The following information has been received by ANCO.
****CMA NEWS****
The California Medical Association (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
CMA Clarifies Medical Liability Provisions in Health Reform Bills
CMS Delays Implementation of PECOS Enrollment Policy
CMA Heads to Washington to Fight for Improvements to Senate Health Reform Bill
CMA Urges CMS to Restore Payments for Consultation Codes
Physicians: Be Prepared for Disruption in Medicare Cash Flow this Month
DOI Lawsuit Against PacifiCare Begins Today
New E-Mail Scam Preys on Patients' H1N1 Fears
State Extends H1N1 Vaccine Thimerosal Exemption
CMA Publishes H1N1 Billing Guide
State Resurrects Regulations that Would Expand Scope of Nonphysicians
AHRQ Looking for Practices to Participate in E-Prescribing Implementation Study
****PALMETTO/J1MAC NEWS****
FAQs: Healthcare Integrated General Ledger Accounting System (HIGLAS)
Transition
Share with your staff - FAQs regarding the J1 Part B Healthcare Integrated
General Ledger Accounting System (HIGLAS) transition have been posted to
our Web site!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YETAB5204?opendocument
J1 Provider Outreach and Education Event Calendar
J1 Part B providers, join Palmetto GBA J1 Provider Outreach and Education
team on December 15 for a Part B Ask the Contractor Teleconference (ACT) on
Medicare Updates!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Wednesday, December 9, 2009
Monday, December 7, 2009
ACCC, CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCConnect_12-2-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
• Who Will Care for Tomorrow's Cancer Patients? ACCC Looks for Answers
• Next Week: Bring Out the Best in Your Cancer Service Line
• 2009 PQRI Conference Call on December 10
• Cancer Screenings Brochure Available From CMS
• Heard on ACCC's ListServ: Family Members in the Radiation Center
• Oncologists Optimistic about Future of Oncology Clinical Trials While Citing Cost as Barrier
****CMS NEWS****
MM6662 – Annual Update of HCPCS Codes Used for Home Health (HH) Consolidated Billing Enforcement
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6662.pdf
MM6728 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 16.0, Effective January 1, 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6728.pdf
MM6540 – Tracking the Hospice Attending Physician’s National Provider Identifier (NPI) for Validating Hospice Part B Payments
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6540.pdf
The Centers for Medicare & Medicaid Services (CMS) would like to remind Physician Quality Reporting Initiative (PQRI) participants that there is a “Verify Report Portlet” look-up tool available on the PQRI Portal for Eligible Professionals (EPs) to verify if a 2007 re-run and/or 2008 PQRI feedback report exists for your organization's Tax Identification Number (TIN) or National Provider Identifier (NPI). The TIN or NPI must be the one used by the EP to submit Medicare claims and valid PQRI quality data codes. This tool is available at (https://www.qualitynet.org/portal/server.pt) on the internet.
If a report is available for your organization’s TIN or NPI there are two ways to access 2007 re-run and/or 2008 PQRI feedback reports:
1) An individual EP can simply call their respective Carrier or A/B MAC provider contact center to request confidential 2007 PQRI re-run and/or 2008 PQRI feedback reports that will contain information based on their individual NPI. If an EP is part of a group practice, each EP in the group practice must individually call their respective Carrier or A/B MAC provider contact center to request a feedback report based on the individual NPI. To obtain a list of Provider Contact Centers, visit (http://www.cms.hhs.gov/MLNProducts/Downloads/CallCenterTollNumDirectory.zip) on the CMS website. In addition to PQRI information, these reports will provide individual EPs with information on their Medicare Part B Physician Fee Schedule allowed charges for the 2007 or 2008 PQRI reporting period, upon which an incentive payment is based.
Additional information about this alternative feedback report request process can be found by accessing special edition Medicare Learning Network (MLN) article (SE0922) “Alternative Process for Individual Eligible Professionals to Access Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Feedback Reports.” Visit (http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0922.pdf) on the CMS website.
or
2) EPs can logon to the secure PQRI Portal on QualityNet at (http://www.qualitynet.org/portal/server.pt) to access their feedback report(s) based their TIN, or for a group. Access to the PQRI Portal requires registration in the Individuals Authorized Access to CMS Computer Services (IACS) system to obtain a userID and password.
Important Information on Updating IACS User Accounts and Passwords
CMS would like to remind users that the CMS Security policy requires IACS passwords to be changed every 60 days. An IACS user who has not changed his or her password in over 60 days will be prompted to do so at the next login attempt.
An IACS user who has not changed his or her password in over 120 days will first be prompted to answer the security questions established at registration. After successfully answering security questions, the user will then be prompted for a password change.
Updating IACS user accounts and passwords is essential to maintaining this access and functionality.
Resources
The IACS account management page is at (https://applications.cms.hhs.gov/category.html?name=acctmngmt).Click on “My Profile” to login, change your password, or use the “Forgot Password?” option.
If you are having difficulty with IACS registration or disabled accounts, follow the self-service instructions below on how to recover your IACS userId and/or password and/or change your IACS password.
Instructions for Retrieving Your IACS UserID
1. Go to the CMS Applications portal at (https://applications.cms.hhs.gov)
2. Enter the portal; select the Account Management tab, and then the “Forgot Your User ID?” link in the Account Management section. Follow the online instructions.
3. You will receive an email at the email address on record.
Instructions for Retrieving Your IACS Password
1. Go to the CMS Applications portal at (https://applications.cms.hhs.gov/warning.html)
2. Enter the portal; select the Account Management tab, and then “My Profile” link in the Account Management section.
3. Enter your UserID
4. Click on “Forgot Your Password?” button on the login page and follow the online instructions.
5. You will receive a onetime password in an email at the email address on record.
Instructions to Login and Change Your IACS Password:
1. Go to the CMS Applications portal at (https://applications.cms.hhs.gov)
2. Enter the portal; select the Account Management tab
3. Select the My Profile link
4. Login using your UserID and onetime temporary Password.
5. The system will prompt you to change your password.
6. Enter your new password in both the New Password and Confirm New Password fields and then select the Change Password button.
7. The system will take you back to the My Profile screen.
8. Log out.
Once you have successfully changed your password you may login and access your PQRI feedback report(s) on the PQRI portal at (https://www.qualitynet.org/portal/server.pt).
