BIDPO News

Notice From Blue Cross Blue Shield of MA

The Centers for Medicare & Medicaid Services (CMS) requires all Medicare Advantage-Prescription Drug health plans to ensure that their participating providers complete Fraud, Waste, and Abuse (FWA) training no later than December 31, 2009 and annually thereafter.

To streamline the training process, HealthCare Administrative Solutions (HCAS) and its member health plans have created an online FWA training program to help you meet the mandated training deadline. HCAS member health plans that have Medicare Advantage - Prescription Drug programs include:

  • Blue Cross Blue Shield of Massachusetts (BCBSMA*)
  • Fallon Community Health Plan
  • Harvard Pilgrim Health Care
  • Health New England
  • Tufts Health Plan

Link to BCBSMA FYI mailed to physicians.

The MA Board of Registration in Medicine Notifies Physicians of the new "FTC Red Flag Rule"

Note- the Red Flag Rule Implementation date has been moved to December 31, 2010.

Board of Registration Release: On August 1, 2009, the Federal Trade Commission (FTC) intends to apply its new “Red Flags Rule” regulations to physician practices.  According to the FTC Rule, physician practices that accept insurance or allow patients to pay in installment plans must have adequate written policies and procedures in place to protect against identity theft by August 1, 2009, or face a penalty of up to $2,500 per “knowing violation.”
 
Medical identity theft occurs when someone uses a person’s identifying information, such as name, Social Security number, credit card number or insurance coverage data, without that person’s knowledge or consent, to obtain or make false claims for medical services or goods. A “red flag” is a pattern, practice or specific account or record activity that indicates possible identity theft.
 
The American Medical Association has prepared a guidance document and sample policies for physician practices. Please note, the AMA objects to the FTC’s interpretation that a physician is a “creditor” and thus subject to the Red Flag Rule, and is seeking to delay or prevent application of the Rule to physician practices. The Board of Registration in Medicine will notify its licensees if there are further developments on these regulations.
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For further information on the Red Flag Rule and for the AMA’s sample policies and procedures, see:
http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/regulatory-compliance-topics/red-flag-rules.shtml

http://www.ama-assn.org/ama1/pub/upload/mm/368/red-flags-rule-policy.pdf

Additional information is also available on the Federal Trade Commission (FTC) website. The FTC has developed a short training video on the Red Flag Rules which practices may find helpful.

CMS- "Meaningful Use"

On Tuesday, June 16th, 2009, the Health Information Technology (HIT) Policy Committee, a Federal Advisory Committee (FACA) to the U.S. Department of Health and Human Services (HHS), met to begin the process of defining "meaningful use" of electronic health records (EHRs), as related to the historic $19 billion investment to further the national adoption and implementation of health information technology as part of the American Recovery and Reinvestment Act of 2009.

The following are links to the CMS website with information on "Meaningful Use":

To view the Meaningful Use Matrix, please click on the following link:

http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11113
_872719_0_0_18/Meaningful%20Use%20Matrix.pdf

To read the Meaningful Use Preamble, please click on the following link:

http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11113
_872720_0_0_18/Meaningful%20Use%20Preamble.pdf

2010 CMS Updates on Meanigful Use

 

 

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