Medicare 2012

Fraud, Waste, and Abuse Initiatives (Ethics)

Overview of ALL Medicare audits
TrailBlazer
Comprehensive Error Rate Testing (CERT)
Office of Inspector General (OIG)
Zone Program Integrity Contractor (ZPIC)
Recovery Audit Contractor (RAC)
RAC audits — updates, examples, and avoiding errors
OIG 2012 Work Plan and new technology for finding fraud and abuse

Medicare Updates (Ethics)
Changes you need to know about: fee schedule, dual eligibles, notice of non-coverage, advanced diagnostic imaging accreditation
Open enrollment period (3 participation options)
Claims reprocessing due to the Affordable Care Act
DMEPOS competitive bidding

Practice Exercises in Medicare Coding and Billing

Health Information Technology (Ethics)
HIPAA 5010: Comply by Jan. 1, 2012, or you won’t get paid.
E-prescribing
Physician Quality Reporting System (PQRS)
Electronic health record incentives

Erin Gregorcyk Smith, CPC, is a TMA reimbursement specialist in the Payment Advocacy Department specializing in Medicare. She also assists physician practices with issues affecting payment through the TMA Hassle Factor Log Program and regular meetings with insurance carriers. She has experience in physician office education and training physicians and staff in correct coding/billing practices. Mrs. Smith also serves as a member of TrailBlazer's Provider Outreach and Education-Advisory Group, co-chair of the AMA Medicare Advantage Work Group, Professional Association of Healthcare Office Management (PAHCOM) and is also an active member of the American Academy of Professional Coders.

Shannon Moore directs TMA’s Health Information Technology Department, which provides education and resources to Texas physicians. She serves on the board of the Austin chapter of the Health Information Management Systems Society and is an active member of the Travis County chapter of Professional Association of Health Care Office Managers. 

Tyler Patterson is with the Texas Medical Association as Marketing and Resource Coordinator for the Health Information Technology (HIT) department, providing education and resources to Texas physicians.  Previously, he ran his own small marketing and consulting business helping clients succeed using open-source platforms and social media.  Tyler completed his MBA at the Acton School of Business in Austin and is a Certified Health Education Specialist (CHES). 

The Texas Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The TMA designates this live activity for a maximum of 4 AMA PRA Category 1 Credits ^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. 

This program has been designated as 3 hours of ethics and/or professional responsibility education. 

This program has prior approval of the American Academy of Professional Coders for 4.0 continuing education units. Granting of this approval in no way constitutes endorsement by AAPC of the program, content, or program sponsor.

CME Disclosure Statement

Policies and standards of the Texas Medical Association, the Accreditation Council for Continuing Medical Education, and the American Medical Association require that speakers and planners for continuing medical education activities disclose any relevant financial relationship they may have with commercial entities whose products, devices or services may be discussed in the content of the CME activity. 

The content of this material does not relate to any product of a commercial interest; therefore, there are no relevant financial relationships to disclose. 

This program is designed for physicians, compliance officers, office managers, and billing/coding personnel in all specialties who treat Medicare patients. 

Upon completion of this program, participants should be able to:

• Describe Medicare's fraud and abuse initiatives and prepare your practice for potential audits.
• Identify best practices for Medicare billing and coding.
• Recognize the importance of health information technology and what is required to achieve meaningful use and 
  comply with HIPAA 5010.
• Identify resources to assist with electronic medical record selection, implementation, e-prescribing, and PQRS.

• Lecture
• Audio-visual presentation
• Interactive participation
• Questions and answers

If you have any questions about the content of this seminar or need help with registration, contact the TMA Knowledge Center at 800-880-7955. You can email them at: knowledge@texmed.org

You may also contact Gay Anderson at 512-370-1421, email: gay.anderson@texmed.org   

If you are unable to attend the seminar, forward a refund request to Gay Anderson via fax at 512-370-1457, or send an email to gay.anderson@texmed.org . TMA charges a $45 processing fee for each refund.

 Individuals in need of special assistance with regard to this educational program should contact Gay Anderson at
800-880-1300, ext. 1421.