Reprocessing Claims Affected by the Affordable Care Act and 2010 Medicare 
Physician Fee Schedule Changes

This message is for physicians, other practitioners, ambulance suppliers, 
inpatient/outpatient hospitals, long term care hospitals, inpatient 
rehabilitation facilities, home health agencies, and any other provider type 
affected by the post-effective date implementation of select provisions of the 
Affordable Care Act and the 2010 Medicare physician fee schedule.

On March 23, 2010, President Obama signed into law the Affordable Care Act.  
Various provisions of the new law were effective April 1, 2010, or earlier and, 
therefore, were implemented some time after their effective date.  In addition, 
corrections to the 2010 Medicare Physician Fee Schedule (MPFS) were implemented 
at the same time as the Affordable Care Act revisions to the MPFS, with an 
effective date retroactive to January 1, 2010.
Due to the retroactive effective dates of these provisions and the MPFS 
corrections, a large volume of Medicare fee-for-service claims will be 
reprocessed.   Given this large workload, the Centers for Medicare & Medicaid 
Services (CMS) is taking steps to ensure that new claims coming into the 
Medicare program are processed timely and accurately, even as the retroactive 
adjustments are being made.  CMS will begin to reprocess these claims over the 
next several weeks.  We expect that this reprocessing effort will take some 
time and will vary depending upon the claim-type, the volume, and each 
individual Medicare claims administration contractor.
In the majority of cases, you will not have to request adjustments because your 
Medicare claims administration contractor will automatically reprocess your 
claims.  Please do not resubmit claims because they will be denied as duplicate 
claims and slow the retroactive adjustment process.  However, any claim that 
contains services with submitted charges lower than the revised 2010 fee 
schedule amount (MPFS and ambulance fee schedule) cannot be automatically 
reprocessed at the higher rates.  In such cases, you will need to request a 
manual reopening/adjustment from your Medicare contractor.  While there is 
normally a one-year time limit for physicians and other providers and suppliers 
to request the reopening of claims, we believe that these circumstances  fall 
under the "good cause" criteria described in the Claims Processing Manual, 
Publication 100-04, Chapter 34, Section 10.11 
(http://www.cms.gov/manuals/downloads/clm104c34.pdf ).  CMS is, therefore, 
extending the time period to request adjustment of these claims, as necessary.
Medicare claims administration contactors will follow the normal process for 
handling any applicable underpayments or overpayments that occur while 
reprocessing your claims.  Underpayments will be included in your next 
regularly scheduled remittance after the adjustment.  Overpayments resulting 
from institutional provider (e.g., hospitals, inpatient rehabilitation 
facilities, etc.) claim adjustments will be offset immediately, regardless of 
the amount, unless there are insufficient funds to make the offset.  When these 
overpayments cannot be offset, the amounts will accumulate until a $25 
threshold is reached.  At that time, a demand letter will be sent to the 
institutional provider.  When a claim adjustment for a non-institutional 
provider (e.g., physician, other practitioner, supplier, etc.) results in an 
overpayment, the Medicare contractor will send a request for repayment.  If 
this overpayment is less than $10, your contractor will not request repayment 
until the total amount owed accrues to at least $10.  See the Financial 
Management Manual, Publication 100-06, Chapter 4, Section 70.16 or Section 90.2 
(http://www.cms.gov/manuals/downloads/fin106c04.pdf ) for more information.

The CMS wants to remind physicians, practitioners, suppliers, and other 
providers, impacted by the retroactive increases in payment rates for claims 
affected by the Affordable Care Act and 2010 MPFS changes, of the Office of 
Inspector General policy related to waiving beneficiary cost-sharing amounts 
attributable to retroactive increases in payment rates resulting from the 
operation of new Federal statutes or regulations.  The policy may be found at 
the following link:
http://oig.hhs.gov/fraud/docs/alertsandbulletins/Retroactive_Beneficiary_Cost-Sharing_Liability.pdf
Please contact your Medicare claims administration contractor with any 
questions about this information.



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February Flu Shot Reminder

It's Not too Late to Give and Get the Flu Vaccine. Take advantage of each 
office visit and continue to protect your patients against the seasonal flu. 
Medicare will continue to pay for the seasonal flu vaccine and its 
administration for all Medicare beneficiaries through the entire flu season. 
The Centers for Disease Control and Prevention (CDC) recommends that patients, 
health care workers and caregivers be vaccinated against the seasonal flu. 
Protect your patients. Protect your family. Protect yourself. Get Your Flu 
Vaccine - Not the Flu.



Remember - Influenza vaccine plus its administration are covered Part B 
benefits. Note that influenza vaccine is NOT a Part D covered drug. For 
information about Medicare's coverage of the influenza vaccine and its 
administration, as well as related educational resources for health care 
professionals and their staff, please visit the following CMS websites: 
http://www.cms.gov/MLNProducts/Downloads/Flu_Products.pdf and 
http://www.cms.gov/AdultImmunizations.


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through an electronic mail server to communicate Medicare policy and 
operational changes and/or updates. Responses to this email are not routed to 
CMS personnel. Inquiries may be sent by going to 
(http://www.cms.hhs.gov/ContactCMS).   Thank you.



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