CMS Announces 5010 Enforcement Delay, Final Rule on Medicaid Expansion

The Centers for Medicare and Medicaid Services (CMS) announced updates on two key policy measures for medical providers in the last twenty-four hours. 

The first, is a delay in the enforcement of the 5010 implementation deadline.  Late last year, CMS announced the would keep the deadline for compliance at January 1, 2012, but move the enforcement to March 31st; earlier this week they announced that after receiving comments from providers they will move the enforcement deadline back again, to June 30th, 2012. The CMS announcement stated that the industry is making “steady progress” in the conversion, and it noted that the Medicare Fee-for-Service program was successfully processing 70% of Medicare Part A claims and more than 90% of Part B claims in the 5010 format. Also, according to the announcement, commercial plans have been reporting “similar numbers;” state Medicaid agencies are “showing progress,” and that 98% compliance is expected before the July 1 enforcement start date. Click here for more information on 5010 implementation.

The CMS also released their final rule on the Affordable Care Act mandated Medicaid eligibility expansion to 133% of the Federal Poverty Level (FPL), beginning in 2014. 133% of the FPL translates into an income of about $15,000 for individuals and $30,700 for a family of four. The federal government will pay for the newly eligible enrollee’s from 2014-2016, then federal funds drop incrementally over the next several years and states will be forced to pick up the additional costs. MORE

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This entry was posted in Orthotics and Prosthetics, Patient, Prosthetist, re provider and tagged , , , , . Bookmark the permalink.

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