Patient Protection and Affordable Care Act 2010
June 23, 2010 - A paper summarizing the healthcare impact on DMEPOS operations by Mark J Higley, Vice President Development, VGM
The Patient Protection and Affordable Care Act (PPACA) contains several provisions affecting DMEPOS programs, of which CMS and OIG consider to be high risk. READ MORE ...
June 21, 2010
REMINDER: The Centers for Medicare & Medicaid Services (CMS) has released MLN Matters Article #MM6960--Systems Changes Necessary to Implement the Patient Protection and Affordable Care Act (PPACA) Section 6404 – Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months to advise providers who submit claims to Medicare contractors that, as a result of the Affordable Care Act (ACA), claims with dates of service on or after January 1, 2010, received later than one calendar year beyond the date of service will be denied by Medicare. For more details, please read the article at http://www.cms.gov/MLNMattersArticles/downloads/MM6960.pdf on the CMS website.
April 1, 2010
From: 18 existing FFS provider listservs [mailto:ALL_FFS_PROVIDERS@LIST.NIH.GOV] On Behalf Of CMS CMSProviderResource
Sent: Thursday, April 01, 2010 10:05 AM
To: ALL_FFS_PROVIDERS@LIST.NIH.GOV
Subject: Timely Filing Requirements for Medicare Fee-For-Service Claims
Timely Filing Requirements for Medicare Fee-For-Service Claims
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which amended the time period for filing Medicare fee-for-service (FFS) claims as one of many provisions aimed at curbing fraud, waste, and abuse in the Medicare program.
The time period for filing Medicare FFS claims is specified in Sections 1814(a), 1835(a)(1), and 1842(b)(3) of the Social Security Act and in the Code of Federal Regulations (CFR), 42 CFR Section 424.44. Section 6404 of the PPACA amended the timely filing requirements to reduce the maximum time period for submission of all Medicare FFS claims to one calendar year after the date of service.
Under the new law, claims for services furnished on or after January 1, 2010, must be filed within one calendar year after the date of service. In addition, Section 6404 mandates that claims for services furnished before January 1, 2010, must be filed no later than December 31, 2010. The following rules apply to claims with dates of service prior to January 1, 2010. Claims with dates of service before October 1, 2009, must follow the pre-PPACA timely filing rules. Claims with dates of service October 1, 2009, through December 31, 2009, must be submitted by December 31, 2010.
Section 6404 of the PPACA also permits the Secretary to make certain exceptions to the one-year filing deadline. At this time, no exceptions have been established. However, proposals for exceptions will be specified in future proposed rulemaking.
Please be on the alert for more information pertaining to the Patient Protection and Affordable Care Act.
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