In a Feb. 11 press release, the Department of Health and Human Services (HHS) announced the publication of the HHS and Department of Justice joint report on their Health Care Fraud and Abuse Control Program. The report indicates that government teams recovered $4.2 Billion in fiscal year 2012. According to the press release, “for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $7.90. This is the highest three-year average return on investment in the 16-year history of the Health Care Fraud and Abuse (HCFAC) Program.”

On Feb. 1, 2013, the Centers for Medicare & Medicaid Services (CMS) published a final rule describing the National Physician Payment Transparency Program, often referred to as the “Sunshine” rule. The rule finalized procedures and processes whereby manufactures or drugs, devices, biologicals, or medical supplies provided under Medicare, Medicaid or CHIP must” report annually to the Secretary certain payments or transfers of value provided to physicians or teaching hospitals.”

The U.S. Department of Health and Human Services (HHS) released a final rule to expand the Health Insurance Portability and Accountability Act (HIPAA). The effective date of the final rule is March 26, 2013, and covered entities and business associates have 180 days after the effective date to comply with the final rule provisions.

The AASM has long been committed to educating members on future sleep care trends. The AASM is currently gathering information on state and federal laws and reimbursement policies for telemedicine services. The objective is to provide our members information on how to integrate telemedicine in a sleep practice. The AASM would also like to hear from our members who have a successful telemedicine program and willing to share your success with your colleagues.

The 2013 Medicare Physician Fee Schedule (MPFS) final rule was published on Nov.16, 2012. Since that time, as a result of the American Taxpayer Relief Act enacted on Jan. 2, 2013, the conversion factor rate used to calculate payment for services has been updated. As a result of the Act, the 26% SGR cut was averted and the 2% sequestration cut was delayed for 2 months.

The attestation deadline for the 2012 Medicare Electronic Health Record (EHR) Incentive Program is February 28, 2013. Eligible professionals who participated in the 2012 reporting period are encouraged to register and attest soon to prevent any delay to incentive payments.

In a Jan. 3 response to enactment of the American Taxpayer Relief Act, the Centers for Medicare & Medicaid Services (CMS) indicated that some carriers may not post updated 2013 Medicare physician payment rates and limiting charges until later in the month. The new law provides for a zero percent update for claims with dates of service on or after Jan. 1, 2013, through Dec. 31, 2013. Claims with dates of service prior to January 1, 2013, are unaffected. Medicare claims administration contractors will be posting the payment rates on their websites no later than Jan. 23, 2013.

AASM members can register for the new PQRIwizard program for only $225 – a savings of $74 compared to the retail price! The program offers eligible professionals a simple and cost-effective online tool to collect and report quality measure data under the CMS PQRS incentive payment program.