Thursday, November 27, 2008

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
Physicians and Other Health Professionals Value-Based Purchasing Issues Paper Posted
The Centers for Medicare & Medicaid Services (CMS) has posted the Issues Paper that is part of the development of a Plan to transition to a Medicare Value-Based Purchasing Program for physician and other professional services, as required by Section 131(d) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). The Issues Paper is posted on the CMS Website Physician Center Spotlights at: http://www.cms.hhs.gov/center/physician.asp.

This Issues Paper will be the basis of a Listening Session to be held at the CMS Central Facility on December 9, 2008, from 10 AM EST to 4 PM EST. The notice for this meeting was published in the Federal Register on October 24, 2008. Physicians and other professionals, their associations, health care purchasers, consumers, and all other interested parties are invited to participate, in person or by calling in to the teleconference. The issues identified and discussed during this meeting will assist CMS in developing options for the Plan. The meeting is open to the public, but attendance is limited to space and teleconference lines available.

Interested parties are reminded that to participate, either in person or by teleconference, on‑line registration is required via the CMS website at: http://registration.intercall.com/go/cms2. Registration will close at 5 PM EST on Tuesday, December 2, 2008.

Written comments or statements on the Issues Paper are welcome and may be sent via email toPhysicianVBP@cms.hhs.gov; faxed to 410-786-8005; or sent via regular mail to: Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244-1850, Mail Stop C5-15-02, Attn: Physician VBP Comments. All persons planning to make a statement in person at the Listening Session are urged to submit statements in writing during the Listening Session and should subsequently submit the information electronically. The deadline for receipt of comments is 5 PM EST on Tuesday, December 16, 2008.

For further information regarding the December 9, 2008 Listening Session, contact Robin Phillips, at 410-786-3010 in the Provider Communications Group. Inquiries may also be sent via e‑mail to mpf@cms.hhs.gov

Listening Session Format
The Listening Session will consider the key design issues raised in the Issues Paper. The session will begin at 10 AM EST with an overview of the objectives for the session and a brief summary of the approach to developing the Plan. Beginning at approximately 10:30 AM EST, the remainder of the meeting will be devoted to presenting and receiving comments on key design and policy issues for each of the major components for the Plan: (1) measures, (2) incentive structure, (3) data strategy and infrastructure, and (4) public reporting. The agenda will provide opportunities for brief 2-minute comments on each of the key issues from on-site session attendees. As time allows, telephone participants will also have the opportunity to provide brief 2-minute comments. A lunch break will occur from approximately 12:15 to 1 PM EST. The meeting will conclude by 4 PM EST with brief comments on next steps.

The final Agenda and copies of the PowerPoint slides to be used in the Listening Session will be posted by 5 PM EST Friday, December 5, 2008, on the CMS Website Physician Center Spotlights at: http://www.cms.hhs.gov/center/physician.asp.


MM6229 – Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6229.pdf

SE0831 – Steps for IACS Defined “Organizations” to Access Their Physician Quality Reporting Initiative (PQRI) Feedback Reports
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf

SE0830 – Steps for Eligible Professionals to Access Their Physician Quality Reporting Initiative (PQRI) Feedback Reports
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf


Medicare Part B Drug Competitive Acquisition Program (CAP): Feedback about the CAP – A Special Open Door Forum (ODF) Teleconference on the 2009 CAP Postponement and How to Submit E-mail Comments
The Centers for Medicare & Medicaid Services (CMS) is soliciting public feedback about the CAP. CMS is interested in hearing 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
§ procedural changes that may increase the program's flexibility and appeal to potential vendors and physicians.

On December 3, 2008, CMS will host a Special ODF Teleconference to obtain feedback about the program. This teleconference will be a listening session and is intended for current and former participating CAP physicians, potential Approved CAP Vendors, and any other interested parties. CMS will assess the information that it receives as it considers implementing changes to the CAP.