If you are still having difficulty with IACS registration or disabled accounts, please contact the External Users Services (EUS) Help Desk
at 1-866-484-8049, TTY/TDD at 1-866-523-4759 (Monday – Friday 7:00 a.m.-7:00 p.m. EST) or via e-mail at EUSSupport@cgi.com.
The IACS home page for the Provider/Supplier user Community, which includes PQRI, is at (http://www.cms.hhs.gov/IACS/04_Provider_Community.asp#TopOfPage) on the CMS website. Provider Community users should direct questions or concerns to the External User Services (EUS) Help Desk at 1-866-484-8049, TTY/TDD at 1-866-523-4759 (Monday - Friday 7:00 a.m.-7:00 p.m. EST) or via email atEUSSupport@cgi.com.
The PQRI Portal is available at (https://www.qualitynet.org/portal/server.pt) on the internet. Although the “Forgot Password” link on the PQRI Portal sends users to the IACS website, IACS and the PQRI Portal are two separate websites.
Additional information about PQRI can be found at (http://www.cms.hhs.gov/PQRI) on the CMS website. For more information on the 2007 re-run and 2008 PQRI feedback reports or incentive payments, see the "PQRI and eRx Quick-Reference Support Guide for Eligible Professionals" at (http://www.cms.hhs.gov/PQRI/Downloads/PQRI-eRxEPQuickRefGuideDiagram_100209.pdf) on the CMS website.
Users who still have questions or need assistance should contact the QualityNet Help Desk at 1-866-288-8912 (Monday-Friday 7:00 a.m.-7:00 p.m. CST) or qnetsupport@sdps.org.
****PALMETTO/J1MAC NEWS****
December 2009 J1 A/B MAC Medicare Advisory
Updates and changes were made to the December 2009 J1 A/B MAC Medicare
Advisory. It is available on the Web site. Please be sure to share this
with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y5M4G5545?opendocument
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 16.0,
Effective January 1, 2010
This J1 Part B MLN Matters article (CR 6728) provides a reminder for
physicians to take note of the quarterly updates to Correct Coding
Initiative (CCI) edits. The last quarterly release of the edit module was
issued in October 2009. The Centers for Medicare & Medicaid Services (CMS)
developed the National Correct Coding Initiative (CCI) to promote national
correct coding methodologies and to control improper coding that leads to
inappropriate payment in Part B claims. Please be sure to share with your
staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YBT823658?opendocument
Annual Update of HCPCS Codes Used for Home Health (HH) Consolidated Billing
Enforcement
This J1 A/B MAC MLN Matters article (CR6662) provides the annual Home
Health (HH) consolidated billing update effective January 1, 2010. The
Centers for Medicare & Medicaid Services (CMS) periodically updates the
lists of Health Care Common Procedure Codes System (HCPCS) codes subject to
the consolidated billing provision of the Home Health Prospective Payment
System (HH PPS). Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YCN4K0087?opendocument
HIGLAS Transition: Impact on J1 Part B Medicare Providers
Palmetto GBA Jurisdiction 1 MAC has updated the Healthcare Integrated
General Ledger Accounting System (HIGLAS) transition time table posted on
our Web site. The HIGLAS transition will be completed December 16, 2009. At
the same time, processing backlogged files and issuing payments will begin.
From December 16 to December 30, 2009, providers may experience a
significant reduction in payments due to the early claim payments issued
immediately prior to the transition. Providers need to monitor and manage
their cash flows during this time period.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y3LRC5231?opendocument
J1 Provider Outreach and Education Event Calendar
What's new in December 2009? The updated Palmetto GBA J1 Event Calenar is
now available on our Web site!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
Technical Corrections To The Relative Value Units
This article reflects technical corrections to the relative value units,
including various CPT codes, and to the CY 2010 conversion factor contained
in the CY 2010 Medicare physician fee schedule final rule. Please be sure
to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YBTF22165?opendocument
2010 J1 Part B Fee Schedules
The 2010 J1 Part B Fee Schedules for California are now available and are
effective January 1, 2010. The 2010 J1 Part B Fee Schedules for Nevada,
Hawaii, Guam, American Samoa and the Northern Mariana Islands will be
coming soon.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y3GZA7365?opendocument
J1 EDI Enrollment Packet
The Jurisdiction 1 A/B MAC EDI Enrollment Packet has been updated with a
new form. The Provider Authorization form must be completed by the provider
to authorize a clearinghouse and/or billing service as an electronic
submitter and recipient of electronic claims data. Please begin using this
updated packet immediately.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XPTLJ4585?opendocument
Therapy Cap Values for Calendar Year (CY) 2010
This J1 A/B MAC MLN Matters article (CR6660a) describes the policy for
outpatient therapy caps for 2010 and announces that therapy caps for 2010
will be $1,860. This article was revised on November 24, 2009, to reflect a
revised CR 6660 that the Centers for Medicare & Medicaid Services (CMS)
issued on November 23, 2009. As a result of the revised CR, the article was
revised to include Regional Home Health Intermediaries as an additional
contractor type involved with this issue. The CR release date, transmittal
number and Web address for accessing CR 6660 were also changed. Also,
carriers were added as a contractor type involved as they were
inadvertently not included in the original article. All other information
remains the same. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YCMRD2255?opendocument
ACT Call: Medicare Updates - December 15, 2009
Join us for a J1 Part B Ask the Contractor Teleconference (ACT) regarding
Medicare Part B General Updates on Tuesday, December 15, 2009, at 12:30
p.m. PST.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YERHB5637?opendocument
ACT Minutes: Top 10 Claim Submission Errors - November 19, 2009
The meeting minutes of the J1 Part A Ask the Contractor Teleconference on
November 19, 2009, is now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YESW92524?opendocument
J1 Provider Outreach and Education Event Calendar
Check out the new Palmetto GBA J1 Provider Outreach and Education events
added to our December 2009 online Events calendar!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
Tracking the Hospice Attending Physician’s National Provider Identifier
(NPI) for Validating Hospice Part B Payments
This J1 A/B MAC MLN Matters article (CR6540) is meant to ensure that the
hospice-reported data in the Notice of Election (NOE) and claims for the
attending physician, which may be a Nurse Practitioner (NP), meet the
definition of attending physician/NP in the Code of Federal Regulations
