Medicare News
In other Medicare news, physicians have until March 17 to change their Medicare “participating” or “non-participating” status; it is unclear whether that deadline will be extended in response to upcoming Congressional action. Additional information regarding changing your participation status may be found on the WVSMA’s website, www.wvsma.com.
The Calendar Year (CY) 2010 anesthesia conversion factor (CF), released on December 23, 2009, is being corrected to reflect the CY 2010 anesthesia fee schedule practice expense changes for West Virginia. Also, the malpractice relative value units (RVUs) for the CY 2010 West Virginia Medicare Physician Fee Schedule are being corrected for 52 codes. For more information, go to
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZULF82485?opendocument
There are times when a provider will receive a primary payment from another insurance company after Medicare has paid as primary. When this happens, it is assumed that Medicare should be the secondary payer. If you receive two primary payments, you should refund Medicare’s payment in full. Additional information may be found at:
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RJJVE5300?opendocument
Aetna Update
Aetna is in the process of expanding their product offerings to include Medicare in 2011. The plan will offer a Medicare Advantage PPO plan in select counties in West Virginia and would like physicians to join this new network. Aetna hopes that physicians will find this network option an exciting opportunity to deliver care to Aetna Medicare members in West Virginia.
West Virginia physicians were recently sent the new Aetna Medicare amendment. In order to participate in Aetna’s Medicare network, physicians need to sign and return both copies of the amendment to Elaine.
Aetna
Attention: Elaine Rader
P.O. Box 593
Hurricane, WV 25526
(304) 562-0824.
If you already participate in Aetna’s Medicare plans, your compensation for providing covered services to enrollees in the Aetna Medicare Advantage PPO and network-based Private Fee For Services plan will be the same.
Inclusion in the Medicare provider network is voluntary but to participate, you do need to sign both copies of the amendment that Aetna provided to your office.
If you have questions about the new Medicare amendment, please contact Aetna network representative, Elaine Rader.
Aetna also is still accepting consult codes for your consults. Before making a change in this policy, they will give a 90 day written notice.
Finally, you may recently have received a letter from Aetna advising you that they are updating their fee schedule. This is the standard letter that they send each year, updating to the current year’s Medicare fee schedule. Any change does not take effect until April 15, 2010. If you have questions about the fee schedule or want access to those fees before they take effect, you may contact Aetna’s Provider Service Center (800-624-0756).
