The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 mandates removal of Social Security Number (SSN)-based HIC numbers from Medicare cards to address current risk of beneficiary medical identity theft. CMS will use a new MBI generator to assign over 150 Million MBIs beginning April 1, 2018, and continuing through December 31, 2019, for full implementation January 1, 2020. While CMS will continue to process transactions utilizing a beneficiary's current HIC number during the transition period, Medicare fee for service entities must modify their current processes and systems to be ready to submit or exchange the MBI by April 1, 2018. The current system requires a 9-byte SSN plus 1 or 2-byte BIC. The MBI system will require an 11-byte alpha numeric numeration system. All Medicare fee for services entities are advised to check all of their internal billing systems to be certain the software they are currently using will accommodate the new MBIs. During the transition period, Medicare entities will be allowed to enter either the MBI or HIC number. If you use vendors to bill Medicare, ask them about their MBI practice management system changes and make sure they are ready for the change.
Where would today's medical profession be without clinical labs? So much of proper diagnosis, treatment and prevention of illness are dependent on the tests conducted on blood, urine and saliva in those labs in New York and elsewhere.
A high-profile criminal trial is under way involving an eye doctor who is accused of operating a $108 million Medicare fraud scam involving senior citizens and minorities.
In recent years, the government has been taking a much more aggressive approach to health care fraud enforcement, and it looks like enforcement efforts could get even more aggressive under the Trump administration.
In its annual report from the 2015 fiscal year, the Department of Health and Human Services' Office of Inspector General had some criticism for hospices.