Actwhich states “if during the course of suchscreening colonoscopy, a lesion or growth isdetected which results in a biopsy orremoval of the lesion or growth, paymentunder this part shall not be made for thescreening colonoscopy but shall be made forthe procedure classified as a colonoscopywith such biopsy or removal.” Based on thisstatutory language, in such instances the testor procedure is no longer classified as a“screening test.” Thus, the deductible WILLNOT be waived in such situations.Conversion Factor Reduced in Final RuleUnless Congress intervenes, the Medicarelaw includes a statutory formula that requiresCMS to implement a minus-5.0-percentupdate in payment rates for physician-relatedservices. This is slightly less than the 5.1-percent reduction in the proposed rule.AdminaStar Federal Medicare Part BOnline Report ToolInformation is critical!! Sign up today for theOnline Report Tool, where you can haveinstant access to the percentage of cleanclaims filed by family physicians; the familyphysicians’ nonpayment rate; yournonpayment rate; your percentage above orbelow Indiana family physicians; and the topten reasons for nonpayment.Register today at:https://www.adminastar.com/Providers/ProviderReports/secure/enrollment.cfmNew Medicare Secondary Payer RecoveryClaims ContractorCMS has contracted with Chickasaw NationIndustries, Inc. to be the new MedicareSecondary Payer Recovery Contractor(MSPRC) effective October 2, 2006. Thisorganization will serve all 51 states.The MSPRC’s trained staff will help youwith your MSP post-payment recoveryinquiries. Their Customer ServiceRepresentatives are available Mondaythrough Friday, from 8:00 a.m. to 8:00 p.m.,Eastern Time, except holidays. Their tollfreeline is 1-866-677-7220. TTY/TDD: 1-866-677-7294 has been set up for thehearing and speech impaired.Written inquiries may be sent to the followingaddresses:MSPRC Auto/LiabilityPO Box 33828Detroit, MI 48232-3828Please note liability insurance includes selfinsuranceand all types of liability insurance,including, but not limited to, automobileliability insurance, uninsured motorists’insurance, underinsured motorists’ insurance,homeowners’ liability insurance, malpracticeinsurance, product liability insurance andgeneral casualty insurance. No-faultinsurance includes, but is not limited to,automobile, homeowners’ and commercialplans. Sometimes no-fault insurance is calledmedical payments coverage or personalinjury protection.Address Group Health Plan insurance MSPrecovery inquiries to:MSPRC GHPPO Box 33829Detroit, MI 48232-3829Address Workers’ Compensation MSPrecovery inquiries to:MSPRC WCPO Box 33831Detroit, MI 48232-3831More information can be found regarding theMSPRC at the following Web site:https://www.cms.hhs.gov/MSPRGenInfo/03_MSPRCRules.aspMedicare Medical Review Has New NameThe Medical Review section of the Web isnow titled “Clinical Education.” TheProgressive Corrective Action (PCA) caseresult information and clinical education youhave always found under Medical Review isstill available under this new link.25