Medicare Update By Joy Newby, LPN, CPC, PCS Newby Consulting ...

Medicare UpdateBy Joy Newby, LPN, CPC, PCSNewby Consulting, Inc.New Medicare Payment ContractorIn 2003, The Medicare Modernization Act (MMA) included a provision requiring the Centers forMedicare & Medicaid Services (CMS) to replace its current claims payment contractors, FiscalIntermediaries and Carriers, with new contract entities called Medicare Administrative Contractors(MACs). The intent of this change is to improve Medicare’s administrative services to beneficiaries andhealth care providers by standardizing contracting principles to Medicare including competition andperformance incentives.The MACs provide a single point-of-contact for conducting all claims-related business including receipt,processing, and payment of claims. They are also responsible for provider enrollment and the first level ofclaim appeal, Redetermination.Currently there are 15 Part A/B MAC jurisdictions designed to reasonably balance distributions ofMedicare Fee-for-Service (FFS) beneficiaries, practitioners and claims volumes. Eventually CMS willconsolidate the 15 A/B MAC jurisdictions into 10 A/B MAC jurisdictions.Indiana is in Jurisdiction 8 (J-8) which also includes Michigan. In February, CMS awarded the J-8contract to Wisconsin Physician Services (WPS). Effective August 20, 2012, National GovernmentServices (NGS) will transition all remaining work in inventory to WPS.ACT NOW TO PREVENT DELAYED PAYMENTSAs part of this process, due to provisions in the Affordable Care Act (ACA), which mandates federalpayments to providers and suppliers be made electronically. Yep, no more paper checks. All providers,including those not currently receiving their Medicare payments electronically, need to complete and aCMS-588 EFT Authorization Agreement to the WPS Provider Enrollment Department.Letters instructing physicians to complete the EFT Agreement were mailed to the practice’s pay-toaddress on May 4, 2012. If you did not receive the letter and/or have not submitted the agreement, theform can be downloaded from the CMS website located at http://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads//cms588.pdf. The form should be completed and sent to WPS as soon aspossible but no later than June 30, 2012.Please read the instructions closely, in addition to the EFT agreement, for example, you must include avoided check or bank letter of verification with the EFT Agreement. The form and voidedcheck/verification letter should be sent to:WPS Medicare Part BFinancial ReportingP.O. Box 8680Madison, WI 53708-8680If you prefer to send it by overnight mail, the address isWPS Medicare Part BFinancial Reporting1717 West BroadwayMadison, WI 53713

Stay InformedJ-8 implementation information on the WPS website http://www.wpsmedicare.com/j8macpartb. Allphysicians should ensure their practice has signed up for the J8 Implementation eNews Listserv. TheWPS Medicare eNews announces the posting of the following:• Time-sensitive national and local Medicare news• Medicare program changes• Policy updates, including new, retired, and revised policies• Training events (including seminars, teleconferences, webinars, and on demand trainings!)• Communiqué newsletters• Specialty- and service-specific educational articles• Much, much more!Participate in educational events. The WPS Education Schedule is on the WPS websitehttp://www.wpsmedicare.com/j8macpartb/implementation/j8-education-schedule.shtmlTo Do List at CrossoverComplete the following items at August 20, 2012 cutover• Sign up for C-SNAP, the WPS internet provider portal, so you can verify patient eligibility, checkclaim status, enter claims online, and carry out other self-service options at your convenience:Registration will be available from the WPS is website after your August 20, 2012 cutover datehttps://www.medicareinfo.com/apps/cms/home.do This program is very similar to NGS’ Connex