Call Details:

Date and Time: December 3, 2008 from 2:00-3:30PM EST
Toll Free Call Number: (800) 837-1935
Conference ID: 66307647

Interested parties can also submit comments to the CAP e-mailbox at MMA303DDrugBid@cms.hhs.gov


****PALMETTO/J1MAC NEWS****
December 2008 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~December%202008%20J1%20AB%20MAC%20Medicare%20Advisory?opendocument

The December 2008 J1 A/B MAC Medicare Advisory is now available to be
viewed on the Palmetto GBA Web site.


Medicare's Practical Guide to the E-Prescribing Incentive Program is now
available online!
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~Medicares%20Practical%20Guide%20to%20the%20E-Prescribing%20Incentive%20Program%20is%20now%20available%20online!?opendocument

The guide explains the e-prescribing incentive program, how eligible
professionals can participate, and how to choose a qualified e-prescribing
system. By adopting e-prescribing through Medicare's program, eligible
professionals can save time, enhance office and pharmacy productivity, and
improve patient safety and quality of care while earning incentives from
Medicare.


Medicare Part B Drug Competitive Acquisition Program (CAP): Feedback about
the CAP - A Special Open Door Forum (ODF) Teleconference on the 2009 CAP
Postponement and How to Submit E-mail Comments
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~Medicare%20Part%20B%20Drug%20Competitive%20Acquisition%20Program%20(CAP):%20Feedback%20about%20the%20CAP%20-%20A%20Special%20Open%20Door%20Forum%20(ODF)%20Teleconference%20on%20the%202009%20CAP%20Postponement%20and%20How%20to%20Submit%20E-mail%20Comments?opendocument

On December 3, 2008, CMS will host a Special ODF Teleconference to obtain
feedback about the program. This teleconference will be a listening session
and is intended for current and former participating CAP physicians,
potential Approved CAP Vendors, and any other interested parties. CMS will
assess the information that it receives as it considers implementing
changes to the CAP.


Part B LCD Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Part%20B%20LCD%20Update?opendocument

There are four J1 Part B LCD updates.


Physicians and Other Health Professionals Value-Based Purchasing Issues
Paper Posted
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~Physicians%20and%20Other%20Health%20Professionals%20Value-Based%20Purchasing%20Issues%20Paper%20Posted%20?opendocument

The Centers for Medicare & Medicaid Services (CMS) has posted the Issues
Paper that is part of the development of a Plan to transition to a Medicare
Value-Based Purchasing Program for physician and other professional
services, as required by Section 131(d) of the Medicare Improvements for
Patients and Providers Act of 2008 (MIPPA). This Issues Paper will be the
basis of a Listening Session to be held at the CMS Central Facility on
December 9, 2008, from 10 AM EST to 4 PM EST.

Wednesday, November 26, 2008

ASCO & CMA News

The following information has been received by ANCO.


****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available at http://view.exacttarget.com/?j=fe571578766d037f7112&m=ff311d707460&ls=fdec12777c65017975127971&l=fe601575776601757d14&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2d16717065017b701174. ANCO is a state/regional affiliate of ACSO. This edition features:

Congress Likely to Take Up Additional NIH Funding After Recess

Prepare for Coding Changes in the New Year

ASCO Encourages President-elect Obama to Name Next NIH Director

ASCO Issues Recommendations to Address Looming Oncology Workforce Shortage

ASCO/AMA Survey Update


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

Healthy Families Facing Minimum 6 Month Enrollment Freeze

Survey Finds Widespread Dissatisfaction Among Primary Care Physicians; Predicts Massive Shortfall by 2025

Medi-Cal Update

Family PACT Waiver Deadline Extended to November 30

Court Weighs CMA Lawsuit Against Balance Billing Regulation

Deadline to Request CPPI Quality Data is December 5

Highlights from AMA's Interim Meeting

Member Benefit of the Week: Magazine Discount Program

Tuesday, November 25, 2008

ACCC, ASCO, & Palmetto/J1MAC News

The following information has been received by ANCO.


****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week at ACCC was published today and is available online at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCCNEWSLETTER_11-24-2008.html. ANCO is an Institutional Member of ACCC. This edition features:

ACCC's Hospital Summit: At Only $169. Don't Miss It!

