Continuation of Payments to IHS Providers
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Continuation of Payments to IHS Providers, Suppliers, Physicians, and Other Practitioners for Certain Part B Services
 
Section 630 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) allowed IHS facilities to bill for other Part B services, which were not previously covered under Section 1848 of the Act, and expanded the scope of items and services for which payment would be made to IHS providers, suppliers, physicians, and other practitioners for a 5-year period beginning January 1, 2005. Section 630 expired on December 31, 2009.
 
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act. Section 2902 of the new law permanently extends Section 630 of the MMA, retroactive to January 1, 2010.  The specific Part B services involved are:
  • Ambulance services;
  • Clinical laboratory services;
  • Part B drugs processed by the J4 A/B Medicare Administrative Contractor (MAC) and the Durable Medical Equipment MACs;
  • Influenza and pneumonia vaccinations;
  • Durable medical equipment;
  • Therapeutic shoes;
  • Prosthetics and orthotics;
  • Surgical dressings, splints and casts; and
  • Screening and preventive services not covered prior to the implementation of Section 630 of the MMA.
Indian Health Service providers, suppliers, physicians and other practitioners should contact their Medicare Administrative Contractor for further guidance regarding IHS claims affected by the new law, for dates of service January 1, 2010, and after, that have been denied.
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