Issue link: https://beckershealthcare.uberflip.com/i/898852
22 CFO / FINANCE CMS Revokes Physician's Medicare Billing Privileges Over $670 in Questionable Charges By Ayla Ellison B ryan Merrick, MD, a physician at McKenzie (Tenn.) Medical Center who has been practicing medicine for more than three decades, says CMS is pulling his Medicare billing privileges due to clerical er- rors, according to e Jackson Sun. Dr. Merrick said CMS revoked his Medicare billing privileges for three years in April. He claims he is being dropped from the Medi- care program because he billed Medicare for 10 patients he didn't see. However, he argues the billing mistakes were clerical errors. For example, he said in one case a staff member mixed up two patients with similar names. "I didn't do anything personally wrong, pro- fessionally wrong or unethical," Dr. Merrick told WBBJ. He said CMS is questioning $670 billed over a 20-month period. e federal government re- viewed 30,000 claims submitted by Dr. Mer- rick and only 30 billings for 10 patients were identified as improper. Dr. Merrick appealed CMS' decision, but his appeal was denied in August. He plans to take his case before an administrative law judge, but there is not a set timeline for that process, according to e Jackson Sun. He has also en- listed the help of former Tennessee Sen. Roy Herron, who is asking Rep. David Kustoff, R-Tenn., and Sen. Lamar Alexander, R-Tenn., to review the case. Commenting on Dr. Merrick's situation, Mr. Herron said, "is is the worst and most egre- gious abuse of an individual by government that I have seen in over a quarter-century of dealing with the government." n What CMS' New Medicare Cards Mean for Providers: 7 Things to Know By Morgan Haefner C MS will begin mailing new Medicare ID cards to roughly 58 million beneficiaries next April to meet the Medicare Access and CHIP Reauthorization Act deadline to remove Social Security numbers from all cards. Here are seven things providers need to know about the new cards, ac- cording to CMS. 1. Providers must change practice management systems to accept new Medicare beneficiary identifiers (MBI) by April 2018 for billing, claims sta- tus and eligibility status transactions. The MBI will be a randomly-assigned 11-character identifier comprising numbers and uppercase letters. 2. Providers using vendors to bill Medicare will need to verify vendors' MBI practice management system changes. 3. CMS will enact a transition period beginning April 2018 through De- cember 2019 during which providers can use either MBIs or SSN-based health insurance claim numbers (HICN) to file claims. Beginning in Octo- ber 2018, CMS will return HICNs and the MBIs on each remittance advice for providers who submit a claim using an SSN-based HICN. 4. Members can up look up their MBI in April 2018 through secure web interfaces. Providers will be able to do the same June 2018. 5. Providers should verify addresses they have on file for Medicare ben- eficiaries match electronic eligibility transaction responses from CMS. Patients with differing addresses will need to contact the Social Security Administration to make a correction. 6. CMS is developing material for providers to give to patients as a re- minder to use the new cards. The agency encourages providers to work with primary care physicians or referring facilities if patients and their caregivers are unable to provide their MBIs. 7. CMS released a first look at the MBI-based cards Sept. 14. n Michael Jordan Donates $7M to Novant Health By Ayla Ellison M ichael Jordan, basketball legend and majority owner of the Char- lotte Hornets, is donating $7 mil- lion to Winston-Salem, N.C.-based Novant Health to build two medical clinics. The Novant Health Michael Jordan Fam- ily Clinics, which will serve at-risk and un- derserved communities in Charlotte, N.C., are expected to open in 2020. Over five years, the two clinics are projected to serve 35,000 patients who do not currently have access to preventive and primary care or who use the emergency department for non-urgent medical care. "I am proud to partner with Novant Health to bring critical health services to under- served areas of Charlotte and the thou- sands of North Carolinians with limited access to healthcare," said Mr. Jordan. "Through my years of working with No- vant Health, I have been impressed with their approach and their commitment to the community. It is my hope that these clinics will help provide a brighter and healthier future for the children and fami- lies they serve." n