Tuesday, September 23, 2008

CMS Releases Q-4 2008 Drug Payment Limits under ASP+6%

The following information is provided by OTN/Onmark, McKesson Specialty Companies, and ANCO Corporate Member.

CMS Releases Q-4 2008 Drug Payment Limits under ASP+6%

On September 16, 2008 CMS posted the Q-4 2008 ASP+6% Drug Payment Limit Files on the drug pages of the CMS Web site, Medicare Part B Drugs Average Sales Price (ASP) Information Resource. As you will see below, there are a number of significant changes to drugs widely administered in oncology offices and HOPD's:

Drug J-Code Q-3 '07 ASP+6% Q-4 '08 ASP+6% % Change
Carboplatin per 50mg J9045 $ 5.23 $ 9.61 + 83.7%
Bleomycin per 15iu J9040 $ 31.52 $ 34.83 + 10.5%
Etoposide per 100mg J9182 $ 4.43 $ 4.84 + 9.3%
Goserelin Acetate Impl. per 3.6mg J9202 $ 177.16 $ 189.45 + 6.9%
Vincristine Sulfate per 1mg J9370 $ 6.47 $ 6.80 + 5.1%
Irinotecan per 20mg J9206 $ 74.75 $ 37.00 - 50.5%
Pamidronate disodium per 30mg J2430 $ 38.21 $ 29.24 - 23.5%
Paclitaxel per 30mg J9265 $ 14.41 $ 11.04 - 23.4%
Granesitron HCL per 100mcg J1626 $ 5.35 $ 4.33 - 19.1%
Amifostine (Ethyol) per 500mg J0207 $ 511.32 $ 424.03 - 17.1%
For the third quarter now the rates reflected in the drug reimbursement files take into account the calculation methodology change mandated MMSEA-2007 for drugs within the multisource/generic category. The data used for the Q-4 2008 ASP+6% reimbursement files is based on the Q-2 2008 sales data submitted to CMS by drug manufacturers on July 31. Reimbursement allowables on NOC drugs were also updated.

The changes are effective October 1 and will remain in effect until either a correction or the next scheduled update by CMS. The next scheduled update will be in December and effective January 1, 2009.

We strongly encourage you to review the entire ASP+6% Drug Payment Limit file which will be available on the OTN Website.

List Serv Palmetto/J1MAC Website Update

The following updates have been posted to the Palmetto/J1MAC website.

CCI Edit Changes: Column I and Column II Codes
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~CCI%20Edit%20Changes:%20Column%20I%20and%20Column%20II%20Codes?opendocument

There is an important change that affects codes bundled with CCI edits.
Effective for date of service on and after July 1, 2008, if documentation
in the patient's medical record supports the use of CPT modifier 59 for
your code pair (containing a Column I and Column II code), CPT modifier
must be submitted with the Column II code only. Previously, Palmetto GBA
accepted claims for Column I/Column II code pairs when either code was
submitted with CPT modifier 59.

Applies to:
Jurisdiction 1//J1 Part B: General
----------


Telephone Claim Correction Checklist
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Appeals~Telephone%20Claim%20Correction%20Checklist?opendocument

Do you need assistance to correct a simple error made on a claim? Please
see the checklist in this article for the type of issues that can be
corrected by telephone instead of filing a Redetermination (1st level of
appeal). Please contact us at 1-866-669-5543, Monday-Friday, anytime
between 7:00 a.m.-3:00 p.m. PST. Be prepared to provide the provider's
identifier and the patient's Medicare number, last name and first initial.
We can handle three qualified requests per call.

Applies to:
Jurisdiction 1//J1 Part B: General

Thursday, September 18, 2008

CMS/Medicare Website Updates

Dear ANCO Online ListServ Subscriber:

The following updates have been posted to the CMS/Medicare website.

MM6175 - October 2008 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/MM6175.pdf

Palmetto/J1MAC Website Updates

Dear ANCO Online ListServ Subscriber:

The following updates have been posted to the Palmetto/J1MAC website.

J1 Part B LCD Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~J1%20Part%20B%20LCD%20Update?opendocument

Click on the link to view the J1 A/B MAC Part B LCDs that have been
revised.

Applies to:
Jurisdiction 1//J1 Part B: General
----------

CMS/Medicare: New Fact Sheets on Reporting Changes to Medicare Enrollment

Dear ANCO Online ListServ Subscriber:

The following information is provided by CMS/Medicare.

The Centers for Medicare & Medicaid Services (CMS) has posted three new Fact Sheets on the Medicare Provider Enrollment page at http://www.cms.hhs.gov/MedicareProviderSupEnroll/, on the CMS website.

These Fact Sheets list the types of changes that enrolled physicians, non-physician practitioners, and group practices are required to report to Medicare within specific times of occurrence. Non-reporting of changes may adversely affect claims processing, claims payment amounts, and the eligibility of the physician, non-physician practitioner, or group practice to participate in Medicare. The Fact Sheets indicate the Medicare provider enrollment forms that must be used to report the changes, and include information on where to go for assistance.

Links to each Fact Sheet are provided below:

Reporting Responsibilities for Individual Physicians Enrolled in the Medicare Program
http://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/PhysicianReportingResponsibilities.pdf

Reporting Responsibilities for Individual Non-Physician Practitioners Enrolled in the Medicare Program
http://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/Non-PhysicianReportingResponsibilities.pdf

Reporting Responsibilities for Physician Group Practices Enrolled in the Medicare Program
http://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/GroupPracticeReportingResponsibilities.pdf

Palmetto/J1MAC Website Updates

Dear ANCO Online ListServ Subscriber:

The following updates have been posted to the Palmetto/J1MAC website.

National Provider Identifier (NPI) for Secondary Providers
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~NPI~National%20Provider%20Identifier%20(NPI)%20for%20Secondary%20Providers?opendocument

This article is based on CR 6093 and outlines the need to use NPIs to
identify secondary providers in Medicare claims beginning May 23, 2008.
Some Medicare claims also need to identify one or more secondary providers.
A secondary provider could be a health care provider who ordered services
for a Medicare patient or who referred a Medicare patient to another health
care provider (ordering/referring providers); an attending, operating,
supervising, purchased service, other, or service facility provider; or a
prescriber (the latter only in retail pharmacy drug claims).

Applies to:
Jurisdiction 1//J1 Part B: General
----------


New Waived Tests
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~New%20Waived%20Tests?opendocument

Change Request 6179, from which this article is taken, informs providers of
new waived tests approved by the Food and Drug Administration (FDA) under
the Clinical Laboratory Improvement Amendments of 1988 (CLIA). Make sure
that your billing staffs are aware of these newly waived tests.

Applies to:
Jurisdiction 1//J1 Part B: General
----------


Reminder Notice: 2008 PQRI National Provider Conference Call with Question
& Answer Session
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~Reminder%20Notice:%202008%20PQRI%20National%20Provider%20Conference%20Call%20with%20Question%20Answer%20Session?opendocument

The Centers for Medicare & Medicaid Services' (CMS) Provider Communications
Group will host the seventh in a series of national provider conference
calls on the 2008 Physician Quality Reporting Initiative (PQRI). This
toll-free call will take place from 3:30 p.m. - 5:00 p.m., EDT, on
Thursday, September 18, 2008.