(CFR), while also reporting the hospice physician responsible for
certifying the terminal illness. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YEMNL2613?opendocument
Webinar: Bundled Services December 16
Palmetto GBA J1 Part B providers, join us on Wednesday, December 16, 2009,
for a free Webinar on Bundled Services!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YERCG5273?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCConnect_12-2-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
• Who Will Care for Tomorrow's Cancer Patients? ACCC Looks for Answers
• Next Week: Bring Out the Best in Your Cancer Service Line
• 2009 PQRI Conference Call on December 10
• Cancer Screenings Brochure Available From CMS
• Heard on ACCC's ListServ: Family Members in the Radiation Center
• Oncologists Optimistic about Future of Oncology Clinical Trials While Citing Cost as Barrier
****CMS NEWS****
MM6662 – Annual Update of HCPCS Codes Used for Home Health (HH) Consolidated Billing Enforcement
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6662.pdf
MM6728 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 16.0, Effective January 1, 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6728.pdf
MM6540 – Tracking the Hospice Attending Physician’s National Provider Identifier (NPI) for Validating Hospice Part B Payments
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6540.pdf
The Centers for Medicare & Medicaid Services (CMS) would like to remind Physician Quality Reporting Initiative (PQRI) participants that there is a “Verify Report Portlet” look-up tool available on the PQRI Portal for Eligible Professionals (EPs) to verify if a 2007 re-run and/or 2008 PQRI feedback report exists for your organization's Tax Identification Number (TIN) or National Provider Identifier (NPI). The TIN or NPI must be the one used by the EP to submit Medicare claims and valid PQRI quality data codes. This tool is available at (https://www.qualitynet.org/portal/server.pt) on the internet.
If a report is available for your organization’s TIN or NPI there are two ways to access 2007 re-run and/or 2008 PQRI feedback reports:
1) An individual EP can simply call their respective Carrier or A/B MAC provider contact center to request confidential 2007 PQRI re-run and/or 2008 PQRI feedback reports that will contain information based on their individual NPI. If an EP is part of a group practice, each EP in the group practice must individually call their respective Carrier or A/B MAC provider contact center to request a feedback report based on the individual NPI. To obtain a list of Provider Contact Centers, visit (http://www.cms.hhs.gov/MLNProducts/Downloads/CallCenterTollNumDirectory.zip) on the CMS website. In addition to PQRI information, these reports will provide individual EPs with information on their Medicare Part B Physician Fee Schedule allowed charges for the 2007 or 2008 PQRI reporting period, upon which an incentive payment is based.
Additional information about this alternative feedback report request process can be found by accessing special edition Medicare Learning Network (MLN) article (SE0922) “Alternative Process for Individual Eligible Professionals to Access Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Feedback Reports.” Visit (http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0922.pdf) on the CMS website.
or
2) EPs can logon to the secure PQRI Portal on QualityNet at (http://www.qualitynet.org/portal/server.pt) to access their feedback report(s) based their TIN, or for a group. Access to the PQRI Portal requires registration in the Individuals Authorized Access to CMS Computer Services (IACS) system to obtain a userID and password.
Important Information on Updating IACS User Accounts and Passwords
CMS would like to remind users that the CMS Security policy requires IACS passwords to be changed every 60 days. An IACS user who has not changed his or her password in over 60 days will be prompted to do so at the next login attempt.
An IACS user who has not changed his or her password in over 120 days will first be prompted to answer the security questions established at registration. After successfully answering security questions, the user will then be prompted for a password change.
Updating IACS user accounts and passwords is essential to maintaining this access and functionality.
Resources
The IACS account management page is at (https://applications.cms.hhs.gov/category.html?name=acctmngmt).Click on “My Profile” to login, change your password, or use the “Forgot Password?” option.
If you are having difficulty with IACS registration or disabled accounts, follow the self-service instructions below on how to recover your IACS userId and/or password and/or change your IACS password.
Instructions for Retrieving Your IACS UserID
1. Go to the CMS Applications portal at (https://applications.cms.hhs.gov)
2. Enter the portal; select the Account Management tab, and then the “Forgot Your User ID?” link in the Account Management section. Follow the online instructions.
3. You will receive an email at the email address on record.
Instructions for Retrieving Your IACS Password
1. Go to the CMS Applications portal at (https://applications.cms.hhs.gov/warning.html)
2. Enter the portal; select the Account Management tab, and then “My Profile” link in the Account Management section.
3. Enter your UserID
4. Click on “Forgot Your Password?” button on the login page and follow the online instructions.
5. You will receive a onetime password in an email at the email address on record.
Instructions to Login and Change Your IACS Password:
1. Go to the CMS Applications portal at (https://applications.cms.hhs.gov)
2. Enter the portal; select the Account Management tab
3. Select the My Profile link
4. Login using your UserID and onetime temporary Password.
5. The system will prompt you to change your password.
6. Enter your new password in both the New Password and Confirm New Password fields and then select the Change Password button.
7. The system will take you back to the My Profile screen.
8. Log out.
Once you have successfully changed your password you may login and access your PQRI feedback report(s) on the PQRI portal at (https://www.qualitynet.org/portal/server.pt).
If you are still having difficulty with IACS registration or disabled accounts, please contact the External Users Services (EUS) Help Desk
at 1-866-484-8049, TTY/TDD at 1-866-523-4759 (Monday – Friday 7:00 a.m.-7:00 p.m. EST) or via e-mail at EUSSupport@cgi.com.
The IACS home page for the Provider/Supplier user Community, which includes PQRI, is at (http://www.cms.hhs.gov/IACS/04_Provider_Community.asp#TopOfPage) on the CMS website. Provider Community users should direct questions or concerns to the External User Services (EUS) Help Desk at 1-866-484-8049, TTY/TDD at 1-866-523-4759 (Monday - Friday 7:00 a.m.-7:00 p.m. EST) or via email atEUSSupport@cgi.com.
