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By Ginger - Site Admin on Tuesday, June 13, 2017 7:58 AM
With the implementation of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) requires all ordering, referring and prescribing providers to be enrolled in the state Medicaid program. Further, all Attending Providers must also be enrolled in Kentucky Medicaid and be eligible on the claim's date of service.

The Department for Medicaid Services implemented new claim editing to monitor this requirement on April 1, 2017. As such, this requirement is applicable to all claims with dates of service beginning on that date and going forward. In order to allow providers time to comply with this requirement, claims with dates of service between April 1. 2017, and July 1, 2017, that do not meet this requirement will continue to be paid and providers will receive an "informational" EOB indicating that incorrect Attending Provider data has been submitted. 

Claims submitted for dates of service beginning on and after July 1, 2017, that do not comply with this...
By Ginger - Site Admin on Monday, April 07, 2014 8:47 AM
For the Medicare Fee-for-Service (FFS) program, claims with dates-of-service or dates-of-discharge on or after April 1, 2013, will continue to incur a 2 percent reduction in Medicare payment through March 31, 2015, due to "Sequestration." Claims for durable medical equipment (DME), prosthetics, orthotics and supplies, including claims under the DME Competitive Bidding Program, will continue to be reduced by 2 percent based upon whether the date-of-service, or the start date for rental equipment or multi-day supplies, is on or after April 1, 2013.

The claims payment adjustment will continue to be applied to all claims after determining coinsurance, any applicable deductible and any applicable Medicare Secondary Payment adjustments. Though beneficiary payments for deductibles and coinsurance are not subject to the 2 percent payment reduction, Medicare’s payment to beneficiaries for unassigned claims is subject to the 2 percent reduction. The Centers for Medicare and Medicaid Services (CMS) is encouraging...
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