MIPPA / CMS Requirements
Accreditation as a REQUIREMENT for Medicare Reimbursement
|When?||January 1, 2012|
All providers that bill under Part B of Medicare
Private outpatient facilities only, NOT to hospitals
|What?||Nuclear, CT, MRI, Breast MRI and PET|
Important: Medicare does not accept “applied”, “under review” or “provisional” accreditation. You will not receive Medicare reimbursement until you are granted accreditation. Applications both through the Intersocietal Accreditation Commission and the American College of Radiology require a 90 day review process! Avoid loss of insurance reimbursement – ACT NOW!
Are you prepared for the new Medicare reimbursement requirements?
Do you fully understand the implications to your Lab?
10 Things You Need to Know About CMS/MIPPA Accreditation Requirements
1. Who needs to be accredited?
Providers of the following tests:
The Medicare Improvements for Patients and Providers Act (MIPPA) calls for all providers that bill under Part B of the Medicare Physician Fee Schedule to be accredited by Jan. 1, 2012 in order to receive payment for the technical component of these services. Currently, the CMS/MIPPA mandates apply to private outpatient facilities only, NOT to hospitals.
2. What are the basic areas of CMS requirements?
3. What if we’re already accredited?
Make sure you renew on a timely basis. And, even if your facility has received accreditation there are additional newly mandated requirements for CMS reimbursements after Jan. 1, 2012. Your facility must be compliant with these requirements by the deadline:
4. What happens if we miss the deadline?
Beginning Jan. 1, 2012, reimbursements will only be made if a provider is fully accredited by one of the three CMS designated accreditation organizations:
Medicare does not accept “under review” or “provisional” accreditation. Your lab will not receive Medicare reimbursement until you achieve full accreditation!
5. Are all three Accrediting Organizations offering the same CMS-mandated accreditation process?
No. CMS did not establish a standard process for accreditation. The pricing, accreditation application, and review process differs among the three Accrediting Organizations.
6. How long does the accreditation process take?
The review process with the accrediting organizations is usually 3 months. Things to think about:
7. How do we get started?
Although the application may be completed by the labs directly we recommend hiring a consultant to ensure a quick and successful application submission.
Visit the accrediting organizations websites to learn more about the standards and guidelines.
(ACR) American College of Radiology: www.acr.org
(IAC) Intersocietal Accreditation Commission: www.intersocietal.org
(JCAHO), Joint Commission: www.jointcommission.org
8. What if we receive a deficiency?
9. Which Accrediting Organization should I choose?
There are many factors to consider when seeking an accrediting organization. We recommend that you contact CardioServ, LLC at 800-964-1372 and a knowledgeable professional will listen to your Lab’s needs and recommend the accrediting organization that best fits your needs. Call today for your free consultation 1-800-964-1372
10. Avoid the 2012 rush!