The PQRI Portal is available at (https://www.qualitynet.org/portal/server.pt) on the internet. Although the “Forgot Password” link on the PQRI Portal sends users to the IACS website, IACS and the PQRI Portal are two separate websites.
Additional information about PQRI can be found at (http://www.cms.hhs.gov/PQRI) on the CMS website. For more information on the 2007 re-run and 2008 PQRI feedback reports or incentive payments, see the "PQRI and eRx Quick-Reference Support Guide for Eligible Professionals" at (http://www.cms.hhs.gov/PQRI/Downloads/PQRI-eRxEPQuickRefGuideDiagram_100209.pdf) on the CMS website.
Users who still have questions or need assistance should contact the QualityNet Help Desk at 1-866-288-8912 (Monday-Friday 7:00 a.m.-7:00 p.m. CST) or qnetsupport@sdps.org.
****PALMETTO/J1MAC NEWS****
December 2009 J1 A/B MAC Medicare Advisory
Updates and changes were made to the December 2009 J1 A/B MAC Medicare
Advisory. It is available on the Web site. Please be sure to share this
with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y5M4G5545?opendocument
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 16.0,
Effective January 1, 2010
This J1 Part B MLN Matters article (CR 6728) provides a reminder for
physicians to take note of the quarterly updates to Correct Coding
Initiative (CCI) edits. The last quarterly release of the edit module was
issued in October 2009. The Centers for Medicare & Medicaid Services (CMS)
developed the National Correct Coding Initiative (CCI) to promote national
correct coding methodologies and to control improper coding that leads to
inappropriate payment in Part B claims. Please be sure to share with your
staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YBT823658?opendocument
Annual Update of HCPCS Codes Used for Home Health (HH) Consolidated Billing
Enforcement
This J1 A/B MAC MLN Matters article (CR6662) provides the annual Home
Health (HH) consolidated billing update effective January 1, 2010. The
Centers for Medicare & Medicaid Services (CMS) periodically updates the
lists of Health Care Common Procedure Codes System (HCPCS) codes subject to
the consolidated billing provision of the Home Health Prospective Payment
System (HH PPS). Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YCN4K0087?opendocument
HIGLAS Transition: Impact on J1 Part B Medicare Providers
Palmetto GBA Jurisdiction 1 MAC has updated the Healthcare Integrated
General Ledger Accounting System (HIGLAS) transition time table posted on
our Web site. The HIGLAS transition will be completed December 16, 2009. At
the same time, processing backlogged files and issuing payments will begin.
From December 16 to December 30, 2009, providers may experience a
significant reduction in payments due to the early claim payments issued
immediately prior to the transition. Providers need to monitor and manage
their cash flows during this time period.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y3LRC5231?opendocument
J1 Provider Outreach and Education Event Calendar
What's new in December 2009? The updated Palmetto GBA J1 Event Calenar is
now available on our Web site!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
Technical Corrections To The Relative Value Units
This article reflects technical corrections to the relative value units,
including various CPT codes, and to the CY 2010 conversion factor contained
in the CY 2010 Medicare physician fee schedule final rule. Please be sure
to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YBTF22165?opendocument
2010 J1 Part B Fee Schedules
The 2010 J1 Part B Fee Schedules for California are now available and are
effective January 1, 2010. The 2010 J1 Part B Fee Schedules for Nevada,
Hawaii, Guam, American Samoa and the Northern Mariana Islands will be
coming soon.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y3GZA7365?opendocument
J1 EDI Enrollment Packet
The Jurisdiction 1 A/B MAC EDI Enrollment Packet has been updated with a
new form. The Provider Authorization form must be completed by the provider
to authorize a clearinghouse and/or billing service as an electronic
submitter and recipient of electronic claims data. Please begin using this
updated packet immediately.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XPTLJ4585?opendocument
Therapy Cap Values for Calendar Year (CY) 2010
This J1 A/B MAC MLN Matters article (CR6660a) describes the policy for
outpatient therapy caps for 2010 and announces that therapy caps for 2010
will be $1,860. This article was revised on November 24, 2009, to reflect a
revised CR 6660 that the Centers for Medicare & Medicaid Services (CMS)
issued on November 23, 2009. As a result of the revised CR, the article was
revised to include Regional Home Health Intermediaries as an additional
contractor type involved with this issue. The CR release date, transmittal
number and Web address for accessing CR 6660 were also changed. Also,
carriers were added as a contractor type involved as they were
inadvertently not included in the original article. All other information
remains the same. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YCMRD2255?opendocument
ACT Call: Medicare Updates - December 15, 2009
Join us for a J1 Part B Ask the Contractor Teleconference (ACT) regarding
Medicare Part B General Updates on Tuesday, December 15, 2009, at 12:30
p.m. PST.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YERHB5637?opendocument
ACT Minutes: Top 10 Claim Submission Errors - November 19, 2009
The meeting minutes of the J1 Part A Ask the Contractor Teleconference on
November 19, 2009, is now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YESW92524?opendocument
J1 Provider Outreach and Education Event Calendar
Check out the new Palmetto GBA J1 Provider Outreach and Education events
added to our December 2009 online Events calendar!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
Tracking the Hospice Attending Physician’s National Provider Identifier
(NPI) for Validating Hospice Part B Payments
This J1 A/B MAC MLN Matters article (CR6540) is meant to ensure that the
hospice-reported data in the Notice of Election (NOE) and claims for the
attending physician, which may be a Nurse Practitioner (NP), meet the
definition of attending physician/NP in the Code of Federal Regulations
(CFR), while also reporting the hospice physician responsible for
certifying the terminal illness. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YEMNL2613?opendocument
Webinar: Bundled Services December 16
Palmetto GBA J1 Part B providers, join us on Wednesday, December 16, 2009,
for a free Webinar on Bundled Services!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7YERCG5273?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Monday, November 30, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
MM6685 – New Waived Tests
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6685.pdf
MM6660 – Therapy Cap Values for Calendar Year (CY) 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6660.pdf
****PALMETTO/J1MAC NEWS****
December 2009 J1 A/B MAC Medicare Advisory
The December 2009 J1 A/B MAC Medicare Advisory is available on the Web
site. Please be sure to share this with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y5M4G5545?opendocument
****CMS NEWS****
MM6685 – New Waived Tests
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6685.pdf
MM6660 – Therapy Cap Values for Calendar Year (CY) 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6660.pdf
****PALMETTO/J1MAC NEWS****
December 2009 J1 A/B MAC Medicare Advisory
The December 2009 J1 A/B MAC Medicare Advisory is available on the Web
site. Please be sure to share this with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7Y5M4G5545?opendocument
Monday, November 23, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host a national provider conference call on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 1:30 p.m. – 3:30 p.m., EST, on Thursday, December 10, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
The topics covered on this national provider call will include:
· Alternate feedback report request process;
· Update on incentive payments and feedback reports;
· Results from the 2008 PQRI and 2007 PQRI re-run; and
· Measures issues identified in 2008 PQRI.