Applies to:
Part B - Ohio / West Virginia//General - Part B
Part B - South Carolina//General - Part B
Railroad Medicare (RRB)//General - Railroad Medicare
Jurisdiction 1//J1 Part B: General
----------

10th Annual UCSF/UCDavis Thoracic Oncology Conference

Dear ANCO Online ListServ Subscriber:

The 10th Annual UCSF/UC Davis Thoracic Oncology Conference takes place on November 8, 2008 at the InterContinental Hotel, San Francisco. UCSF and UC Davis are Institutional Members of ANCO.

For additional information, please visit https://www.cme.ucsf.edu/cme/CourseDetail.aspx?coursenumber=MSU09004.

Billing of and Reimbursement for ESAs

Dear ANCO Online ListServ Subscriber:

The Community Oncology Alliance (COA) and the newly formed COA Administrators' Network (CAN), in conjunction with Amgen and Ortho Biotech, cordially invite you to attend a live web cast on Tuesday, September 30, 2008, moderated by COA Board Member and Coding Mistress, Ms. Bobbi Buell. The focus of this web cast will be the Billing of and Reimbursement for ESAs, in light of past and current FDA label changes.

So, please plan on joining us for one of two webinars to be broadcast live onTuesday, September 30, 2008.

First Call: 12 Noon EDT, 11AM CDT, 10AM MDT, 9AM PDT, 8AM AK, 6AM HI

Second Call: 3PM EDT, 2PM CDT, 1PM MDT, 12Noon PDT, 11AM AK, 9AM HI

During the live call, you will be afforded the opportunity to submit questions which will be answered in real time by Bobbi Buell. Also participating will be representatives from both Amgen and Ortho Biotech, to field any and all questions or comments relating to the Medication Guide or the Risk Evaluation Mitigation Strategy (REMS).

To register for this training session, go to:

https://shp.webex.com/shp/k2/j.php?ED=112017747&UID=1029693472&FM=1

Once you are approved by the host, you will receive a confirmation email with instructions for joining the session.

For assistance, you can contact Dee Shook at dshook@sosacorn.com 901-259-3220.


Jose Luis Gonzalez, Executive Director
Association of Northern California Oncologists (ANCO)
Post Office Box 151109
San Rafael, CA 94915-1109
V: (415) 472-3960
F: (415) 472-3961

ASCO's Cancer Policy Today Published

Dear ANCO Online ListServ Subscriber:

The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published today and is available at http://view.exacttarget.com/?j=fe5e1577736c057e7412&m=ff311d707460&ls=fdf912757061027e75117274&l=fe5d15747c6d027d7717&s=fe1f15797d620479731d75&ju=fe2e16707d660779761c73. ANCO is a state/regional affiliate of ASCO.

It features:

Congress Begins Drafting a Continuing Resolution

Presidential Candidates Discuss Their Plans to Fight Cancer

CMS Announces CAP Postponement

ASCO Urges CMS Not to Expand the Anti-Markup Rule

FDA Posts List of Prescription Drugs under Investigation for Safety Problems

ASCO Alerts Medicare Contractor Medical Directors on Changes to Medicare Off-label Coverage Rules

ASCO President Reports to NCI Advisory Board

IOM to Host Workshop on Oncology Workforce

ASCO Requests Clarification of Federal Employees' Clinical Trial Coverage

ASCO Comments on FDA Advisory Committee Draft Guidance

Your Participation Needed for Physician Practice Information Survey

Wednesday, September 17, 2008

CMS/Medicare Website Updates

The following updates have been posted to the CMS/Medicare website.

MM6179 – New Waived Tests
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6179.pdf

MM6093 – National Provider Identifier (NPI) for Secondary Providers
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6093.pdf

Immediate Opening for Oncology Nurse

The following information is from an ANCO member practice.

Two physician busy hematology –oncology practice in Modesto, California has immediate opening for a chemotherapy certified oncology nurse.

Job Description: Outpatient chemotherapy center requiring patient care; mixing (we’ll train) and administration of chemotherapy drugs; and, working closely with our oncologists.

Competitive salary and benefits

To inquire and for more information, please contact:

Kim Lang or Diana Miguel

Office Phone: 209-524-7000

Fax 209-527-5601

Tuesday, September 16, 2008

CMA Alert: New Joint Commission Standard on Disruptive Behavior Does Not Supersede State Law on Medical Staff Self-Governance

The California Medical Association (CMA) Alert was published today and is available at http://www.calphys.org/html/news.asp.

It features:


New Joint Commission Standard on “Disruptive Behavior” Does Not Supersede State Law on Medical Staff Self-Governance

Key CMA Victory - DHCS Now Paying Medi-Cal Claims at Full Rate

Physicians Urged to Carefully Review Blue Cross Contract Amendment

CMA Sponsored Bills Await Governor’s Signature

Don’t Miss out on Your Chance to Impact CMA Policy

Tickets Now on Sale for CMA Foundation Annual Dinner

Benefit of the Week: Workers' Comp Insurance

CMS/Medicare Website Updates

The following updates have been posted to the CMS/Medicare website.

MM6175 – October 2008 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/MM6175.pdf

Palmetto/J1MAC Website Update

The following updates have been posted to the Palmetto/J1MAC website.

Medicare Provider Feedback Town Hall Meeting
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~Medicare%20Provider%20Feedback%20Town%20Hall%20Meeting?opendocument

The Centers for Medicare & Medicaid Services (CMS) requests your
participation in a Town Hall meeting on September 22, 2008, from 2:00 PM to
4:00 PM (Eastern Time). The meeting will be held via conference call as
well as in the auditorium at the Centers for Medicare & Medicaid Services,
7500 Security Boulevard, Baltimore, Maryland 21244.

Applies to:
Jurisdiction 1//J1 Part A : General
Jurisdiction 1//J1 Part B: General
Part A - North Carolina//General - Part A
Part A - South Carolina//General - Part A
Part B - Ohio / West Virginia//General - Part B
Part B - South Carolina//General - Part B
Railroad Medicare (RRB)//General - Railroad Medicare
Regional Home Health & Hospice Intermediary (RHHI)//General - RHHI

ASCO e-News Published

The American Society of Clinical Oncology's (ASCO) e-News was published today and is available online at http://view.exacttarget.com/?j=fe5a15777362077a7513&m=ff2d16787160&ls=fded12757d62027b70167574&l=fe5c1575756704757c1d&s=fdf2157972640d79751d7073&ju=fe2716707d64007c7d1d78. ANCO is a state/regional affiliate of ASCO.

It features:

Register by October 1 for Best Rates: 2008 ASCO/Children's Oncology Group (COG) Symposium

Registration Now Open for 2009 Gastrointestinal Cancers Symposium

Electronic Resources Available from 2008 Breast Cancer Symposium

ASCO Joins Frosted Pink with A Twist and Mary Lou Retton to Raise Awareness of Cancer

Apply Today for CDA and YIA Grants from The ASCO Cancer Foundation

Cancer Policy Alert: ASCO Comments on the Medicare Physician Fee Schedule, Congress Returns for Three-Week Legislative Session

Translational Cancer Medicine 2008: Bridging the Lab and the Clinic in Cancer Medicine

Aging and Cancer: Two Sides of the Same Coin?

For Your Patients: Reports and Highlights from 2008 Breast Cancer Symposium

For Your Patients: Techniques for Pain Management

New JCO Early Release Articles Published

See What's Coming Up in JCO

THIS WEEK AT ACCC: SEPTEMBER 15-19, 2008

The Association of Community Cancer Center's (ACCC) This Week At ACCC was published today and is available at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCCNEWSLETTER_9-15-2008.html. ANCO is an Institutional Member of ACCC.

