Content Section
|
Medicare Information Resource
|
Note: Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material which is copyrighted by the American Medical Association (AMA). You are forbidden to download the files unless you read, agree to and abide by the provisions of the copyright statement. Read the copyright statement now (you will be linked back to here).
|
MIR-2007-2AB, February 2007
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
|
Private Contracting- Definition of Physician/Practitioner
Provider Types Affected
Registered dietitians or nutrition professionals providing services to Medicare beneficiaries
Provider Action Needed
This article is based on Change Request (CR) 5426 which updates the Medicare Benefit Policy Manual (Publication 100-02, Chapter 15, Section 40.4) to include registered dietitians and nutrition professionals in the list of practitioners who can opt out of Medicare if certain conditions are met, and to provide services through private contracts that would otherwise be covered by Medicare.
Background
Prior to enactment of the Medicare Benefits Improvement and Protection Act of 2000 (BIPA), the Social Security Act (Section 1802(b)(5)(C) ) did not include registered dietitians or nutrition professionals among the list of practitioners who may choose to opt out of Medicare.
BIPA (Section 105(d)) amended the definition of practitioner included in the Social Security Act (Section 1842(b)(18)(c)) to include registered dietitians or nutrition professionals in the list of practitioners who can opt out of Medicare if certain conditions are met..
CR5426 amends the Medicare Benefit Policy Manual (Publication 100-02, Chapter 15, Section 40.4 (Definition of Physician/Practitioner)) to include registered dietitians and nutrition professionals to be consistent with the Social Security Act (Section 1802(b)(5)(C)). The revised Section 40.4 (Pub. 100-02, Chapter 15) which is attached to CR5426.
Additional Information
The official instruction, CR5426, issued to your carrier or A/B MAC regarding this change may be viewed at http://www.cms.hhs.gov/Transmittals/downloads/R62BP.pdf  on the CMS Web site.
If you have any questions, please contact your Medicare carrier or A/B MAC at their toll-free number, which may be found on the CMS Web site at: http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip. 
Flu Shot Reminder
As a respected source of health care information, patients trust their doctors’ recommendations. If you have Medicare patients who haven’t yet received their flu shot, help protect them by recommending an annual influenza and a one time pneumococcal vaccination. Medicare provides coverage for flu and pneumococcal vaccines and their administration. - And don’t forget to immunize yourself and your staff. Protect yourself, your patients, and your family and friends. Get Your Flu Shot. Remember - Influenza vaccination is a covered Part B benefit. Note that influenza vaccine is NOT a Part D covered drug. For more information about Medicare’s coverage of adult immunizations and educational resources, go to CMS’s Web site: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0667.pdf .
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.
MLN Matters Number: MM5426
Pub. 100-2, Transmittal# R62BP, CR# 5426
Related CR Release Date: December 22, 2006
Effective Date: November 13, 2006
Implementation Date: April 2, 2007
Do you have your NPI?
National Provider Identifiers (NPIs) will be required on claims sent on or after May 23, 2007. Every health care provider needs to get an NPI. Learn more about the NPI and how to apply for an NPI by visiting http://www.cms.hhs.gov/NationalProvIdentStand/  on the CMS Web site.
|
