February 12, 2020
Area(s) of Interest: Payor Issues and Reimbursement Public Payors
Noridian, the California Medicare contractor, has recently advised that it will begin reprocessing claims impacted by errors in the Centers for Medicare and Medicaid Services (CMS) Geographic Practice Cost Indices (GPCIs) file.
In the proposed 2020 Medicare Physician Payment Rule, California Medical Association (CMA) physician analysts Edward Bentley, M.D., and Larry DeGhetaldi, M.D., found numerous errors in the California geographic payments. After CMA notified CMS, those errors were corrected in the final rule. However, Drs. Bentley and DeGhetaldi found that CMS made additional mistakes with the California geographic payments in the final rule. Once again, CMA notified CMS and they have acknowledged the errors. CMA continued working with CMS to make the changes to ensure accurate Medicare payments are made to California physicians in 2020 and 2021 and to avoid recoupments in future years.
Now that the corrected payment amounts are in its system, Noridian will begin to process and mass adjust all affected claims beginning the week of February 10, 2020. Physicians do not need to take any action.
Physicians with questions can call (855) 609-9960 or visit the Noridian website for more information. To view the CMA letter to CMS regarding the payment error click here.