It features:

ACCC's National Oncology Economics Conference Gets Underway

CMS to Halt In-Office Drug Program In 2009, Cites Contract Issues With Vendors

ACCC's Highly Acclaimed Hospital Summit Back By Popular Demand

Hot Off the Press: Check Out Your New Oncology Issues Online

New GI Cancer Consortium Launched, Aptium Oncology Reports

US Oncology Launches New Services Division: Innovent Oncology

Palliative Care Consultation Lowers Hospitalization Costs

Q&A on ACCC's Listserv: The Value of ACoS Accreditation

ACCC's CE Blackboard: New Continuing Education Programs for You

State Medical Oncology Societies Host Upcoming Meetings

Monday, September 15, 2008

Webcast on HER2 Reporting-Oncotype DX

The following information is provided by Genomic Health, an ANCO Corporate Member.

As part of Genomic Health's continuing effort to keep you informed on the latest information and emerging data regarding Oncotype DX, you are invited to participate in an interactive conference call on September 18th (5PM) or October 3rd (9AM).

To participate, please register by contacting Nikki Detore at (770) 763-5694 or ndetore@envisioncomm.net.

Palmetto/J1MAC Website Updates

The following updates have been posted to the Palmetto/J1MAC website.
Begin forwarded message:

Clinical Laboratory Fee Schedule: Medicare Travel Allowance Fees for
Collection of Specimens
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Clinical%20Laboratory%20Fee%20Schedule:%20Medicare%20Travel%20Allowance%20Fees%20for%20Collection%20of%20Specimens?opendocument

This article is based on Change Request (CR) 6195 and revises and clarifies
payment of travel allowances that are based on either a per mileage basis
(P9603) or on a flat rate basis (P9604) for calendar year (CY) 2008. The
new rates are $1.035 per mile (P9603) and $9.55 per flat-rate trip (P9604).



Applies to:
Jurisdiction 1//J1 Part B: General
----------




Indicator for the Technical Component of Purchased Diagnostic Services
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Indicator%20for%20the%20Technical%20Component%20of%20Purchased%20Diagnostic%20Services?opendocument

This article provides instructions to Palmetto GBA on how to process claims
for diagnostic services when there is no entry (either an indication in
Block 20 of the CMS-1500 form or a claim or line level PS1 segment on the
837P X12 4010A1 electronic format) on the claim to indicate that whether
the diagnostic services were purchased. Palmetto GBA will adjudicate a
claim lacking an entry for the "Yes/No" indicator or lacking the PS1
segment for a diagnostic service as if it were not a purchased service.

Applies to:
Jurisdiction 1//J1 Part B: General
----------




Medicare Part B Drug Competitive Acquisition Program (CAP):
Ask-the-Contractor Teleconference - CAP Postponement for 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~Drugs%20and%20Biologicals~Medicare%20Part%20B%20Drug%20Competitive%20Acquisition%20Program%20(CAP):%20Ask-the-Contractor%20Teleconference%20-%20CAP%20Postponement%20for%202009?opendocument

On September 10, 2008, the Centers for Medicare & Medicaid Services (CMS)
announced the postponement of the 2009 Medicare Part B Competitive
Acquisition Program (CAP). As a result, CAP physician election for
participation in the CAP in 2009 will not be held, and CAP drugs will not
be available from an approved CAP vendor for dates of service after
December 31, 2008.

Applies to:
Jurisdiction 1//J1 Part A : General
Jurisdiction 1//J1 Part B: General
Part B - Ohio / West Virginia//General - Part B
Part B - South Carolina//General - Part B
----------


NPPES - Keeping It Safe and Keeping it Updated
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~News~NPPES%20-%20Keeping%20It%20Safe%20and%20Keeping%20it%20Updated?opendocument

This message is for healthcare providers, particularly physicians and other
practitioners, who have obtained National Provider Identifiers (NPIs) and
have records in the National Plan and Provider Enumeration System (NPPES).

Applies to:
Jurisdiction 1//J1 Part A : General
Jurisdiction 1//J1 Part B: General
Part A - North Carolina//General - Part A
Part A - South Carolina//General - Part A
Part B - Ohio / West Virginia//General - Part B
Part B - South Carolina//General - Part B
Railroad Medicare (RRB)//General - Railroad Medicare
Regional Home Health & Hospice Intermediary (RHHI)//General - RHHI

CMS/Medicare: 2009 Competitive Acquisition Program (CAP) Postponement

The following information is provided by CMS/Medicare.

The Centers for Medicare & Medicaid Services (CMS) today announced the postponement of the 2009 Medicare Part B Competitive Acquisition Program (CAP). The program will continue through December 31, 2008.

Earlier this year, CMS accepted bids for vendor contracts for the 2009-11 CAP. While CMS received several qualified bids, contractual issues with the successful bidders resulted in CMS postponing the 2009 program. As a result, CAP physician election for participation in the CAP in 2009 will not be held, and CAP drugs will not be available from an approved CAP vendor for dates of service after December 31, 2008.

Later this fall, CMS will provide additional guidance for participating CAP physicians on how to transition out of the program. This information will be posted on the CMS CAP physician’s page at http://www.cms.hhs.gov/CompetitiveAcquisforBios/02_infophys.asp.

CMS also plans to seek feedback on the CAP from participating physicians, potential vendors, and other interested parties. CMS will assess the information and consider implementing changes to the CAP before proceeding with another bid solicitation. As part of the process, CMS is interested in hearing from the public about a range of issues, including, but not limited to, the categories of drugs provided under the CAP, the distribution of areas that are served by the CAP, and procedural changes that may increase the program’s flexibility and appeal to potential vendors and physicians.

Information about how to submit comments will be available at http://www.cms.hhs.gov/CompetitiveAcquisforBios/.

CMS/Medicare: National Plan and Provider Enumeration System (NPPES) User Maintenance Tips

The following information is provided by CMS/Medicare.

This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES). The Centers for Medicare & Medicaid Services (CMS) recommends that each health care provider, including individual physicians and non-physician practitioners:

Know and maintain their NPPES User Ids and passwords.

Reset their NPPES passwords at least once a year. See the NPPES Application Help page regarding the ‘Reset Password’ rules. Those rules indicate the length, format, content and requirements of NPPES passwords.

Review their NPPES records in order to ensure that the information reflects current and correct information.

Maintaining NPPES Account Information for Safety and Accessibility
Health care providers, including physicians and non-physician practitioners, should maintain their own NPPES account information (i.e., User ID, Password, and Secret Question/Answer) for safety and accessibility purposes.

Viewing NPPES Information
Health care providers, including physicians and non-physician practitioners, can view their NPPES information in one of two ways:

(1) By accessing the NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created. *

* If the health care provider has forgotten the password, enter the User ID and click the “Reset Forgotten Password” button to navigate to the Reset Password Page. If the health care provider enters an incorrect User ID and Password combination three times, the User ID will be disabled. Please contact the NPI Enumerator at 1-800-465-3203 if the account is disabled or if the health care provider has forgotten the User ID.

OR

(2) By accessing the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do. The NPI Registry gives the health care provider an online view of Freedom of Information Act (FOIA)-disclosable NPPES data. The health care provider can search for its information using the name or NPI as the criterion.

Updating NPPES Information
Health care providers, including physicians and non-physician practitioners, can correct, add, or delete information in their NPPES records by accessing their NPPES records at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.

Please note: Required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information. Certain information is inaccessible via the web, thus requiring the change/update to be made via paper application. The paper NPI Application/Update Form can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.

