Medicare Interest Rate to Go Up With Overpayments

As Medicare Part B Providers, chiropractors (and other physicians) will pay Medicare contractors more in interest for unrecouped overpayments and delinquent unrecouped underpayments in the fourth quarter of 2012.  According to a recent announcement by CMS, Effective July 18 (start of Medicare 4^th Q), the interest rate will increase to 11%.

So, if you’ve been hit by a Medicare audit or are facing post-payment demands, your worst move is to do nothing!  Either pay up or appeal to get the amount reduced, but don’t just sit there – as interest in racking up.

Not sure what to do, what you’ve done wrong or how to fight back?  I’m happy to help you sort things out.  Consider scheduling a Chiropractic Audit Consult if you are facing post-payment demands from ANY payer and need a strategy, some answers or guidance on the process.  I’ve advised chiropractors on audits ranging as small as $15,000 to as large as $1.25 Million, so there’s a good chance I’ve seen it before and can help you navigate those muddy waters.

Time is Running Out for EMR Stimulus Money

The $44K EHR Stimulus drops by $5,000 if you don’t make the September deadline. To be eligible for the full $44,000 stimulus funds, you have to be using EMR for at least 90 days in 2012.  Those of you who have know you need to jump to EMR but are dragging your feet, now is your last chance to get on and be eligible for the full $44,000 stimulus.  After that, you can still get stimulus funding but it will be at a reduced rate.

Switching to Non-PAR Status With Medicare

This deadline is a bit further away. But every year I get tons of emails from chiropractors who are fed up with the Medicare system and want to “opt out.”  So I will give you plenty of notice of the deadline.

First, a clarification:  as chiropractors, you cannot opt out of Medicare!

As DC’s we have a “special” status in the Medicare system; we are neither full-fledged physicians (like MD’s) but we are also more than practitioners (like PT’s).  To quote the Medicare Benefit Policy Manual “The opt out law does not define “physician” to include chiropractors; therefore, they may not opt out of Medicare and provide services under private contract.” (Ch 15, Section 40.4).  Basically, this means you cannot leave the Medicare family.  I know that sounds a lot like the mentality of certain “agreements” made with gangs, loan sharks, drug dealers or the mob, it is an accurate comparison. The coffin, provided you are in it legitimately and permanently, is one notable exception to “opting out” of Medicare. But at that point, your participation in Medicare is so limited it is probably a non-issue.

However, you can change your provider status from PAR to NON-PAR and you have only one chance per year to do it.  Contrary to rumors, this does NOT affect the rules, does NOT give you a measure of audit protection and does NOT allow you to bypass Medicare’s fee system.

PAR vs NON-PAR status is a reimbursement issue.

Par providers are paid 5% more than Non-Par for the chiropractic adjustment.  Non-Par providers can collect upfront from their patients if they do not accept assignment.   So, the PAR vs NON-PAR debate is really an issue of cash flow.  Do you prefer to wait and receive the extra 5% reimbursement or do you wish to collect up front?

Medicare allows DC’s to change provider status the last 6 weeks of every year.  That’s mid-November through the end of December.  So, if you are contemplating the switch to Non-Par status, mark this date on the calendar.  Miss it and you have to wait another year!