Following the presentation, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at, http://www.cms.hhs.gov/PQRI, on the CMS website, in the Educational Resources section, as well as educational products are available on the e-prescribing dedicated web page located at http://www.cms.hhs.gov/ERxIncentive on the CMS website. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: December 10, 2009
Conference Title: Physician Quality Reporting Initiative (PQRI) - National Provider Call
Time: 1:30 p.m. EST
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation.
Registration will close at 1:30 p.m. EST on December 9, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to:
http://www.eventsvc.com/palmettogba/121009
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of who will be unable to attend, a transcript of the call will be available at least one week after the call at http://www.cms.hhs.gov/pqri on the CMS website.
If you require services for the hearing impaired please send an email to: Medicare.TTT@PalmettoGBA.com.
The Centers for Medicare & Medicaid Services (CMS) is now accepting quality measure suggestions for consideration for possible inclusion in the proposed set of quality measures for use in the 2011 Physician Quality Reporting Initiative (PQRI).
Interested parties have an additional opportunity to submit measure suggestions for the 2011 PQRI program beyond the request for 2011 measure suggestions included in the Calendar Year (CY) 2010 Medicare Physician Fee Schedule (PFS) proposed rule published in theFederal Register (74 FR 33587) on July 13, 2009. Interested parties who have already submitted measure suggestions in response to the request for 2011 PQRI measures included in the CY 2010 PFS proposed rule do not need to re-submit their measure suggestions.
To learn more about the 2011 PQRI Call for Measures, visit the CMS Quality Measures Management Information System (QMIS) website at http://www.cms.hhs.gov/apps/QMIS/CallforMeasures.asp on the CMS website.
All suggestions must be received by CMS no later than 5:00 p.m. EST December 16, 2009.
Please note: Suggesting individual measures or measures for a new or existing measures group does not guarantee that the measure(s) will be included in the proposed or final sets of measures of any proposed or final rules that address the 2011 PQRI. CMS will determine what individual measures and measures group(s) to include in the proposed set of quality measures, and after a period of public comment, the agency will make the final determination with regard to the final set of quality measures for the 2011 PQRI.
****PALMETTO/J1MAC NEWS****
Claim Status Category Code and Claim Status Code Update
This J1 Part A/B MLN Matters article (CR6723) explains that the claim
status codes and claim status category codes for use by Medicare
contractors with the Health Claim Status Request and Response ASC X12N
276/277 were updated during the September 2009 meeting of the national Code
Maintenance Committee and code changes approved at that meeting were posted
on the Internet on November 1, 2009. Please be sure to share with your
staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XXT8Q7657?opendocument
J1 Part B LCDs Update
Share with your staff - The J1 Part B LCDs, Ambulance Services L28235 and
Diagnostic Colonoscopy L28253 have been revised.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XYP9B7353?opendocument
Therapy Cap Values for Calendar Year (CY) 2010
This J1 Part A/B MLN Matters article (CR6660) describes the policy for
outpatient therapy caps for 2010 and announces that therapy caps for 2010
will be $1,860. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XWTJR5402?opendocument
Update to Medicare Deductible, Coinsurances and Premium Rates for 2010
This J1 Part A/B MLN Matters article (CR6690) provides the Medicare rates
for deductible, coinsurance and premium payment amounts for calendar year
(CY) 2010. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XXTP96437?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****CMS NEWS****
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host a national provider conference call on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 1:30 p.m. – 3:30 p.m., EST, on Thursday, December 10, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
The topics covered on this national provider call will include:
· Alternate feedback report request process;
· Update on incentive payments and feedback reports;
· Results from the 2008 PQRI and 2007 PQRI re-run; and
· Measures issues identified in 2008 PQRI.
Following the presentation, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at, http://www.cms.hhs.gov/PQRI, on the CMS website, in the Educational Resources section, as well as educational products are available on the e-prescribing dedicated web page located at http://www.cms.hhs.gov/ERxIncentive on the CMS website. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: December 10, 2009
Conference Title: Physician Quality Reporting Initiative (PQRI) - National Provider Call
Time: 1:30 p.m. EST
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation.
Registration will close at 1:30 p.m. EST on December 9, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to:
http://www.eventsvc.com/palmettogba/121009
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of who will be unable to attend, a transcript of the call will be available at least one week after the call at http://www.cms.hhs.gov/pqri on the CMS website.
If you require services for the hearing impaired please send an email to: Medicare.TTT@PalmettoGBA.com.
The Centers for Medicare & Medicaid Services (CMS) is now accepting quality measure suggestions for consideration for possible inclusion in the proposed set of quality measures for use in the 2011 Physician Quality Reporting Initiative (PQRI).
Interested parties have an additional opportunity to submit measure suggestions for the 2011 PQRI program beyond the request for 2011 measure suggestions included in the Calendar Year (CY) 2010 Medicare Physician Fee Schedule (PFS) proposed rule published in theFederal Register (74 FR 33587) on July 13, 2009. Interested parties who have already submitted measure suggestions in response to the request for 2011 PQRI measures included in the CY 2010 PFS proposed rule do not need to re-submit their measure suggestions.
To learn more about the 2011 PQRI Call for Measures, visit the CMS Quality Measures Management Information System (QMIS) website at http://www.cms.hhs.gov/apps/QMIS/CallforMeasures.asp on the CMS website.
All suggestions must be received by CMS no later than 5:00 p.m. EST December 16, 2009.
