CMA this week learned that California’s Medicare carrier (NHIC) has begun reprocessing Medicare claims paid under the old 2006 fee schedule. As you know, the federal budget package signed by the president on February 9 reversed the 4.4 percent cut to Medicare physician payments that took effect January 1. The Centers for Medicare & Medicaid Services (CMS) instructed carriers to retroactively adjust claims to compensate physicians for the 4.4 percent cut.

Physicians should not resubmit claims. Medicare carriers will automatically make retroactive payments for eligible claims. It may, however, take a few months to reprocess all the claims. The oldest claims will be processed first.

CMS is also offering a second 2006 Medicare participation enrollment period. This second enrollment period will allow physicians to reconsider their decisions in light of the revised 2006 fee schedule, which rolls back the conversion factor to the higher 2005 level.

Physicians have until March 31 to make any changes to their Medicare participation status. Changes made during this new enrollment period will be retroactive to January 1.

Contact: CMA’s reimbursement help line, 888/401-5911 or fnavarro@cmanet.org.