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Medicare Changes for 2011

Below is information you need to know about changes to the Medicare program in 2011.

• Medicare Primary Care Bonus Payment Program Established through the Patient Protection and Affordable Care Act of 2010 FAQs
  This program that makes a 10 percent Medicare bonus payment on primary care services provided by primary care physicians starting in 2011 includes most general internists.
• Medicare Annual Wellness Visit to Provide a Personalized Preventive Plan Benefit
  This benefit starts in 2011 and pays physicians for furnishing an annual wellness visit service to a beneficiary to establish a personalized prevention plan. Physicians can also furnish a “medically necessary” service during the same encounter, as needed.
• Medicare E-prescribing Incentive Program
  The Medicare 2011 e-prescribing incentive program is in many ways similar to the structure of the 2010 program. Important changes include the bonus payment for successful 2011 participation has decreased to 1% and you must participate in 2011 to avoid a payment penalty in 2012.
• Electronic Health Record (EHR) Incentive Program
  Physicians can begin to earn an incentive payment for EHR acquisition and maintenance in 2011 if they demonstrate they are using it in a meaningful way. Learn the details of the EHR Incentive Program, which is payable by Medicare or Medicaid, including the “meaningful use” requirements that must be satisfied.
• Billing Code Changes Most Relevant to Internists
  Changes have been made to the procedure codes, CPT, and the diagnosis codes, ICD-9, that physicians use to bill for their services. Learn more about the changes most relevant to internists.
• New Requirement for Face-to-Face Encounter as Part of Process for Certifying Beneficiary Home Health Care
  The Affordable Care Act (ACA) mandates that a physician conduct a face-to-face encounter to certify a beneficiary need for home health care services. The CMS rules to implement this provision require that the face-to-face encounter must occur within the 90 days prior to the start of home health care, or within the 30 days after the start of care. Review the details of this new requirement, which has significant impact on internists.
• Medicare Claim Review Programs: MR, NCCI Edits, MUEs, CERT, and RAC
• EHR Incentive Program
  Learn more about the government's EHR Incentive Program from ACP's AmericanEHR Partners.
• Medicare Pay-for-Report Program: Physician Quality Reporting System (PQRS) Resources

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