CMS Clarifies Requirements for Physician Supervision of HOPD Services

Time is Running Out: Apply for ACCC Cancer Care Navigation Project Pilot Site

Regional Symposium Coming to Philadelphia Next Week

Q&A on ACCC's Listserv: Coding for Multiple Encounters

ACCC's CE Blackboard: Breast Cancer Concepts

Take Our Survey: Oncology Issues and ACCC's Website

NCI Advisors Approve Major Cancer Research Initiatives

NCI Technology Research Facility Gets Off the Ground

State Medical Oncology Societies Host Membership Meetings


****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) e-News was published today and is available at http://view.exacttarget.com/?j=fe5c1578766c027d7111&m=ff2d16787160&ls=fded127873670c7c73147770&l=fe5f157577630c7d7713&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe3416717064007c741178. ANCO is a state/regional affiliate of ASCO. This edition features:

Last Chance to Vote in the 2009 ASCO Election

Check Out What's New in JCO

Newest Issue of JOP Available Online

Virtual Meeting for the ASCO-NCI-EORTC Annual Meeting on Molecular Markers in Cancer Now Available for Free

EHR Field Guide Now Available on ASCO's Bookstore

New Online CME Activities Available for Members

ASCO Launches Its First Maintenance of Certification Module

Letters of Intent for 2009 ACRAs in Breast Cancer and Glioma Due Dec. 4

Application Deadline Approaching for 2009 ASCO State Affiliate Grants

Apply for the 2009 Susan G. Komen for the Cure®/ASCO Loan Repayment Program

Register and Reserve Housing for the 2009 GU Cancers Symposium

Apply for the 2009 IDEA Grant

Review ASCO State/Regional Affiliates Calendar of Events

Cancer Policy Alert: President's Cancer Panel Releases Report on Combating Cancer; CMS Issues Final Medicare Physician Payment Rule for 2009; New Report Issues Recommendations on Improving Cancer Clinical Trials

Cancer.Net Features: Answers to Holiday Questions


****PALMETTO/J1MAC NEWS****
CMS Issues Improper Payment Rates for Medicare, Medicaid, and SCHIP
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~CMS%20Issues%20Improper%20Payment%20Rates%20for%20Medicare,%20Medicaid,%20and%20SCHIP?opendocument

CMS today reported it protected roughly $400 million of taxpayer dollars as
improper payments for Medicare fee-for-service (FFS) decreased from 3.9
percent in Fiscal Year (FY) 2007 to 3.6 percent, or $10.4 billion, in FY
2008. The Medicare, Medicaid and SCHIP improper payment rates are issued
annually as part of the HHS Agency Financial Report.


Inappropriate Access to or Use of Electronic Data Interchange (EDI)
Transaction Data by Third Party Entities
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Railroad%20Medicare~EDI~General~Inappropriate%20Access%20to%20or%20Use%20of%20Electronic%20Data%20Interchange%20(EDI)%20Transaction%20Data%20by%20Third%20Party%20Entities?opendocument

This MLM article was originally published in 2004. Palmetto GBA wants to
make sure all submtiters understand the existing Medicare requirements and
prohibitions concerning use of EDI numbers and passwords.

Monday, November 24, 2008

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.

****CMS NEWS****
MM6187 – 2008 Physician Quality Reporting Initiative Claims-Based Reporting of Measures Groups
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6187.pdf

Revised:
MM6258 – Update to Medicare Deductible, Coinsurance and Premium Rates for 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6258.pdf


****PALMETTO/J1MAC NEWS****
2008 Physician Quality Reporting Initiative Claims-Based Reporting of
Measures Groups
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~Physician%20Quality%20Reporting%20Initiative~2008%20Physician%20Quality%20Reporting%20Initiative%20Claims-Based%20Reporting%20of%20Measures%20Groups?opendocument

This article announces that the 2008 PQRI Claims-Based Measures Groups
reporting alternative is available for the six-month reporting period from
July 1 through December 31, 2008.


Medicare Billing Information for Rural Providers, Suppliers, and Physicians
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~Medicare%20Billing%20Information%20for%20Rural%20Providers,%20Suppliers,%20and%20Physicians?opendocument

"Medicare Billing Information for Rural Providers, Suppliers, and
Physicians" (October 2008), which consists of charts that provide Medicare
billing information for Rural Health Clinics, Federally Qualified Health
Centers, Skilled Nursing Facilities, Home Health Agencies, Critical Access
Hospitals, and Swing Beds, is now available.


Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code
(CARC) Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Remittance%20Advice%20Remark%20Code%20(RARC)%20and%20Claim%20Adjustment%20Reason%20Code%20(CARC)%20Update?opendocument

This article is based on Change Request (CR) 6229 which updates Remittance
Advice Remark Codes (RARCs) and Claim Adjustment Reason Codes (CARCs). If
you use the Medicare Remit Easy Print software, note that Medicare will
update that software as a result of implementing CR 6229. Be sure billing
staff are aware of these updates.

Friday, November 21, 2008

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
“Medicare’s Practical Guide to the E-Prescribing Incentive Program” is now available online!

The guide explains the e-prescribing incentive program, how eligible professionals can participate, and how to choose a qualified e-prescribing system. To read or print the guide, visit: http://www.cms.hhs.gov/partnerships/downloads/11399.pdf.

By adopting e-prescribing through Medicare’s program, eligible professionals can save time, enhance office and pharmacy productivity, and improve patient safety and quality of care while earning incentives from Medicare.

For additional information about e-prescribing, you can also visit:
www.cms.hhs.gov/PQRI. Select “E-prescribing Incentive Program”;
www.cms.hhs.gov/eprescribing. (for information on Part D e-prescribing standards that will be effective April 1, 2009); and
www.ehealthinitiative.org to download “A Clinician’s Guide to Electronic Prescribing.”

Continuing Education Credits Available
On October 6–7, 2008, CMS and 34 partner organizations hosted the National E-Prescribing Conference to promote and explain the potential of e-prescribing to improve health care in the United States. Sessions included the e-prescribing incentive payment program; strategies and tools for integrating e-prescribing with current health care delivery practices; and privacy, security, and risk management implications.

The Massachusetts Medical Society and the American Pharmacists Association will provide continuing education for selected presentations from the conference through an online education portal. Available credits are a maximum of 22.5 AMA PRA Category 1 Credits™, and Continuing Education for pharmacists (up to 13.25 hours of continuing education credit (1.325 CEUs)). To view or listen to the presentations, and complete an online test on each segment, go to www.massmed.org/cme/CMS_eprescribing.

Additional information is available on the National E-Prescribing Conference site at http://www.epsilonregistration.com/er/EventHomePage/CustomPage.jsp?ActivityID=378&ItemID=1117.

The Centers for Medicare & Medicaid Services looks forward to working with you on the adoption of e-prescribing and implementation of the incentive program.


****PALMETTO/J1MAC NEWS****
J1 Interactive Voice Response (IVR) System Enhancements
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~J1%20Interactive%20Voice%20Response%20(IVR)%20System%20Enhancements?opendocument

Palmetto GBA is pleased to announce updates to our IVR system serving the
J1 Part B provider community. The IVR enhancements will be available for
Part B providers beginning Monday, November 24, 2008. An overview of the
Part B enhancements includes: Payment Floor information: Part B Providers
will be able to obtain the number of claims approved to pay and the pending
payment amount for those claims; Providers will continue to have access to
information regarding the last three checks paid; Blood Deductible
information: Part B Providers will be able to verify the total number of
pints remaining for a patient to meet the Blood Deductible; Psychiatric
information: Part B Providers will now be able to obtain the number of
Psychiatric days remaining in the benefit; Physical Therapy: Part B
Providers will have access to the amount of the Physical Therapy Cap
satisfied by a patient; and Occupational Therapy: Part B Providers will be
able to obtain the amount of the Occupational Therapy Cap satisfied by a
patient.

Thursday, November 20, 2008

Cephalon/ION Program

The following information has been received by ANCO.