Please note: Suggesting individual measures or measures for a new or existing measures group does not guarantee that the measure(s) will be included in the proposed or final sets of measures of any proposed or final rules that address the 2011 PQRI. CMS will determine what individual measures and measures group(s) to include in the proposed set of quality measures, and after a period of public comment, the agency will make the final determination with regard to the final set of quality measures for the 2011 PQRI.
****PALMETTO/J1MAC NEWS****
Claim Status Category Code and Claim Status Code Update
This J1 Part A/B MLN Matters article (CR6723) explains that the claim
status codes and claim status category codes for use by Medicare
contractors with the Health Claim Status Request and Response ASC X12N
276/277 were updated during the September 2009 meeting of the national Code
Maintenance Committee and code changes approved at that meeting were posted
on the Internet on November 1, 2009. Please be sure to share with your
staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XXT8Q7657?opendocument
J1 Part B LCDs Update
Share with your staff - The J1 Part B LCDs, Ambulance Services L28235 and
Diagnostic Colonoscopy L28253 have been revised.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XYP9B7353?opendocument
Therapy Cap Values for Calendar Year (CY) 2010
This J1 Part A/B MLN Matters article (CR6660) describes the policy for
outpatient therapy caps for 2010 and announces that therapy caps for 2010
will be $1,860. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XWTJR5402?opendocument
Update to Medicare Deductible, Coinsurances and Premium Rates for 2010
This J1 Part A/B MLN Matters article (CR6690) provides the Medicare rates
for deductible, coinsurance and premium payment amounts for calendar year
(CY) 2010. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XXTP96437?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Wednesday, November 18, 2009
CMA, CMS, & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/alert111609.asp. This edition features:
Blue Shield Planning to Publish Physician Ratings Based on Faulty CPPI Data
U.S. House Introduces Bill that Would Exempt Small Health Care Organizations from Red Flags Rule
Are Your Payors in Good Financial Health?
2010 Medicare Payment Rule Cuts Physician Payments by 21.2%; Eliminates Payment for Consultations
U.S. House to Take Critical SGR Vote this Week; Physicians Urged to Call
Appeals Court Protects California’s Voter-Enacted Drug Treatment Program
Blue Cross Extends Healthy Families Continuity of Care Plan
****CMS NEWS****
Due to recent revisions that were made to the 2010 Medicare Physician Fee Schedule (MPFS), the Centers for Medicare & Medicaid Services (CMS) has extended the 2010 Annual Participation Enrollment Program end date from December 31, 2009, to January 31, 2010 – therefore, the enrollment period now runs from November 13, 2009, through January 31, 2010.
The effective date for any Participation status change during the extension, however, remains January 1, 2010; and will be in force for the entire year.
Contractors will accept and process any Participation elections or withdrawals, made during the extended enrollment period that are received or post-marked on or before January 31, 2010.
Note: This is an extension of the annual participation enrollment period dates in CR 6637 (Transmittal 1832 -- Calendar Year (CY) 2010 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures), dated October 16, 2009.
The Participation Agreement (CMS-Form 460) is available on the CD-ROM that is sent out annually by your Medicare contractor during the Annual Participation Enrollment period. Your contractor will also make the Participation Agreement available to you by placing it on their Websites with Participation enrollment (and termination) instructions.
MM6660 – Therapy Cap Values for Calendar Year (CY) 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6660.pdf
MM6690 – Update to Medicare Deductible, Coinsurance, and Premium Rates for 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6690.pdf
MM6723 – Claim Status Category Code and Claim Status Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6723.pdf
MM6708 – January 2010 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6708.pdf
SE0929 – 2010 Annual Participation Enrollment Program Extension
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0929.pdf
****PALMETTO/J1MAC NEWS****
California Contractor Advisory Committee Meeting Minutes
The following are minutes from the California Contractor Advisory Committee
Meeting on October 13, 2009, in San Francisco, CA. Please be sure to share
with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XRT268315?opendocument
CMS No Longer Recognizes HCPCS Code for Payment of Non-Outpatient Hospital
Claims
The following article announces that, effective immediately, the Centers
for Medicare & Medicaid Services (CMS) will no longer recognize the
Healthcare Common Procedure Coding System (HCPCS) Code for payment of
non-outpatient hospital claims. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XVLYX8318?opendocument
J1 Provider Outreach and Education Event Calendar
What's new in November 2009? The updated Palmetto GBA J1 Event Calenar is
now available on our Web site!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/alert111609.asp. This edition features:
Blue Shield Planning to Publish Physician Ratings Based on Faulty CPPI Data
U.S. House Introduces Bill that Would Exempt Small Health Care Organizations from Red Flags Rule
Are Your Payors in Good Financial Health?
2010 Medicare Payment Rule Cuts Physician Payments by 21.2%; Eliminates Payment for Consultations
U.S. House to Take Critical SGR Vote this Week; Physicians Urged to Call
Appeals Court Protects California’s Voter-Enacted Drug Treatment Program
Blue Cross Extends Healthy Families Continuity of Care Plan
****CMS NEWS****
Due to recent revisions that were made to the 2010 Medicare Physician Fee Schedule (MPFS), the Centers for Medicare & Medicaid Services (CMS) has extended the 2010 Annual Participation Enrollment Program end date from December 31, 2009, to January 31, 2010 – therefore, the enrollment period now runs from November 13, 2009, through January 31, 2010.
The effective date for any Participation status change during the extension, however, remains January 1, 2010; and will be in force for the entire year.
Contractors will accept and process any Participation elections or withdrawals, made during the extended enrollment period that are received or post-marked on or before January 31, 2010.
Note: This is an extension of the annual participation enrollment period dates in CR 6637 (Transmittal 1832 -- Calendar Year (CY) 2010 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures), dated October 16, 2009.
The Participation Agreement (CMS-Form 460) is available on the CD-ROM that is sent out annually by your Medicare contractor during the Annual Participation Enrollment period. Your contractor will also make the Participation Agreement available to you by placing it on their Websites with Participation enrollment (and termination) instructions.
