Tuesday’s Tidbits

The President will be making a Congressional recess appointment in order to place Harvard professor Donald Berwick in charge of the Centers for Medicare and Medicaid Services according to Modern Healthcare.com. The recess appointment allows Dr. Berwick to hold the post for the remainder of the next Session of Congress (December 2011) without Senate confirmation.

Speaking of Medicare today is the date for implementation of the Provider Enrollment, Chain and Ownership System, or PECOS created as a result of the Affordable Care Act, according to a CMS press release. A stamp honoring Pecos Bill is to your left.

“CMS issued an interim final regulation on May 5, 2010 implementing provisions of the Affordable Care Act that permit only a Medicare enrolled physician or eligible professional to certify or order  home health services, durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) , and certain items and services under Medicare Part B.  The new law applies to orders, referrals and certifications made on or after July 1.

“While the regulation will be effective July 6, 2010, CMS will not implement automatic rejections of claims submitted by providers that have attempted to enroll in PECOS.  However, until the automatic rejections are operational, providers should not see any change in the processing of submitted claims, they will continue to be reviewed and paid as they have historically been reviewed and paid.”

The Kaiser Family Foundation has a helpful preview of the health care issues — Medicaid funding for the States, resuscitation of the COBRA/TCC premium subsidy, and the Medicare Part B physician reimbursement schedule — facing Congress when it returns from its recess next week. It’s all about the Benjamins.

The Labor Department’s Employee Benefits Security Administration, which enforces ERISA, the FEHBA’s private sector analog, has its own healthcare reform website. Posted on that site are model notices for ERISA governed plans to use when implementing certain Affordable Healthcare Act immediate reforms, such as the expansion of dependent child coverage up to age 26. That particular change takes effect for the FEHB Program on January 1, 2011.