Also in the News


President Obama Signs Pathway for SGR Reform Act of 2013 – On December 26, 2013, President Obama signed the Pathway for SGR Reform Act of 2013 (the “Act”), preventing the scheduled payment reduction for Medicare-treating physicians and other practitioners from taking effect on January 1, 2014.  The Act provides a 0.5 percent update for claims with dates of service on or after January 1, 2014 and extends certain fee-for-service provisions of the Middle Class Tax Relief and Job Creation Act of 2012 as well as provisions of the Affordable Care Act.  The CMS announcement regarding the Act is available on the CMS Website or by clicking here.

CMS Revises Instructions for CMS-1500 Form – On December 27, 2013, CMS issued revised CMS-1500 claim form instructions in the Medicare Claims Processing Manual.  The revisions provide instructions on completing the most recently approved Office of Management & Budget version of the CMS-1500 claim form (version 02/12). Among other changes, there are revised instructions pertaining to the use of new indicators to differentiate between ICD-9 and ICD-10 codes and qualifiers used to indicate whether a provider furnished services in an ordering, referring and supervising capacity.  While Medicare will begin accepting version 02/12 of the CMS-1500 form as of January 6, 2014, the new version must be used with claims received on or after April 1, 2014.  The revised CMS-1500 claim form instructions are available from the CMS Website, or by clicking here.  

CMS Issues Proposal Regarding Emergency Preparedness Requirements – CMS has issued a Notice of Proposed Rulemaking that would establish national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers to ensure that they adequately plan for both natural and man-made disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems. According to CMS, the proposed rule would ensure that providers and suppliers are adequately prepared to meet the needs of patients, residents, clients, and participants during disasters and emergency situations. 

Proposal Would Permit Disclosure of Mental Health Information for Gun Checks – On January 3, 2014, HHS released a proposal to modify the HIPAA Privacy Rule to permit certain HIPAA covered entities to disclose to the National Instant Criminal Background Check System (NICS) the identities of individuals who are, for mental health reasons, federally prohibited from handling or owning a firearm.  The proposed rule is set to be published in the January 7, 2014 Federal Register, and comments must be submitted no later than March 8, 2014.  A copy of the proposed rule is available from the Office of the Federal Register website, or by clicking here.

IRS Releases Notices for 501(r) Tax-Exempt Hospitals – On December 30, 2013, the IRS released two notices pertaining to rules for 501(r) tax-exempt hospitals.  Notice 2014-2 confirms that, pending publication of final regulations or other guidance, 501(r) hospitals should rely on proposed regulations contained in prior notices of proposed rulemaking issued June 26, 2012 and April 5, 2013.  Notice 2014-3 clarifies when hospitals may be excused for certain failures to meet 501(r) requirements. Copies of Notices 2014-2 and 2014-3 are available from the IRS website, or by clicking here and here.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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