On July 8, the AASM announced that the Centers for Medicare & Medicaid Services (CMS) had released the display copy of the 2012 Physician Fee Schedule Proposed Rule, which is being reviewed and analyzed by AASM staff. This week the Proposed Rule was published online in the Federal Register. The final decisions on the proposed policy and payment changes are scheduled to be published in November 2011 in the final rule.

As an additional resource, the AASM has developed a template letter to assist members in drafting a response to the CBR Producer. This two-page form letter can be used in whole or in part, and it should be modified to reflect the specifics of each member’s practice. Members interested in responding to the CBR are encouraged to send a personally modified version of the form letter or their own individually crafted letter to the CBR Producer.

The AASM’s letter outlines the potential difficulties that sleep specialists will run into when prescribing hypnotics and stimulants in states that do not allow these medications to be prescribed electronically.

The AASM has received feedback from a number of members regarding the recent memo from Dr. Strollo about the Comparative Billing Reports (CBRs) that have been issued on behalf of the Centers for Medicare & Medicaid Services (CMS).  A number of members’ questions relate to how one can contact Medicare regarding the CBR content.

Centers for Medicare and Medicaid Services (CMS) provided Comparative Billing Reports (CBRs) nationally to the highest frequency billers of the sleep medicine services to educate providers regarding proper billing practices. Steps to take in response to receiving a Medicare CBR only relate to those sent during May and June 2011 to the highest frequency billers of the following CPT/HCPCS codes: 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399 and G0400.

Earlier this week the Institute of Medicine of the National Academies (IOM) issued a new consensus committee report, “Geographic Adjustment in Medicare Payment: Phase I: Improving Accuracy.” The report, which was sponsored by the Centers for Medicare & Medicaid Services (CMS), examined Medicare’s practice of adjusting fee-for-service payments to hospitals, physicians, and other clinical practitioners according to the geographic locations in which they practice.

On June 1 the Office of the Inspector General (OIG) released a statement announcing that it expects to recover $3.4 billion from investigations, audits and reviews occurring between October 2010 and March 2011, mainly involving Medicare and Medicaid. Coding Corner articles are archived on the Coding Page of the AASM website for future reference.

In April, Medicare published a proposed rule describing the Shared Savings Program, which is required by the Affordable Care Act to improve outcomes by promoting accountability and quality of care. Providers are encouraged to review the proposed rule and submit comments to Medicare by close of business on June 6, 2011.

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule for changes to the Medicare Electronic Prescribing (eRx) Incentive Program.  The proposed rule is on display at the Federal Register, and the deadline for submitting comments is July 25, 2011.