Medicare Compliance & Reimbursement
CMS Launches Demo Directed At FFS Benes
The Centers for Medicare and Medicaid Services wants physicians' help with a new demonstration that is under way to identify and manage high-cost Medicare fee-for-service beneficiaries.
Under the Care Management for High Cost Beneficiaries demonstration, CMS has dispersed six Care Management Organizations that will "deliver provider-based intensive care management services to certain FFS Medicare beneficiaries with one or more chronic diseases," CMS announced in a Sept. 28 Medlearn Matters article.
The CMHCB demonstration and the associated CMO projects will test whether supplemental care management services can decrease unnecessary hospital stays and emergency room visits for FFS beneficiaries who have more than one chronic disease, while improving quality of care.
CMOs may facilitate "collaboration among beneficiaries' primary and specialist providers" for beneficiaries enrolled in a CMHCB program to enhance communication of important clinical information. A CMO might contact physicians with a patient who is participating in the demo, but "it is up to each physician to determine whether he or she wishes to collaborate with the CMO," CMS says.
Important: Physicians who want to work with the CMO should continue to bill services for participating patients as they normally would. CMS hasn't made any changes to Medicare FFS billing instructions or claims processing regarding the CMHCB demonstration.
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