Need More Information?
Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. Having trouble viewing any of the URLs in this message? If so, try to cut and paste any URL in this message into your web browser to view the intended information.

Note: All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage.

CMS/Medicare Website Updates

The following updates have been posted to the CMS/Medicare website.

MM6136 – Revised Form CMS-R-131 Advance Beneficiary Notice of Noncoverage
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6136.pdf

Thursday, September 11, 2008

CMS/Medicare: CMS Form 1500 Web-Based Training Course

The CMS Form 1500 Web-based Training (WBT) course has been updated (July 2008) and is now available from the Centers for Medicare & Medicaid Services Medicare Learning Network. This WBT course provides information that will allow you to file Medicare Part B claims accurately and reduce your chances of receiving unprocessable rejections.
To access this WBT, visit http://www.cms.hhs.gov/mlngeninfo/ , scroll down to “Related Links Inside CMS” and select “Web-based training Modules”, scroll down to “Office Management Information” to select this training.

ACCC Dinner Event

US Oncology Physician Services, an ANCO Corporate Member, will be hosting a dinner event during the ACCC National Economics Meeting at the Waterfront Restaurant in San Francisco on Thursday September 18th at 7:30PM. If interested please RSVP by this Friday September 12th by calling 1-866-216-5053 (option 2).

Wednesday, September 10, 2008

Palmetto/J1MAC Website Updates

The following updates have been posted to the Palmetto/J1MAC website.


2009 Annual Update for the Health Professional Shortage Area (HPSA) Bonus
Payments
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~2009%20Annual%20Update%20for%20the%20Health%20Professional%20Shortage%20Area%20(HPSA)%20Bonus%20Payments?opendocument

Change Request 6150 provides Palmetto GBA with the names of the test and
final files for the Health Professional Shortage Area (HPSA) bonus payments
for 2009 and alerts providers that the 2009 file will be posted to the
Centers for Medicare & Medicaid Services (CMS) Web site when it is
available.


Applies to:
Jurisdiction 1//J1 Part B: General
----------


Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) Imaging for
Infection and Inflammation
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~Radiology~Fluorodeoxyglucose%20(FDG)%20Positron%20Emission%20Tomography%20(PET)%20Imaging%20for%20Infection%20and%20Inflammation?opendocument

This article is based on Change Request (CR) 6099 instructing that the
Centers for Medicare & Medicaid Services (CMS) is continuing its national
non-coverage policy for the off-label indications of fluorodeoxyglucose
(FDG) Positron emission tomography (PET) imaging for chronic osteomyelitis,
infection of hip arthroplasty, and fever of unknown origin.


Applies to:
Jurisdiction 1//J1 Part B: General
----------


October Update to the 2008 Medicare Physician Fee Schedule Database
(MPFSDB)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Publications~Fee%20Schedules~October%20Update%20to%20the%202008%20Medicare%20Physician%20Fee%20Schedule%20Database%20(MPFSDB)?opendocument

Physicians and providers who submit claims to Palmetto GBA for services
rendered to Medicare beneficiaries paid based on the MPFSDB. The October
2008 MFSDB changes are outlined in this article.


Applies to:
Jurisdiction 1//J1 Part B: General
----------


Overpayment Refund Form: Medicare Part A and B
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Forms~Overpayment%20Refund%20Form:%20Medicare%20Part%20A%20and%20B?opendocument

An updated Medicare Overpayment form is now available online. Overpayments
are Medicare funds a Provider, Physician/Supplier or Beneficiary has
received in excess of amounts due and payable by Medicare. Once a
determination of overpayment has been made, the amount is a debt owed to
the United States Government. When you identify an overpayment, please send
a check with the completed form to Medicare for that amount. This will
prevent offsets or delay of future claim payments.

Applies to:
Jurisdiction 1//J1 Part A : General
Jurisdiction 1//J1 Part B: General
----------


Physician Signature Requirements for Diagnostic Tests
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Physician%20Signature%20Requirements%20for%20Diagnostic%20Tests?opendocument

A physician’s signature is not required on orders for clinical diagnostic
tests (including x-ray, laboratory, and other diagnostic tests) that are
paid on the basis of the clinical laboratory fee schedule, the Medicare
physician fee schedule, or for physician pathology services. While a
physician order is not required to be signed, the physician must clearly
document in the medical record his or her intent that the test be
performed. Make sure that your office, billing, and/or laboratory staffs
are aware of this updated guidance regarding the signature requirement for
diagnostic tests.


Applies to:
Jurisdiction 1//J1 Part B: General

IMPACT: California's Prostate Cancer Treatment Program

IMPACT is a state funded program whose mission it is to provide high quality prostate cancer treatment to Californians who are low income and uninsured. In order to qualify for free prostate cancer treatment through IMPACT, a patient must have a positive biopsy for prostate cancer; have no current insurance coverage except CMSP (including Medicaid or Medicare), and be low income. Potentially eligible patients may be referred to IMPACT at 1-800-409-8252. IMPACT's eligibility staff will take it from there.

Please contact Rick Edmiston, MPH, at (415) 353-7390 or rick.edmiston@ucsfmedctr.org, to discuss referrals.

For more information, visit www.california-impact.org.

IMPACT thanks to ANCO for helping spread the word about California’s free prostate cancer treatment program.

AMGEN & Ortho Biotech ESA Resource Links

In light of recent FDA label revision to ESAs, coupled with the release of the Medication Guide to be reviewed and furnished to all patients who are contemplating receiving ESAs, please find below links to manufacturer resources.

ORTHO BIOTECH

PIs, Medication Guides, Patient Instructions for Use

Users can find the Medication Guide/PIU/Prescribing Information at www.procrit.com.

http://www.procrit.com/procrit/shared/OBI/PI/ProcritBooklet.pdf#page=1 (Prescribing Information)
http://www.procrit.com/procrit/shared/OBI/PI/MedGuide.pdf (Medication Guide)
http://www.procrit.com/procrit/shared/OBI/PI/PIU.pdf (Patient Instructions for Use)
Medication Guides are currently being printed and will be available by your PROCRIT Product Specialist starting in mid September.

Customer Contacts

• For PROCRIT Prescribing Information, Medication Guide, and Patient Instructions for Use questions, please contact your Ortho Biotech Product Specialist. If you need to contact your Product Specialist, please contact 1-888-227-5624 or click here (https://www.orthobiotech.com/orthobiotech/contactus.html)

• For questions surrounding the studies within the PROCRIT label or available data, please contact your Ortho Biotech Medical Scientific Liaisons. If you need to contact your Medical Scientific Liaison, please contact 1-888-227-5624 or click here (https://www.orthobiotech.com/orthobiotech/contactus.html).

Reimbursement Tools

NIMO (NCD Interpretation Model) - a software tool that allows customers to assist in reimbursement decisions for Medicare patients

AMGEN

AMGEN's Medical Information services are available at 1-800-77-AMGEN. Assistance with issues regarding reimbursement can be attained through their Reimbursement Connection Services at 1-800-272-9376.

The following links lead directly to the Aranesp package insert, Medication Guide and an Invitation to register for an Educational Webcast to be aired September 3rd thru September 18th .

Aranesp_pi v19 0808.pdf (138KB),
Aranesp_medication guide 0808.pdf (46KB)
Aranesp Educational Webcast Series Invite FINAL.pdf (474KB)
Also, users can find more information at the Aranesp.com website http://www.aranesp.com

Tuesday, September 9, 2008

THIS WEEK AT ACCC

The Association of Community Cancer Centers (ACCC) This Week at ACCC was published today and is available at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCCNEWSLETTER_9-8-2008.html. ANCO is an Institutional Member of ACCC.

