Client Alerts, News Articles & Blog Posts

Everything you need to know about BMD and the industry.

CLIENT ALERT: Medicare Providers having multiple locations should verify and revalidate their address information to avoid claim denials

MLN Matters SE19007 “Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations” notifies providers that Medicare is now requiring the exact match of all addresses for practice locations that are listed on provider claim submissions to Medicare. (See attached)

Medicare began auditing in July 2018 for purposes of reinforcing Chapter 1, Section 170 of the Medicare Claims Processing Manual “Payments on the MPFS for Providers with Multiple Service Locations.”  The exact address match will be in full and effect once the July 2019 quarterly release is implemented.

Claims that do not have an exact address match will be returned to the provider.  Providers can make corrections to their service facility address for a claim submitted in the DDE MAP 171F screen for DDE submitters.

It is recommended that providers review their Medicare enrollment record and billing practices to ensure compliance with the exact address match requirement.  Medicare recommends that all providers update their billing records to match Medicare enrollment records.  Providers should verify and submit changes through the CMS-855A or CMS-855B application through the Provider Enrollment, Chain, and Ownership System (PECOS) as soon as possible.  Changes and updates to an address or the addition of a new location typically take Medicare 30–60 days to process.

If you would like copies of the regulations, need legal assistance with updating your Medicare enrollment information, or have any questions concerning these matters, please contact Amanda Waesch at 330-253-9185 or via email at alwaesch@bmdllc.com.

Motor Carriers Beware - Lack of Written Independent Contractor Agreement Can Be Costly

Given recent changes in Ohio workers’ compensation law, “motor carriers” (as defined by Ohio law), operating in Ohio should carefully review their arrangements with independent contractor drivers and promptly implement changes to ensure compliance with statutory criteria.

Employers: Consider Important Deadlines for New H-1B Cap-Subject Foreign Worker Petitions

First-time new H-1B petitions or change of status petitions by employers can be filed for the upcoming U.S. Citizenship and Immigration Services (“USCIS”) fiscal year in April 2020 as long as the individual for whom the petition is being filed is in lawful status at the time of filing, and has not engaged in any unauthorized employment since his or her last lawful admission.

CLIENT ALERT UPDATE: AHCA License Alert

IMPORTANT UPDATE: AHCA updated its website to clarify that all Behavior Analysis (“BA”) Groups have either (1) a health care clinic license or (2) an exemption from licensure as a health care clinic under Fla. Stat. 400.9905(4)(g) by December 1, 2020. Florida Medicaid has also updated Section 9.5, Appendix E of the Florida Medicaid Enrollment Policy, which confirms the December 1, 2020 date. This date extends the previously published date from July 1, 2020 to December 1, 2020.

Client Alert: AHCA License Alert: What Every Behavior Analysis Provider Should Know!

By July 1, 2020 the Florida Agency for Health Care Administration (“AHCA”) will require that all Behavior Analysis (“BA”) Groups have either (1) a health care clinic license or (2) an exemption from licensure as a health care clinic under Fla. Stat. 400.9905(4)(g).

CLIENT ALERT: CMS Unveils New Price Transparency Rules

On November 15th, the Trump administration put forth two long-anticipated rules that increase price transparency for both hospitals and insurers. These rules are a step toward price transparency across the health care industry and are in furtherance of the Trump administration’s goal of empowering healthcare consumers. The finalized rule and the proposed rule strive to make pricing information more available to healthcare consumers so they can make informed health care decisions. Through price transparency, consumers should expect to see a reduction in healthcare costs in the future. In order to provide hospitals enough time for compliance with the new requirements, the effective date of the finalized rule is January 1, 2021. The comment period for the proposed rule is open until January 14, 2020.