****CEPHALON/ION PROGRAM****
Cephalon Oncology and ION cordially invite you to a unique live event:
NEW TREATMENT ADVANCES IN CHRONIC LYMPHOCYTIC LEUKEMIA
A Webcast presented on behalf of Cephalon Oncology
Speaker: Wolfgang Knauf, M.D.,
Friday, December 12, 2008 11AM PDT
During this Web event, topics of discussion will focus on Treanda and:
• clinical understanding of Treanda's use in CLL
• clinical rational for using Treanda in CLL
• proper dosing and administration of Treanda
• Treanda's overall response in CLL
• safety profile of Treanda

Contact Julie Goldberg at (888) 536-7697 x6826 or julie.goldberg@iononline.com for further assistance.

Wednesday, November 19, 2008

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
MM6258 – Update to Medicare Deductible, Coinsurance and Premium Rates for 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6258.pdf

MM6191 – Compendia as Authoritative Sources for Use in the Determination of a "Medically Accepted Indication" of Drugs and Biologicals Used Off-Label in an Anti-Cancer Chemotherapeutic Regimen
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6191.pdf


****PALMETTO/J1MAC NEWS****
2008 Physician Quality Reporting Initiative National Provider Question &
Answer Session
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~2008%20Physician%20Quality%20Reporting%20Initiative%20National%20Provider%20Question%20Answer%20Session?opendocument

The Centers for Medicare & Medicaid Services' (CMS) Provider Communications
Group will host the eighth in a series of national provider conference
calls that began in November of 2007 on the 2008 Physician Quality
Reporting Initiative (PQRI). This toll-free call will take place from 1:30
pm - 3:30 pm, EST, on Thursday, November 20, 2008. Registration will close
at 1:30 p.m. EST, November 19, 2008, or when available space has been
filled. No exceptions will be made, so please be sure to register prior to
this time.

Tuesday, November 18, 2008

ACCC & Palmetto/J1MAC News

The following information has been received by ANCO.


****ACCC NEWS****
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_11-17-2008.html. ANCO is an Institutional Member of ACCC. This edition features:

ACCC Analysis of Final 2009 Hospital Outpatient Department Rule

ACCC Analysis of Final 2009 Physician Fee Schedule

ACCC President Interviewed in Pharmacy Practice News

Still Time to Apply for ACCC Cancer Care Navigation Project Pilot Site

Make Your Cancer Service Line More Competitive: ACCC's Hospital Summit

Regional Symposium Coming to Philadelphia

Q&A on ACCC's Listserv: Chemo and a "Present" Physician

ACCC's CE Blackboard: New Multiple Myeloma Therapy Symposium

State Medical Oncology Societies Host Upcoming Meetings


****PALLMETTO/J1MAC NEWS****
Compendia as Authoritative Sources for Use in the Determination of a
"Medically Accepted Indication" of Drugs and Biologicals Used Off-Label in
an Anti-Cancer Chemotherapeutic Regimen
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~Oncology%20Hematology~Compendia%20as%20Authoritative%20Sources%20for%20Use%20in%20the%20Determination%20of%20a%20"Medically%20Accepted%20Indication"%20of%20Drugs%20and%20Biologicals%20Used%20Off-Label%20in%20an%20Anti-Cancer%20Chemotherapeutic%20Regimen%20?opendocument

This updates the list of compendia recognized as authoritative sources of
information for the determination of drugs and biologicals used off-label
in anti-cancer chemotherapeutic regimens.

Sunday, November 16, 2008

CMS & Palmetto/J1MAC NEWS

The following information has been received by ANCO.


****CMS NEWS****
Physicians and providers who were unable to attend the previous two ICD-10-CM/PCS conference calls may now register for the Centers for Medicare & Medicaid Services ICD-10-CM/PCS National Provider Conference Call that will be conducted on November 17, 2008 from 12:30 p.m. – 2:30 p.m. EST. Registration will close at 12:30 p.m. EST on November 16, 2008 or when available space has been filled. To register for this call, go to http://www.cms.hhs.gov/icd10/Downloads/Physicians_ICD10_CM_PCS_Conference_Call.pdf. To find additional information about this conference call and to access the ICD-10 Overview Presentation that will be discussed during the call, go to http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp.