It features:

Are You Coming to San Francisco? Still Time for You to Register

ACCC Submits Comments to CMS on Proposed Hospital Outpatient Rule

Tell Your Pharmacists: An ACCC Meeting Just For Them

Sneak Peek: ACCC Meeting to Showcase Exhibitors

ACCC's Highly Acclaimed Hospital Summit Back By Popular Demand

The Cancer Genome Atlas Reports First Results of Brain Tumor Study

Colon Cancer Patients Not Getting Follow-up Care

Welcome Aboard to ACCC's Newest Members

Q&A on ACCC's Listserv: Benchmarks for Radiation Oncology Staffing

ACCC's CE Blackboard: New Continuing Education Programs for You

State Medical Oncology Societies Host Upcoming Meetings

CMS/Medicare: Medicare Part B Competitive Acquisition Program (CAP) for Drugs and Biologicals: October 2008 CAP Drug List Update

The following information is provided by CMS/Medicare.


The list of drugs available under the CAP has been updated and is now available in the ‘Downloads’ section on the CMS CAP “Information for Physicians” page at http://www.cms.hhs.gov/CompetitiveAcquisforBios/02_infophys.asp.

The following drug has been added to the CAP effective October 1, 2008: Vivitrol® naltrexone (J2315).

CMS/Medicare: Medicare Part B Drug Competitive Acquisition Program (CAP): "CAP Physician Billing Tips" Handout for Submitting CAP Claims Now Available

The following information is provided by CMS/Medicare.

An updated version of the “CAP Physician Billing Tips” handout is now available. This reference contains information on the claims submission requirements for the CAP such as the CAP modifiers and other necessary elements. A copy of this document is available on the ‘Information for Physicians’ page on the CMS CAP website at http://www.cms.hhs.gov/CompetitiveAcquisforBios/02_infophys.asp

Palmetto/J1MAC Website Updates

The following updates have been posted to the Palmetto/J1MAC website.


2008 PQRI National Provider Conference Call with Question & Answer Session
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Ohio%20Part%20B%20Carrier~Articles~Physician%20Quality%20Reporting%20Initiative~2008%20PQRI%20National%20Provider%20Conference%20Call%20with%20Question%20Answer%20Session?opendocument

The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications
Group will host the seventh in a series of national provider conference
calls on the 2008 Physician Quality Reporting Initiative (PQRI). This
toll-free call will take place from 3:30 p.m. – 5:00 p.m., EDT, on
Thursday, September 18, 2008.


Applies to:
Part B - Ohio / West Virginia//General - Part B
Part B - South Carolina//General - Part B
Jurisdiction 1//J1 Part B: General
Railroad Medicare (RRB)//General - Railroad Medicare
----------


Availability of an Interim Study of Alternative Payment Localities under
the MPFS
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~News~Availability%20of%20an%20Interim%20Study%20of%20Alternative%20Payment%20Localities%20under%20the%20MPFS?opendocument

Medicare is statutorily required to adjust payments for physician fee
schedule services to account for differences in costs due to geographic
location. There are currently 89 different localities which have not been
revised since 1997. In the CY 2009 Physician Fee Schedule notice of
proposed rulemaking which was released on June 30, 2008, we indicated that
we would post on the CMS website a preliminary study of several options for
revising the payment localities.

Applies to:
Part A - North Carolina//General - Part A
Part A - South Carolina//General - Part A
Part B - Ohio / West Virginia//General - Part B
Part B - South Carolina//General - Part B
Railroad Medicare (RRB)//General - Railroad Medicare
Regional Home Health & Hospice Intermediary (RHHI)//General - RHHI
Jurisdiction 1//J1 Part A : General
Jurisdiction 1//J1 Part B: General
----------


Roster Billing Flu & Pneumonia Billing to Medicare Part B
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Roster%20Billing%20Flu%20Pneumonia%20Billing%20to%20Medicare%20Part%20B?opendocument

Palmetto GBA J1 has prepared this packet for health care providers who mass
immunize their patients against influenza and pneumonia. The packet
contains instructions on how to submit claims using the roster billing
method.

Applies to:
Jurisdiction 1//J1 Part B: General
----------


Save the Date: National E-Prescribing Conference
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~News~Save%20the%20Date:%20National%20E-Prescribing%20Conference?opendocument

Register Today! Be part of a groundbreaking opportunity. CMS along with
industry partners from health and technology are hosting a National
E-prescribing Conference on October 6 – 7, 2008 at the Sheraton Boston
Hotel, Boston, MA.

Applies to:
Part B - Ohio / West Virginia//General - Part B
Part A - North Carolina//General - Part A
Part A - South Carolina//General - Part A
Jurisdiction 1//J1 Part A : General
Jurisdiction 1//J1 Part B: General
Part B - South Carolina//General - Part B
Railroad Medicare (RRB)//General - Railroad Medicare
Regional Home Health & Hospice Intermediary (RHHI)//General - RHHI
----------


Providers sent this e-mail to you because your Member Profile indicates
that you want to receive information from us for these listserv(s):
Jurisdiction 1//J1 Part B: General
Jurisdiction 1//J1 Part B: EDI

Friday, September 5, 2008

CMS/Medicare Website Update

The following updates have been posted to the CMS/Medicare website.

MM6180 – October Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6180.pdf

MM6100 – Physician Signature Requirements for Diagnostic Tests
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6100.pdf

MM6145 – Screening DNA Stool Test for Colorectal Cancer
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6145.pdf

Judge Trims Time in DHCS/MediCal 10% Fee Ruling

A federal judge has scaled back her order overturning a 10 percent cut in Medi-Cal fees to thousands of doctors and other health professionals.

The ruling spares the state from tens of millions of dollars of reimbursements over seven weeks and requires repayment only for services performed on or after Aug. 18.

U.S. District Judge Christina Snyder of Los Angeles had ruled Aug. 18 that the fee reductions threatened health care for many of Medi-Cal's 6.6 million low-income patients and appeared to violate federal standards for access to high-quality medical services. She ordered state officials to reimburse health care providers dating back to July 1, when the cuts took effect.

But after lawyers for the Medi-Cal program argued that the Constitution shields states from retroactive damage awards, Snyder revised her ruling Aug. 27 to eliminate the back payments and require full fees at pre-July 1 levels only from Aug. 18 onward. The state has asked a federal appeals court to overturn the entire ruling, arguing that federal law does not entitle Medi-Cal providers or patients to challenge fee levels in court.

State lawmakers approved the fee cuts in February, effective with the start of the fiscal year July 1. The Legislature remains in a partisan deadlock over the 2008-09 budget, which has a $17.2 billion deficit.

State officials had estimated that Snyder's original injunction - which covered fees to doctors, dentists, pharmacists, adult day health centers and clinics - would cost California $500 million a year. By that estimate, her Aug. 27 ruling would save the state $65 million. Because the fee reduction also applies to the federal government's 50 percent funding of Medi-Cal, the loss to health care providers would total $130 million.

"It's a blow to providers' ability to take care of the Medi-Cal population ... and a blow to the effort to insure that poor Californians have access to health care," Ned Wigglesworth, spokesman for the California Medical Association, said Wednesday.

Noting that many doctors already shun Medi-Cal because of low fees, Wigglesworth said, "If the state continues to insist on cutting health care during times of budget problems, providers are going to be less willing to participate."

