Delay in Implementation of Automated Medicare Secondary Payer (MSP) Adjustments (CR 6225)
On Fri July 1, CMS implemented change request (CR) 6625 that created a systematic process in which Medicare automatically reopens/adjusts certain MSP claims when a beneficiary's MSP claims record was deleted or an end date was applied to an open beneficiary MSP record. This automated process no longer required physicians, providers, and suppliers to contact their Medicare contractors to adjust or reprocess these types of MSP claims. CMS informed physicians, providers, and suppliers of these changes through a listserv message. Due to systems issues currently affecting CR 6625, CMS directed its A/B Medicare Administrative Contractors, Durable Medical Equipment Medicare Administrative Contractors, and legacy contractors (FIs and Carriers) to immediately suspend all actions on this CR. This means that our Medicare contractors are unable to automatically reopen/adjust claims when Medicare takes action to delete or terminate a previously existing MSP record. Physicians, providers, and suppliers must revert to the pre-July 1 process and contact their Medicare contractor to request re-openings/adjustments of claims that were previously considered MSP. Therefore, if you have claims that were processed since July 1 that need to be reopened/ adjusted due to Medicare now being the primary payer, you should contact your local Medicare contractor to request that action. CMS will alert physicians, providers, and suppliers once the current issues tied to the implementation of CR 6625 have been resolved. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- Vaccinate Early to Protect Against the Flu. The Centers for Disease Control and Prevention (CDC) recommends a yearly flu vaccination as the first and most important step in protecting against flu viruses. Remind your patients that annual vaccination is recommended for optimal protection. Medicare pays for the flu vaccine and its administration for seniors and other Medicare beneficiaries with no co-pay or deductible. Take advantage of each office visit and start protecting your patients as soon as your 2011-2012 seasonal flu vaccine arrives. And, don't forget to immunize yourself and your staff. Get the Flu Vaccination -- 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 http://www.cms.gov/MLNProducts/35_PreventiveServices.asp. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed 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.gov/ContactCMS). Thank you.