Noridian Administrative Services, the designated carrier for the CAP, offers interactive, online workshops about the CAP for Part B Drugs and Biologicals. These workshops train CAP vendors and elected physicians on a variety of CAP topics, including how to transition out of the CAP at the end of 2008 due to the postponement of the program for 2009. NAS staff will also be available to answer questions. Interested parties may view additional information about and register for these workshops on the Noridian website at:

https://www.noridianmedicare.com/cap_drug/train/schedule.html

A workshop will be held on the following date:

§ 11/24/08 at 2:00 pm CST

Additional information about the CAP and the 2009 postponement is available at http://www.cms.hhs.gov/CompetitiveAcquisforBios/01_overview.asp


****PALMETTO/J1MAC NEWS****
2009 J1 Part B Fee Schedules
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Publications~Fee%20Schedules~2009%20J1%20Part%20B%20Fee%20Schedules?opendocument

This is the 2009 J1 Part B Fee Schedules, which includes California,
Nevada, Hawaii, Guam, American Samoa and the Northern Mariana Islands.


ICD-10-CM/PCS National Provider Conference Call for Physicians
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~ICD-10-CMPCS%20National%20Provider%20Conference%20Call%20for%20Physicians?opendocument

Physicians and providers who were unable to attend the previous two
ICD-10-CM/PCS conference calls may now register for the Centers for
Medicare & Medicaid Services ICD-10-CM/PCS National Provider Conference
Call that will be conducted on November 17, 2008 from 12:30 pm - 2:30 pm
EST. Registration will close at 12:30 pm EST on November 16, 2008 or when
available space has been filled.

Friday, November 14, 2008

CMS News

The following information has been received by ANCO.


****CMS NEWS****
MM6262 – Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes Used for Home Health Consolidated Billing Enforcement
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6262.pdf

Thursday, November 13, 2008

ASCO, Celgene/ION, MOASC/ Palmetto/J1MAC News

The following information has been received by ANCO.


****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe5a1578776c037c7d16&m=ff311d707460&ls=fdec12777c65017975127971&l=fe601575776601757d14&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2d167171640674721075. ANCO is a state/regional affiliate of ASCO. This edition features:

Obama/Biden Administration Priorities for Cancer Care

NCI and CEO Roundtable on Cancer Develop Standard Clinical Trial Contract Language

CMS Issues Final Medicare Physician Payment Rule for 2009

CMS Issues Final Hospital Outpatient Payment Rule for 2009

President's Cancer Panel Releases Report on Combating Cancer

New NIH Policy Aims to Support Scientists Early in their Careers

FDA Requires Toll-Free Number for Reporting Adverse Effects on Drug Label

New Report Issues Recommendations on Improving Cancer Clinical Trials


****CELGENE/ION PROGRAM****
Celgene and ION cordially invite you to a unique live event:

THE SIGNIFICANCE OF SURVIVAL IN MDS PATIENTS
An Interactive Live Satellite Broadcast

Celgene will be hosting a National Satellite Dinner Program with ION on Tuesday, December 2nd. During this program, Dr. Lewis Silverman from Mount Sinai School of Medicine will present an update on the Vidaza survival data.

Physicians will have the opportunity to either go to a local Morton’s restaurant to watch the presentation with their colleagues or go to their computer to watch the presentation through the web.

The program will start at the following times:
· 6:30 pm - 8:00 pm Eastern
· 5:30 pm - 7:00 pm Central
· 7:30 pm - 9:00 pm Mountain
· 6:30 pm - 8:00 pm Pacific

An invitation with instructions for registering is available at http://www.anco-online.org/CelgeneION.pdf.

The live site locations are available to physicians, physician’s assistants or nurse practitioners.

The program is open to ION and non-ION members. If space allows, the live sites will be open for nurses and pharmacists one week prior to the program.

Attendance at the live sites will be on a first come, first served basis.

All healthcare professionals including nurses and pharmacists can participate in the program via the Webcast.


****MOASC PROGRAM****
Practice Efficiencies: Ideas that work in assisting your survival in providing community oncology care
Presented by: Ricky Newton, CPA

Call: 866-212-0875
Enter pass code: 737194#
Press *3 to enter the Recording Playback menu

The system will prompt you for the file number: 62180#
The system will confirm the file number entered

The system will prompt you to enter the number of minutes you wish to skip from the beginning of the recording, followed by the # key.
If you do not wish to skip any minutes, press 0 followed by the # key, or stay on the line.

