CMS Strikes Again

Those wild and crazy people at The Centers for Medicare & Medicaid Services have been busy again.

They recently launched a new Twitter handle @CMSgovPress. If you’re interested in real-time updates from CMS, be sure to follow it. Their first tweet was about open enrollment, and reaped this responsive tweet from @MedicareGov : “Proud to the be the subject of your first tweet, @CMSgovPress! Thanks for spreading the word on the start of #Medicare Open Enrollment.”

How millennial. Hopefully they won’t open a SnapChat account anytime soon.

Since March of 2016, CMS has been working on another stealth project – issuing brand new identification numbers and cards to each of the 60 million Medicare beneficiaries. The goal is to replace the current ID numbers, which include Social Security numbers and have been a bonanza for medical identity thieves, with a new 11-digit alpha-numeric code that will be called – wait for it – Medicare Beneficiary Identifier (“MBI”). So creative.  

The Medicare Beneficiary Identifier was authorized by Congress in the Medicare Access and CHIP Re-authorization Act and is being criticized by the Medical Group Management Association. So if you want to impress your friends, just tell them that “CMS has a new MBI and now MGMA hates MACRA” and casually stroll away.

The reason the medical groups are in an uproar is that now physician practices will have to upgrade to new practice management software to accommodate the new numbering system, they say they are concerned that Medicare beneficiaries will be confused about the change, and secondary insurance companies will have to completely revamp their coordinating benefits. All of which will cost doctors money. Not to be pessimistic, but this could drive even more doctors out of the Medicare business.  

Undaunted, CMS plans to issue new cards beginning in April, 2018.

On another front, CMS is working on a new policy about surprise bills.

Those are the extremely unwelcome bills that a consumer receives when he or she has gone to an in-network facility and then finds out that care has been provided by an out-of-network specialist. CMS has suggested a consumer’s deductible could be counted towards the cost. A trade group representing doctors and hospitals has another two-step solution – requiring insurance companies to use standardized disclosure language and allowing consumers to appeal the bills in a mediation process. So far, no one has suggested that the middlemen – insurance companies – just take some of their ludicrous profits and pay hospitals and doctors decent money to widen their in-network provider list.   

There is a tweet in there somewhere.  

On another issue – the flu vaccination numbers are in, and they aren’t looking good. Turns out that 54% of the general population didn’t get a flu vaccination last year. That is a 1.5% increase over last year. Since older adults are more likely to be hospitalized by the flu if they catch it, this is a troubling trend. This year there is a special vaccine, containing an immune-boosting ingredient called ‘an adjuvant”,  available to people over 65.     

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The information contained in this article is general information only and does not constitute legal advice.