MM6660 – Therapy Cap Values for Calendar Year (CY) 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6660.pdf
MM6690 – Update to Medicare Deductible, Coinsurance, and Premium Rates for 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6690.pdf
MM6723 – Claim Status Category Code and Claim Status Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6723.pdf
MM6708 – January 2010 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6708.pdf
SE0929 – 2010 Annual Participation Enrollment Program Extension
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0929.pdf
****PALMETTO/J1MAC NEWS****
California Contractor Advisory Committee Meeting Minutes
The following are minutes from the California Contractor Advisory Committee
Meeting on October 13, 2009, in San Francisco, CA. Please be sure to share
with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XRT268315?opendocument
CMS No Longer Recognizes HCPCS Code for Payment of Non-Outpatient Hospital
Claims
The following article announces that, effective immediately, the Centers
for Medicare & Medicaid Services (CMS) will no longer recognize the
Healthcare Common Procedure Coding System (HCPCS) Code for payment of
non-outpatient hospital claims. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XVLYX8318?opendocument
J1 Provider Outreach and Education Event Calendar
What's new in November 2009? The updated Palmetto GBA J1 Event Calenar is
now available on our Web site!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Monday, November 16, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
More than 85,000 physicians and other eligible professionals who successfully reported quality-related data to Medicare under the 2008 Physician Quality Reporting Initiative (PQRI) received incentive payments totaling more than $92 million, the Centers for Medicare & Medicaid Services (CMS) announced today, well above the $36 million paid in 2007.
The number of eligible professionals who earned an incentive payment increased by one-third from 2007, when 56,700 eligible professionals earned an incentive payment. In 2007, eligible professionals could only participate in the program during a 6-month reporting period. In 2008, the program expanded to allow reporting for either a 6-month or a 12-month period.
“We are very pleased with the results for 2008,” said Charlene Frizerra, Acting CMS Administrator. “More health professionals have successfully reported data, and the substantial growth in the national total for PQRI incentive payments demonstrates that Medicare can align payment with quality incentives.
To read the entire CMS Press release issued today (11/13) click here: http://www.cms.hhs.gov/apps/media/press_releases.asp
To read the entire CMS Fact Sheet issued today (11/13) click here: http://www.cms.hhs.gov/apps/media/fact_sheets.asp
CMS recently announced its plan for the 2010 PQRI Program as part of the Medicare Physician Fee Schedule final rule. A fact sheet on the 2010 PQRI Program is available online at http://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=3541&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date.
More information about the PQRI program, including participation guidance and the criteria to qualify for an incentive payment is available at www.cms.hhs.gov/PQRI.
****PALMETTO/J1MAC NEWS****
Radiopharmaceutical Drugs that Require An Invoice for Pricing
The list of HCPCS codes for radiopharmaceutical drugs that require an
invoice for pricing has been updated. An invoice is required with each
claim in order for the service to be priced for radiopharmaceuticals that
Palmetto GBA does not have pricing available for.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RAQMD6147?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****CMS NEWS****
More than 85,000 physicians and other eligible professionals who successfully reported quality-related data to Medicare under the 2008 Physician Quality Reporting Initiative (PQRI) received incentive payments totaling more than $92 million, the Centers for Medicare & Medicaid Services (CMS) announced today, well above the $36 million paid in 2007.
The number of eligible professionals who earned an incentive payment increased by one-third from 2007, when 56,700 eligible professionals earned an incentive payment. In 2007, eligible professionals could only participate in the program during a 6-month reporting period. In 2008, the program expanded to allow reporting for either a 6-month or a 12-month period.
“We are very pleased with the results for 2008,” said Charlene Frizerra, Acting CMS Administrator. “More health professionals have successfully reported data, and the substantial growth in the national total for PQRI incentive payments demonstrates that Medicare can align payment with quality incentives.
To read the entire CMS Press release issued today (11/13) click here: http://www.cms.hhs.gov/apps/media/press_releases.asp
To read the entire CMS Fact Sheet issued today (11/13) click here: http://www.cms.hhs.gov/apps/media/fact_sheets.asp
CMS recently announced its plan for the 2010 PQRI Program as part of the Medicare Physician Fee Schedule final rule. A fact sheet on the 2010 PQRI Program is available online at http://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=3541&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date.
More information about the PQRI program, including participation guidance and the criteria to qualify for an incentive payment is available at www.cms.hhs.gov/PQRI.
****PALMETTO/J1MAC NEWS****
Radiopharmaceutical Drugs that Require An Invoice for Pricing
The list of HCPCS codes for radiopharmaceutical drugs that require an
invoice for pricing has been updated. An invoice is required with each
claim in order for the service to be priced for radiopharmaceuticals that
Palmetto GBA does not have pricing available for.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RAQMD6147?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Friday, November 13, 2009
ASH, CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****ASH NEWS****
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/Practice/Practice-Updates/4498.aspx. This edition features:
• House Advances Health-Care Reform Legislation: Now Is the Time to Take Action to Support Physician Payment Fix
• ASH Practice Forum: New American Health-Care Policy and the Practice of Hematology
• Medicare Releases Final 2010 Payment Regulations; Physician Payment to Be Cut 21 Percent Absent Congressional Action
• Medicare Announces Changes to Hospital Outpatient Payment in 2010
• Medicare RAC Program Goes National – What You Need to Know
• FDA Issues Drug Warning on Dexferrum (Iron Dextran Injection)
• Medicare Contractors to Review Claims Data Related to Chemotherapy Administration
• CMS Announces 2008 PQRI Payments and Feedback Reports
• ASH Annual Meeting: Policy & Practice Events You Will Want to Attend
• Four Dates, Six Locations, One Great Program – The Only Official Highlights of ASH
****CMS NEWS****
MM6670 – Instructions for Processing Claims Containing Anti-Markup Services but with Partial Information Completed in Item 20 of the CMS-1500 Claim Form
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6670.pdf
MM6717 – Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6717.pdf
Centers for Medicare & Medicaid Services
Special Open Door Forum:
2009 Physician Quality Reporting Initiative (PQRI) Program with the American College of Emergency Physicians (ACEP)/CEP America
Thursday, November 12, 2009
2:00-3:30 pm ET Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will co-host a Special Open Door Forum on the 2009 PQRI Program with the American College of Emergency Physicians/CEP America. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
This Special Open Door Forum will be geared towards emergency medicine-specific topics related to participation in the PQRI Program. Following the presentation, the telephone lines will be opened to allow participants to ask questions of the ACEP/CEP America presenters, including: Dennis Beck, MD FACEP; Richards Newell, MD MPH; and Mike Granovsky, MD FACEP, as well as CMS PQRI subject matter experts.