Lynn Carman, lawyer for pharmacists, patients and community organizations that challenged the cuts in Medi-Cal prescription drug fees, said he would ask the appeals court to reinstate Snyder's original ruling and require reimbursement from July 1 onward. He renewed his accusation that state officials are dragging their feet on complying with the injunction, a subject of a hearing scheduled before Snyder on Friday.

Norman Williams, spokesman for the Department of Health Care Services, said the department has told its employees and contractors to "fully comply with the order" unless the judge agrees to suspend the injunction during the state's appeal.

Palmetto/J1MAC Website Updates

The following updates have been posted to the Palmetto/J1MAC website.


New Web Site Addresses for J1 A/B MAC Providers
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~New%20Web%20Site%20Addresses%20for%20J1%20AB%20MAC%20Providers?opendocument

On September 3, 2008, Jurisdiction 1 A/B providers were redirected to a new
Web site. www.PalmettoGBA.com/J1 is now going to a new page that prompts
you to select either the J1 A or J1 B homepages. To make sure you get to
your page faster, please update your Palmetto GBA Jurisdiction 1 A/B MAC
bookmarks and/or favorites with these new links.

Applies to:
Jurisdiction 1//J1 Part A : General
Jurisdiction 1//J1 Part B: General
----------


PET Scan Tracer Codes: HCPCS Codes A9552 and A9555
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~PET%20Scan%20Tracer%20Codes:%20HCPCS%20Codes%20A9552%20and%20A9555?opendocument

When submitting claims for HCPCS Codes A9552 and A9555, an invoice is
required with each claim in order for Palmetto GBA to determine the
appropriate payment.

Applies to:
Jurisdiction 1//J1 Part A : General
Jurisdiction 1//J1 Part B: General

OTN/Onmark Legislative Calls: September 16th and 17th

The following information is provided by OTN/Onmark, McKesson Specialty Companies, an ANCO Corporate Member.

Join your fellow community-practice physicians for a presentation and discussion, led by John Akscin, OTN's Vice President of Government Relations.

When: OTN and Onmark have scheduled two times for your convenience:

Tuesday, September 16 at 3 p.m. CST
Wednesday, September 17 at 12 p.m. CST

Where: Call 877-856-1956 at least 10 minutes prior to the meeting start time. No pre-registration required!

Discussion will include:

CMS Q4 ASP+6%
CMS Update, Accessing Your 2007 PQRI Reports
Summary Recent OIG Report to CMS on ASP
New Drug Reimb. Info.: Nplate, Fusilev, Hycamtin Oral
CMS Tidbits
CMS Transmittals and MLMs
Legislative Update
Q&A

The Legislative, Regulatory and Reimbursement program is made possible through the generous support of Genentech. OTN appreciates their sponsorship of these calls.

Did you miss the August Legislative Update? Listen to a playback by calling 888-203-1112, ID #6740733 or, click here to download and listen to a podcast of OTN's conference call.
Good News for Coders: This program has prior approval of the American Academy of Professional Coders (AAPC) for 1.0 Continuing Education Unit. Granting of this approval in no way constitutes endorsement by the Academy of the program, content or the program sponsor.

Additional Credits Available: This program may qualify for continuing education credit for the American College of Medical Practice Executives (ACMPE). An ACMPE credit form will be sent to all attendees shortly after the end of the event.

Onmark's September Programs

The following information is provided by OTN/Onmark, McKesson Specialty Companies, an ANCO Corporate Member.

Enroll today for two upcoming programs:

Next Week: Learn Private Payor Negotiating Strategies
Effective managed care negotiations are critical to the health of your practice. The next CORE webcast will prepare you for more productive contract negotiations by examining the payor mindset and offering practical tips and creative strategies to help you succeed. This webcast features guest panelist Ron Howrigon, President of Fulcrum Strategies. Learn more and enroll today!

• September 9, 2008 – 9 a.m. PT / 12 p.m. ET
• September 10, 2008 – 12 p.m. PT / 3 p.m. ET

Sept. 23: Using Onmark's Patient Education Materials
Onmark offers a complementary suite of over 300 online patient education handoutswritten at the drug, regimen, symptom and disease level. Enroll today for an upcoming training session to learn how to customize these materials for use in your practice:

• September 23, 2008 – 12 p.m. PT / 3 p.m. ET

Thursday, September 4, 2008

ASCO's Cancer Policy Today Published

The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe661577706405797711&m=ff311d707460&ls=fdf912757061027e75117274&l=fe5d15747c6d027d7717&s=fe1f15797d620479731d75&ju=fe2c167073600c7f771374. ANCO is a state/regional affiliate of ASCO.

It features:

Congress Returns for Three-Week Legislative Session

ASCO Comments on the Medicare Physician Fee Schedule

ASCO Comments on the Proposed Hospital Outpatient Rule for 2009

FDA To Host Workshop on Clinical Trials for Local Treatment of Breast Cancer

CMS & HHS Issue Proposed Rules on ICD-10

2009 ASCO Community Oncology Research Grant Nomination Opens

Your Participation Needed for Physician Practice Information Survey

Oncology Today

The attached information is provided by US Oncology Physician Services, an ANCO Corporate Member.

The Oncology Today meeting takes place on October 25th and is accredited for community based Nurse Practitioners, Nurses, Pharmacists, and Physician Assistants. The program offers 6.5 AMA Credits, 6.0 AACN Contact Hours.

REGISTER TODAY FOR THIS UPCOMING CME/CE ACCREDITED MEETING:
Healthcare Provider Conference 2008: Collaboration for
Advancing the Quality of Community Cancer Care
Mission Bay Conference Center at UCSF
San Francisco, California
Saturday, October 25, 2008
7:00AM–4:00PM

6.5 AMA PRA Category 1 Credit(s)™  6.0 AACN Contact Hours  6.5 ACPE Contact Hours
Registration, course, and meals are free
Join Oncology Today™ for the third annual accredited conference for community-based oncology nurse practitioners, nurses, pharmacists, and physician assistants.
A unique opportunity to learn and discuss some of the most
important and practice changing updates in cancer care today. Learn what
your colleagues are doing to improve care in their practices.

Multidisciplinary expert faculty will present and discuss the latest research
data and practical management issues in community oncology:

• New drugs utilized to treat hematologic disorders and solid tumors
• Advances in breast cancer, bone marrow transplantation, and genitourinary cancer care
• Overview and focus sessions on integrative medicine
• Impact of epigenetics on current treatment options

More Information Coming Soon…
CLICK HERE to register for this meeting

Wednesday, September 3, 2008

ASCO e-News Published

The American Society of Clinical Oncology (ASCO) e-News was published today and is available online at http://view.exacttarget.com/?j=fe51157771630c7a7312&m=ff2d16787160&ls=fdef1275716d027d7314747d&l=fe4b15747c6c0d7a7c11&s=fdf2157972640d79751d7073&ju=fe2116707366007a721d79. ANCO is a state/regional affiliate of ASCO.

