For Physicians

2013 Medicare claims: How to handle charges in January

While Congress averted the 26.5 percent Medicare pay cut last week, Medicare carriers might not post the updated 2013 payment rates until later this month.

To avoid cuts to their Medicare payments, physicians should charge their 2013 retail rates or defer submitting claims for 2013 dates of service until the new Medicare rates are published. Medicare is required by law to pay physicians the lesser amount of either their billed charge or the Medicare approved amount.

In addition, physicians are advised to wait to bill patients directly for cost-sharing amounts until the updated 2013 rates are published because changes to relative values will affect some 2013 payment amounts and limited charges.

Under the American Taxpayer Relief Act of 2012, which was signed into law Jan. 2, the 26.5 percent Medicare cut under the sustainable growth rate formula is postponed until 2014, and the 2 percent sequester cut is postponed for two months.

The Centers for Medicare & Medicaid Services (CMS) announced Jan. 3 that some Medicare carriers may not be posting the updated 2013 rates and limiting charges on their websites until as late as Jan. 23.

CMS also announced that the deadline to make Medicare participation elections has been extended to Feb. 15. Physicians can use the AMA's Medicare Participation Kit to understand their participation options.

Read CMS's announcement to learn more about processing 2013 Medicare claims and the Medicare participation enrollment deadline extension.

Sign up for Medicaid primary care pay increase

Primary care physicians who care for Medicaid patients could receive a hike in their payment rates as early as Jan. 1.

Under the Affordable Care Act, state Medicaid programs are required to pay for primary care services and vaccine administration at rates equal to Medicare payments from Jan. 1, 2013, through Dec. 31, 2014. 

Medicaid has previously paid physicians 66 percent of what Medicare pays on average. Medicaid fees for primary care doctors will rise by an average of 73 percent in 2013, American Medical News reported in a recent article.

To receive the pay increase, qualified physicians first must submit the required attestation forms. Each state's Medicaid program website should provide the appropriate forms and other state-specific resources and implementation details. State medical societies may also offer resources to help their members secure the payment increase.

Read a set of frequently asked questions from the Centers for Medicare & Medicaid Services to learn more about implementation of the new policy, including which specialties and subspecialties qualify to receive the higher payments.

Apply today for training program in tobacco control advocacy leadership

Physicians interested in becoming strong advocates for tobacco control policies in their communities and practices can apply for a special leadership program to take place April 26–27 in Washington, D.C.

The 2013 Protecting Children and Families from Tobacco Leadership Advocacy Training program will prepare physicians to be effective leaders in state and community work to promote policies that support tobacco control, protect nonsmokers and provide better access to tobacco cessation services.

The deadline to submit an application is 3 p.m. Eastern time Jan. 18. Download the application form today.

Accepted applicants will receive coach airfare and up to two nights of hotel accommodations.

This program is jointly hosted by the AMA, the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the American College of Physicians. 

The AMA is also soliciting nominations to fill vacancies on AMA councils for the 2013 year (including the Council on Medical Education). Learn more about the nominations process and how to apply.