Physician Assistant Medicaid Enrollment Update

Following a stakeholder meeting last week in which the North Carolina Medical Society played an active role, the Division of Medical Assistance (DMA) has announced that the enrollment requirement for physician assistants (PAs), as well as for nurse practitioners (NPs), is being delayed until further notice.  DMA has submitted a State Plan Amendment to the Centers for Medicaid and Medicare Services (CMS) to allow the direct enrollment of PAs. The North Carolina State Plan already allows NPs the option to direct enroll. NCMS continues to urge PAs to hold their Medicaid enrollment applications until CMS approves the State Plan Amendment and DMA clarifies details around billing, rates, and other applicable requirements for these practitioners.  NCMS will continue to provide updates on this issue as we receive them.

BCBSNC to Postpone Radiology Reimbursement Policy Change

StraightLine Medical expressed our concern to BCBSNC directly and to radiology practices when the carrier announced impending radiology reimbursement reductions. We provided information from the Federal Register to counter BCBSNC's justification that their policy was in line with Medicare and encouraged our radiology community to express their concern.

Our thanks to the North Carolina Medical Society, North Carolina Radiological Society and the North Carolina Hospital Association for their work with BCBSNC on behalf of radiologists. The policy has not been changed based on my initial review however it has been delayed until December 1, 2011. I trust that provides the NCMS, NCACR and NCHA adequate time to provide more data showing that BCBSNC extending the reduction of the technical component of multiple (non-contiguous) imaging services across all modalities is beyond the reductions of carriers in North Carolina, including Medicare and Medicaid.

UPDATE: BCBSNC’s Radiology Services Reimbursement Policy Revised and Reposted

October 7th, 2011 by Conor Brockett

Tis the Season - Part Two

It feels like everyone has an opinion about an SGR fix and reductions in Medicare and Medicaid spending. It often feels like a losing proposition to be able to accomplish both goals simultaneously. Welcome to Washington!

Regardless of which side of the reimbursement bandwagon you sit on, what happens on The Hill over the next couple of months is going to impact how much payers pay or how much physicians get paid. Commercial contracted fee schedules can be tied to Medicare's rates so the decisions can have far-reaching effects some physicians may not realize.

As I mentioned in yesterday's blog post, not every physician will be impacted in exactly the same way. This article, again from the folks at Physician Practice, provides the perspective from a few different players on the "get paid" end of the discussion. Get out your roster so you can keep all the players straight.

What Various Proposals to Cut Medicare Mean to Physicians

Tis the Season to Appeal to Congress

There is a buzz in the air with all the appeals to Congress to fix the SGR and at the same time reduce Medicare and Medicaid spending. I expect everyone to weigh in with their opinion on the proposed physician pay cuts over the next month. This is a conversation all of us in the medical community need to be paying attention to. Pay attention to the position of the AMA, your state and local medical boards and certainly that of your specialty as well. The cuts will not affect every physician in exactly the same way so gains that benefit one group (primary care physicians) might have a negative effect on specialists.

I've seen many articles so far on my RSS feed but the one I chose to share here is from the American Medical Association:

AMA Urges Congress to Repeal, Replace Medicare Physician Pay Formula