It features:

Latest Issue of ASCO News & Forum Available Online

Register for 2008 ASCO/Children's Oncology Group Symposium

RSVP for Cancer Advances: A Public Forum on Breast Cancer

ASCO Joins Frosted Pink with A Twist and Mary Lou Retton to Raise Awareness of Cancer

Submit an Abstract for 2009 Gastrointestinal Cancers Symposium

Submit an Abstract for 2009 Genitourinary Cancers Symposium

ASCO Launches Electronic Health Record (EHR) Podcasts

Applications for the 2009 ASCO Cancer Foundation Grants Program Now Being Accepted

Editors Sought for ASCO Daily News and ASCO News & Forum

Translational Cancer Medicine 2008: Bridging the Lab and the Clinic in Cancer Medicine

Cancer Policy Alert: Senate Appropriations Committee Details Second Economic Stimulus Package, FDA Orders Label Change for ESAs, New Advances on E-Prescribing Adoption

For Your Patients: ASCO Expert Corner Discusses Older Adults With Cancer

For Your Patients: Latest Cancer.Net Podcast Explores Grieving Process

JCO Early Release Articles Examine Endocrine Therapy and Bone Loss in Breast Cancer; Denosumab in Patients Receiving Adjuvant Aromatase Inhibitors for Nonmetastatic Breast Cancer; Cerebrovascular Disease Risk in Older Head and Neck Cancer Patients after Radiotherapy

Future JCO Table of Contents

THIS WEEK AT ACCC: SEPTEMBER 2-5, 2008

The Association of Community Cancer Center's (ACCC) This Week at ACCC was published today and is available at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCCNEWSLETTER_9-2-2008.html. ANCO is an Institutional Member of ACCC.

It features:

ACCC Submits Comments to CMS on 2009 Proposed Physician Fee Schedule

Tell Your Pharmacists: An ACCC Meeting Just For Them

Make Your Labor Day Resolution to Be the Best You Can Be

Sneak Peek: ACCC Meeting to Showcase Exhibitors

ACCC Testifies Before APC Advisory Panel

Q&A on ACCC's Listserv: Turn Around Time for Breast Biopsy

FDA Approves New Oral Aloxi Capsules

Vidaza Gets FDA Approval to Change Prescribing Information

ACCC's CE Blackboard: New Continuing Education Programs for You

State Medical Oncology Societies Host Upcoming Meetings

ASH Practice Update: August 28, 2008

The following information is provided by the American Society of Hematology (ASH) and is available online at http://www.hematology.org/policy/practice/08282008.cfm#1.

It features:

ASH Comments on Proposed Medicare Physician Fee Schedule Changes

ASH Comments on Proposed Hospital Outpatient Prospective Payment System Changes

ASH Recommends Changes to ICD-9 Codes for MDS

FDA Approves Romiplostim for the Treatment of Thrombocytopenia in Patients With Chronic ITP

Comparative Effectiveness Research Act Introduced in the Senate

CMS Releases Guide to Medicare Coverage, Coding, Payment

Information Available for Receiving PQRI Feedback Reports

Blood Moves to Weekly Publication in 2009

CMA Alert: Federal Court Rules Budget Cuts Unlawfully Jeopardize Health Care

The California Medical Association (CMA) Alert was published today and is available online at http://www.calphys.org/html/news.asp.

It features:

Federal Court Rules Budget Cuts Unlawfully Jeopardize Health Care for Millions of Californians

CMA Files Brief with U.S. Supreme Court in Case that Could Increase Physician Liability for Prescription Drug-Related Injuries

Proposed Regulations Would Expand Health Professionals’ Scope of Practice and Weaken Medical Staff Self-Governance

At Least 1,200 Physicians Experiencing Medicare Payment Stoppage

CMA Files Brief in Peer Review Case Before State Supreme Court

CMA Urges CMS Not to Release Unvalidated Physician Quality Data

State Supreme Court Rules Noncompetition Clauses Unenforceable in California

Members Invited to Participate in the House of Delegates Discussion Forum

All Physicians Invited to Attend CMA’s OMSS Annual Assembly, October 3 in Sacramento

Please Support CMA’s Medical Student Charity Basketball Tournament

Tickets Now on Sale for CMA Foundation Annual Dinner

Member Benefit of the Week: 30 - 50% off Epocrates

Palmetto/J1MAC Website Updates

The following updates have been posted to the Palmetto/J1MAC website.



J1 A/B MAC Transition is Complete!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/J1%20AB%20MAC%20Transition%20is%20Complete!?opendocument

The J1 A/B MAC transition has successfully been completed for all three
segments! The implementation information announcement line, 888-318-7246,
will be discontinued on Wednesday, September 3, 2008.

Applies to:
Part A Transition: EDI
Part A Transition: General
Part B Transition: EDI
Part B Transition: General

Tuesday, September 2, 2008

CMS/Medicare: Updates to the Physician Quality Reporting Initiative (PQRI) Web Page

CMS is pleased to announce that several section pages on the PQRI web page have been updated to include the following:

v The Overview page has been updated to announce the posting of the Registries that qualified for 2008 PQRI and information about the availability of the 2007 Feedback
Reports.
v The Reporting page has been updated to add the list of Registries that qualified for 2008 PQRI as a new downloadable file under the “Downloads” section.
v On the CMS Sponsored Calls page, the updated slides from the July 9 National Provider Call has been posted as a downloadable file under the “Downloads” section.
v The Educational Resources page has been updated to add the “2008 Errata Sheet: Getting Started with Claims-Based Reporting of Measures Groups” as a new downloadable file under the “Downloads” section.
v The 2007 PQRI Educational Resources page has been updated to add the two new Special Edition MLN articles on accessing the 2007 Feedback Reports (by individuals and by organizations) as new downloadable files under the “Downloads” section.

All publicly available information on the CMS Physician Quality Reporting Initiative can be found at (http://www.cms.hhs.gov/PQRI), on the CMS website.

CMS/Medicare: CMS Announces 32 Registries Qualify for 2008 PQRI Reporting

CMS is pleased to announce the 32 registries that have been “qualified” by CMS to submit quality data on behalf of their participants for the 2008 Physician Quality Reporting Initiative (PQRI) registry submission option. A list of each registry and their website is available at http://www.cms.hhs.gov/pqri as a downloadable document accessible by clicking on the Reporting page on the left. Each of the listed registries has gone through a thorough vetting process including investigating their capabilities, reviewing a sample measure flow (this checks to see whether the registry calculates the measure’s reporting and performance rates correctly), and transmitting the required information in the requested file format (XML). Eligible professionals interested in registry-based participation for PQRI in 2008 are encouraged to contact the registries directly to determine which registry meets their practice’s needs and collects quality information on measures that are important to the practice.

CMS/Medicare: 2008 Physician Quality Reporting Initiative (PQRI) National Provider Conference Call with Question & Answer Session

The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the seventh in a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 3:30 p.m. – 5:00 p.m., EDT, on Thursday, September 18, 2008.

This call will provide an update on registry reporting for 2008; information on the E-prescribing measure for 2008 PQRI (measure #125) and proposed measures for 2009 PQRI; incentives for electronic prescribing; 2007 PQRI feedback reports and incentive payments, and a question and answer session.

A PowerPoint slide presentation will be posted to the PQRI webpage at http://www.cms.hhs.gov/PQRI/02_CMSSponsoredCalls.asp on the CMS website for you to download prior to the call so that you can follow along with the presenters, Dr. Michael Rapp, and Dr. Daniel Green.

Following the presentation, callers will have an opportunity to ask questions of CMS subject matter experts.

Conference call details:

Date: September 18, 2008
Conference
Title: 2008 Physician Quality Reporting Initiative National Provider Call
Time: 3:30-5:00 EDT

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. If you cannot attend the call, replay information is available below.

Registration will close at 3:30 p.m. EDT on September 17, 2008, 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://www2.eventsvc.com/palmettogba/091808

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 you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 5:30 p.m. EDT 9/18/2008 until 11:59 p.m. EDT 9/25/2008. The call in data for the replay is (800) 642-1687 and the passcode is 61954941.

