CDPHP Providers Important Information - Medicare Modernization Act Means Document Submission

Recently, CDPHP contacted its providers to inform them that the Centers for Medicare and Medicaid Services (CMS) has implemented a risk-adjustment methodology for all Medicare Advantage beneficiaries. As part of their participation in the Medicare program, CDPHP is obligated to submit all documented ICD-9-CM codes associated with provider's patients who are members of their Medicare Advantage health plans to CMS on an annual basis.

CDPHP is partnering with Altegra Health, Inc., a health care consulting services firm, in a data collection process that will be initiated in the near future. Be assured that this effort is not an audit; the data is needed for CMS and CDPHP to get an accurate picture of health status of their Medicaid members.

If you are a CDPHP provider, you may receive a call from a representative of Altegra Health, who will share further details about this project. CDPHP assures that this will be done with as little disruption to your practice as possible. Records may be scanned onsite or sent back to Altegra Health via fax.

Furthermore, CDPHP has entered into a Health Insurance Portability and Accountability Act (HIPAA) Business Associate Agreement with Altegra Health for this purpose. Accordingly, the release of this information to Altegra Health is permissible under HIPAA. Altegra Health maintains the security of data as required under HIPAA and its Business Associate Agreement with CDPHP.

If you are a CDPHP Provider, and you have any questions about this project, contact the CDPHP Provider Services Department at 1-800-926-7526 or 1-518-641-3500.

Taking a Closer Look at the NY Medicaid EHR Incentive Program

The New York Medicaid Electronic Health Records (EHR) Incentive Program provides financial incentives to eligible practitioners and hospitals to promote the transition to electronic health records. Providers who practice using EHR's are in the forefront of improving quality, reducing costs, and addressing health disparities. Since December 2011 over $381 million in incentive funds have been distributed to over 7,200 New York State Medicaid providers.

For more information, go to https://www.emedny.org/meipass/index.aspx.

2% Medicaid Payment Reduction Extension

The final 2013-2014 state budget requires an extension of the 2% across the board reduction on most Medicaid payments. Such payment reductions will apply for dates of service on and after April 1, 2013. The reduction will remain in effect for dates of service through March 31, 2015.

All current agreements on the manner in which the reduction is applied to a specific provider will be upheld unless otherwise noted.

For more information, go to http://www.health.ny.gov/health_care/state/.