A confirmation message will be heard and the playback will begin.

The accompanying PowerPoint presentation is available for download at http://www.anco-online.org/MOASC_Newton.ppt.

If you have any questions, please contact the MOASC office.

Phone: (909) 985-9061
Fax: (909) 985-8581
P.O. Box 161
Upland, California 91785-0161
moasc@moasc.org


****PALMETTO/J1MAC NEWS****
2008 Web Safari for Medicare Part B Providers– November 18 and 21, 2008
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~2008%20Web%20Safari%20for%20Medicare%20Part%20B%20Providers–%20November%2018%20and%2021,%202008%20?opendocument

Are you new to Palmetto GBA? Do you want to navigate the Palmetto GBA Web
site like a pro? Plan to join Palmetto GBA for an informative Webinar to
learn more about the features our Web site has to offer and how to use the
site more effectively.


Temporary Procedures To Facilitate Remittance Status Change Requests from
J1 Part B Providers
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~General~Temporary%20Procedures%20To%20Facilitate%20Remittance%20Status%20Change%20Requests%20from%20J1%20Part%20B%20Providers?opendocument

As mandated by CMS Change Request 4376, Palmetto GBA stops the receipt of
hardcopy remits 45 days after providers are enrolled for electronic
remittances. Some J1 providers who were enrolled for electronic remits at
cutover are no longer receiving hardcopy remittances. This article provides
an explanation on this change and what you can do to switch from electronic
remit to hardcopy remits.

Wednesday, November 12, 2008

CMA & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMA NEWS****
The California Medical Association's (CMA) CMA Alert was published and is available online at http://www.calphys.org/html/news.asp. It features:

HHS Proposes Move to ICD-10 by 2011

Please Tell Us About Your Medicare Payment Problems

CMA Objects to FTC Interpretation of “Red Flag” Identity Theft Rules

Balance Billing Regs Apply to Care Provided on or After October 15

Subscribe to CMA’s Press Clips

Member Benefit of the Week: 6% off athenaCollector


****PALMETTO/J1MAC NEWS****
Claim Corrections and Appeals: Tips for Faster Service
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Appeals~Claim%20Corrections%20and%20Appeals:%20Tips%20for%20Faster%20Service?opendocument

Palmetto GBA processes “reopenings” (claim corrections) and redetermination
requests (first level appeals) for all Jurisdiction 1 providers, including
requests related to claims that were processed by the previous contractors.
We are committed to providing you with the best possible service for these
requests. To ensure that we are able to handle your requests for
reopenings and redeterminations correctly and efficiently, please include a
copy of your original remittance notice and any other written communication
from the previous contractor, such as an automated development request
(letter), with all written requests for reopenings and redeterminations.


Contacting Your New J1 A/B MAC
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~Contacting%20Your%20New%20J1%20AB%20MAC?opendocument

Since the J1 A/B MAC transition is complete, the J1 Transitional e-mail
address, J1MAC@PalmettoGBA.com, is no longer active.


E-mail Updates: Why You Can’t Afford to Miss Them
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~New%20to%20Medicare~E-mail%20Updates:%20Why%20You%20Can’t%20Afford%20to%20Miss%20Them?opendocument

Palmetto GBA sends e-mail updates to registered subscribers to share
time-sensitive information, changes in guidelines and processes, and
information on documentation and claim submission...sign up today! It is a
challenge for everyone to keep up with the latest news. Imagine how much
more efficiently you could manage your practice or facility, ensure your
compliance with federal rules and regulations, and have confidence in the
accuracy of your claims and your reimbursement from Medicare.


J1 Part B EDI Communications Tip
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~General~J1%20Part%20B%20EDI%20Communications%20Tip?opendocument

When communicating with Palmetto GBA, please indicate whether you are a
Northern California or Southern California J1 provider in all
communications. This will help us expedite research and your requests.


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.