If you require services for the hearing impaired please send an email to Medicare.TTT@PalmettoGBA.com.

Palmetto/J1MAC Website Updates

The following updates have been posted to the Palmetto/J1MAC website.

Clinical Social Worker Services
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Clinical%20Social%20Worker%20Services?opendocument

Services of a clinical social worker (aka CSW) are not covered when
furnished to inpatients of a hospital or to inpatients of a SNF if the
services furnished in the SNF are those that the SNF is required to furnish
as a condition of participation in Medicare.

Applies to:
Part A Transition: General
Part B Transition: General
----------


J1 A/B MAC LCD Reconsideration Requests
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/J1%20AB%20MAC%20LCD%20Reconsideration%20Requests?opendocument

J1 A/B MAC LCD Reconsideration Requests

Applies to:
Part A Transition: General
Part B Transition: General
----------


J1 EDI Extended Hours for One Week
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/J1%20EDI%20Extended%20Hours%20for%20One%20Week?opendocument

Palmetto GBA EDI Operations will remain open an extra two hours Tuesday
through Friday, September 2-5, as well as on Saturday from 8:00 a.m. PT
until 5:00 p.m. PT.

Applies to:
Part A Transition: EDI
Part B Transition: EDI
----------


NHIC Customers (Segment 3): The J1 Part B Go Live date is September 2,
2008!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NHIC%20Customers%20(Segment%203)%3A%20The%20J1%20Part%20B%20Go%20Live%20date%20is%20September%202%2C%202008!?opendocument

Attention NHIC Customers (Segment 3): 4 days and counting. Are you ready
?!? If you currently receive electronic payments from your current
contractor and have not submitted an updated CMS-588 Form to Palmetto GBA,
please do so immediately.

Applies to:
Part B Transition: EDI
----------


Paper Claims Containing Multiple Services: Verify Payments
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Paper%20Claims%20Containing%20Multiple%20Services%3A%20Verify%20Payments?opendocument

If you submitted paper claims to your Jurisdiction 1 Outgoing Contractor
(OGC) prior to August 1, 2008, some service lines may have been
inadvertently omitted from the information transferred to Palmetto GBA.
These processing errors affect paper claims only that were submitted during
this transitional period.

Applies to:
Part B Transition: General

Palmetto/J1MAC Website Updates

The following updates have been posted to the Palmetto/J1MAC website.

Clinical Social Worker Services
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Clinical%20Social%20Worker%20Services?opendocument

Services of a clinical social worker (aka CSW) are not covered when
furnished to inpatients of a hospital or to inpatients of a SNF if the
services furnished in the SNF are those that the SNF is required to furnish
as a condition of participation in Medicare.

Applies to:
Part A Transition: General
Part B Transition: General
----------


J1 A/B MAC LCD Reconsideration Requests
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/J1%20AB%20MAC%20LCD%20Reconsideration%20Requests?opendocument

J1 A/B MAC LCD Reconsideration Requests

Applies to:
Part A Transition: General
Part B Transition: General
----------


J1 EDI Extended Hours for One Week
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/J1%20EDI%20Extended%20Hours%20for%20One%20Week?opendocument

Palmetto GBA EDI Operations will remain open an extra two hours Tuesday
through Friday, September 2-5, as well as on Saturday from 8:00 a.m. PT
until 5:00 p.m. PT.

Applies to:
Part A Transition: EDI
Part B Transition: EDI
----------


NHIC Customers (Segment 3): The J1 Part B Go Live date is September 2,
2008!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NHIC%20Customers%20(Segment%203)%3A%20The%20J1%20Part%20B%20Go%20Live%20date%20is%20September%202%2C%202008!?opendocument

Attention NHIC Customers (Segment 3): 4 days and counting. Are you ready
?!? If you currently receive electronic payments from your current
contractor and have not submitted an updated CMS-588 Form to Palmetto GBA,
please do so immediately.

Applies to:
Part B Transition: EDI
----------


Paper Claims Containing Multiple Services: Verify Payments
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Paper%20Claims%20Containing%20Multiple%20Services%3A%20Verify%20Payments?opendocument

If you submitted paper claims to your Jurisdiction 1 Outgoing Contractor
(OGC) prior to August 1, 2008, some service lines may have been
inadvertently omitted from the information transferred to Palmetto GBA.
These processing errors affect paper claims only that were submitted during
this transitional period.

Applies to:
Part B Transition: General

Palmeto/J1MAC Website Update

The following updates have been posted to the Palmetto/J1MAC website.

Electronic Claims and FAX Attachments
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Electronic%20Claims%20and%20FAX%20Attachments?opendocument

Palmetto GBA offers the availability of a FAX service for electronic
submitters to submit additional documentation. The FAX Documentation Cover
Sheets are now available to download. ********If you are unable to access
the link below, please go to www.palmettogba.com/J1, click on Publications,
then click on Articles.********

Applies to:
Part B Transition: General
----------


Electronic Submission of MSP Claims
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Electronic%20Submission%20of%20MSP%20Claims?opendocument

Reading the updated procedure for Electronic Submission of MSP Claims.

Applies to:
Part B Transition: General
----------


Important Information for Stratford Software Users
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Important%20Information%20for%20Stratford%20Software%20Users?opendocument

Palmetto GBA and Stratford Software are working together to facilitate
connectivity to Palmetto GBA for Stratford Software customers. At this
time, please use the HyperTerminal instructions below to connect and
transmit files to Palmetto GBA using your Stratford Software.

Applies to:
Part B Transition: EDI
----------


Important Medicare Addresses and Telephone Numbers for Segment 3 Providers
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Important%20Medicare%20Addresses%20and%20Telephone%20Numbers%20for%20Segment%203%20Providers?opendocument

View and/or download a list of Important Medicare Addresses and Telephone
Numbers for Segment 3 Part B providers in the state of California.

Applies to:
Part B Transition: General
----------


J1 A/B MAC Billing Instructions for IDEs
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/J1%20AB%20MAC%20Billing%20Instructions%20for%20IDEs?opendocument

Billing Instructions for Investigational Device Exemptions (IDEs) for Part
A Providers in A/B MAC Jurisdiction 1.

Applies to:
Part A Transition: General
Part B Transition: General
----------


J1 A/B MAC PCC Customer Service Training – August 29, 2008
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/J1%20AB%20MAC%20PCC%20Customer%20Service%20Training%20%E2%80%93%20August%2029%2C%202008?opendocument

J1 A/B MAC Provider Contact Center (PCC) Customer Service Training – August
29, 2008


Applies to:
Part A Transition: General
Part B Transition: General
----------


NHIC Customers (Segment 3): The J1 Part B Go Live date is September 2,
2008!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/NHIC%20Customers%20(Segment%203)%3A%20The%20J1%20Part%20B%20Go%20Live%20date%20is%20September%202%2C%202008!?opendocument

Attention NHIC Customers (Segment 3): 6 days and counting. Are you ready
?!? If you currently receive electronic payments from your current
contractor and have not submitted an updated CMS-588 Form to Palmetto GBA,
please do so immediately.

Applies to:
Part B Transition: EDI
----------


Updated FAQs
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Updated%20FAQs?opendocument

Based on questions we've received from you, we've recently added FAQs in
Appeals, EDI, EFT, LCDs, Medical Review, and Provider Enrollment. Click on
the link to read the new FAQs.

Applies to:
Part A Transition: General
Part B Transition: General
----------