PQRI information and educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI, on the CMS website.
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 31712023
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will A Relay Communications Assistant will help.
An audio recording and transcript of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning November 23, 2009.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/.
Thank you for your interest in CMS Open Door Forums.
****PALMETTO/J1MAC NEWS****
How to Determine If You Are an Independent Diagnostic Testing Facility
(IDTF)?
Are you an Independent Diagnostice Testing Facility? If a substantial
portion of the entity’s business involves the performance of diagnostic
tests, the diagnostic testing services might be a sufficiently separate
business to warrant enrollment as an independent diagnostic testing
facility. In that case, the physician or group can continue to be enrolled
as a physician or a group practice of physicians, but must also enroll as
an independent diagnostic testing facility.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7QMR824802?opendocument
Updated: Independent Diagnostic Testing Facility Table
The updated version of the Independent Diagnostic Testing Facility Table
(IDTF) is now available on the Palmetto GBA J1 Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7QUPVL5118?opendocument
Reason/Remark Code Lookup
Check out the handy PDF lists of the current Medicare specific
Reason/Denial Codes and the Remark Codes on the Palmetto GBA J1 Web site!
These two PDF lists will be updated annually.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XMTNC3288?opendocument
Updated: Independent Diagnostic Testing Facilities:Therapeutic
Procedures/Effect on Availability of Codes
The Independent Diagnostic Testing Facility (IDTF) Local Coverage
Determination (LCD) was retired, as there were CPT codes listed in the LCD
that were not diagnostic services or were inappropriate for an IDTF. A mass
adjustment was completed on August 24, 2009, with 619 claims adjusted in
Southern California, 259 claims in Northern California and 28 claims in
Hawaii and Nevada.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7T4KKD1007?opendocument
2010 Medicare Physician Fee Schedule (MPFS) Amounts Currently Unavailable
The 2010 Medicare Physician Fee Schedule (MPFS) amounts are currently
unavailable until further notice, but will be posted as soon as they become
available. Please check this Web site periodically for any updates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XPMAE2184?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****ASH NEWS****
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/Practice/Practice-Updates/4498.aspx. This edition features:
• House Advances Health-Care Reform Legislation: Now Is the Time to Take Action to Support Physician Payment Fix
• ASH Practice Forum: New American Health-Care Policy and the Practice of Hematology
• Medicare Releases Final 2010 Payment Regulations; Physician Payment to Be Cut 21 Percent Absent Congressional Action
• Medicare Announces Changes to Hospital Outpatient Payment in 2010
• Medicare RAC Program Goes National – What You Need to Know
• FDA Issues Drug Warning on Dexferrum (Iron Dextran Injection)
• Medicare Contractors to Review Claims Data Related to Chemotherapy Administration
• CMS Announces 2008 PQRI Payments and Feedback Reports
• ASH Annual Meeting: Policy & Practice Events You Will Want to Attend
• Four Dates, Six Locations, One Great Program – The Only Official Highlights of ASH
****CMS NEWS****
MM6670 – Instructions for Processing Claims Containing Anti-Markup Services but with Partial Information Completed in Item 20 of the CMS-1500 Claim Form
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6670.pdf
MM6717 – Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6717.pdf
Centers for Medicare & Medicaid Services
Special Open Door Forum:
2009 Physician Quality Reporting Initiative (PQRI) Program with the American College of Emergency Physicians (ACEP)/CEP America
Thursday, November 12, 2009
2:00-3:30 pm ET Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will co-host a Special Open Door Forum on the 2009 PQRI Program with the American College of Emergency Physicians/CEP America. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
This Special Open Door Forum will be geared towards emergency medicine-specific topics related to participation in the PQRI Program. Following the presentation, the telephone lines will be opened to allow participants to ask questions of the ACEP/CEP America presenters, including: Dennis Beck, MD FACEP; Richards Newell, MD MPH; and Mike Granovsky, MD FACEP, as well as CMS PQRI subject matter experts.
PQRI information and educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI, on the CMS website.
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 31712023
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will A Relay Communications Assistant will help.
An audio recording and transcript of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning November 23, 2009.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/.
Thank you for your interest in CMS Open Door Forums.
****PALMETTO/J1MAC NEWS****
How to Determine If You Are an Independent Diagnostic Testing Facility
(IDTF)?
Are you an Independent Diagnostice Testing Facility? If a substantial
portion of the entity’s business involves the performance of diagnostic
tests, the diagnostic testing services might be a sufficiently separate
business to warrant enrollment as an independent diagnostic testing
facility. In that case, the physician or group can continue to be enrolled
as a physician or a group practice of physicians, but must also enroll as
an independent diagnostic testing facility.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7QMR824802?opendocument
Updated: Independent Diagnostic Testing Facility Table
The updated version of the Independent Diagnostic Testing Facility Table
(IDTF) is now available on the Palmetto GBA J1 Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7QUPVL5118?opendocument
Reason/Remark Code Lookup
Check out the handy PDF lists of the current Medicare specific
Reason/Denial Codes and the Remark Codes on the Palmetto GBA J1 Web site!
These two PDF lists will be updated annually.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XMTNC3288?opendocument
Updated: Independent Diagnostic Testing Facilities:Therapeutic
Procedures/Effect on Availability of Codes
The Independent Diagnostic Testing Facility (IDTF) Local Coverage
Determination (LCD) was retired, as there were CPT codes listed in the LCD
that were not diagnostic services or were inappropriate for an IDTF. A mass
adjustment was completed on August 24, 2009, with 619 claims adjusted in
Southern California, 259 claims in Northern California and 28 claims in
Hawaii and Nevada.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7T4KKD1007?opendocument
2010 Medicare Physician Fee Schedule (MPFS) Amounts Currently Unavailable
The 2010 Medicare Physician Fee Schedule (MPFS) amounts are currently
unavailable until further notice, but will be posted as soon as they become
available. Please check this Web site periodically for any updates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XPMAE2184?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
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