November 18, 2008, 9am – 11am: Open Draft LCD Meeting Scheduled for
California
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~November%2018,%202008,%209am%20–%2011am:%20Open%20Draft%20LCD%20Meeting%20Scheduled%20for%20California?opendocument

Palmetto GBA J1 A/B MAC has scheduled an Open Draft LCD meeting in
California in order to allow for the submission of information related to
the proposed LCDs on November 18, 2008, from 9am – 11am. Click on the link
to view more details.


October 2008 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~October%202008%20J1%20AB%20MAC%20Medicare%20Advisory%20?opendocument

This is the first issue of the J1 A/B MAC Medicare Advisory. To ensure no
information is excluded, we have combined information from July, August and
September into the October Issue.


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.


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.


Physician Opt Out Lists
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Physician%20Opt%20Out%20Lists?opendocument

The Palmetto GBA Web site contains listings of health professionals who
have elected to opt out of the Medicare program for the following areas:
Northern California, Southern California, Hawaii and Nevada


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.


Remark Code MA130: Stop, Correct, and Resubmit
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Remark%20Code%20MA130:%20Stop,%20Correct,%20and%20Resubmit?opendocument

Services that are rejected by Palmetto GBA with remark code MA130 must be
corrected and resubmitted. MA130 indicates that the claim could not be
processed because it contained one or more billing errors. Services
rejected with remark code MA130 do not have appeal rights and cannot be
“reopened” to correct errors. MA130 is always accompanied by other, more
specific remark codes on your remittance notice. Review your remittance
notice carefully to ensure that you have identified all of the remark codes
before correcting and resubmitting the service.


Resolving Common NPI Problems
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~NPI~Resolving%20Common%20NPI%20Problems?opendocument

Palmetto GBA is rejecting claims that are submitted with valid NPIs that
cannot be matched to existing PTANs. The NPI/ PTAN combination may be
used to identify the Billing, Pay-to, or Rendering Provider (the Pay-to
Provider is identified only if it is different from the Billing Provider).
This applies to claims that are submitted by corporations formed by
physicians and non-physician practitioners and by physicians and
non-physician practitioners that submit claims directly to Palmetto GBA.
The purpose of this article is to identify common crosswalk issues we are
encountering and to provide guidance in how to resolve these problems.


Why is a Provider ID not linked to a J1 Submitter ID?
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~FAQs~EDI~Why%20is%20a%20Provider%20ID%20not%20linked%20to%20a%20J1%20Submitter%20ID?opendocument

This article outlines the steps needed to "relink" a J1 provider number to
a billing service or clearinghouses's Submitter ID.


“NPI Only” Claim Submission Problems: Minimizing Delays
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~NPI~“NPI%20Only”%20Claim%20Submission%20Problems:%20Minimizing%20Delays?opendocument

If you are experiencing problems submitting claims due to issues with your
NPI number, please be aware that Palmetto GBA will request additional
information from you to resolve some of these situations. The most common
reason for our requests for more information is the existence of multiple
locations (and multiple PTANs) when we do not have sufficient information
to match your NPI with your physical location. These requests may cause
delays in processing your claims.

Tuesday, November 11, 2008

ACCC & ASCO News

The following information has been received by ANCO.


****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week at ACCC was published and is available at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCCNEWSLETTER_11-10-2008.html. ANCO is an Institutional Member of ACCC. This edition features:

Conference Call on Final Medicare Rules: Join Us This Thursday

CMS Postpones RAC Program

Still Time to Apply for ACCC Cancer Care Navigation Project Pilot Site

Make Your Cancer Service Line More Competitive: ACCC's Hospital Summit

ACCC's Compendia-Based Drug Bulletin on Hold Until 2009

SWOG Joins EDRN in Furthering Prostate Cancer Research

Regional Symposium Coming to Philadelphia

Q&A on ACCC's Listserv: Radiation Therapy Center Competition

ACCC's CE Blackboard: New Multiple Myeloma Therapy Symposium

State Medical Oncology Societies Host Upcoming Meetings


****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) e-News was published and is available at http://view.exacttarget.com/?j=fe56157877620175761c&m=ff2d16787160&ls=fdf1127875610c7871157571&l=fe6715757767027d7412&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe27167176630374751077. ANCO is a state/regional affiliate of ASCO. This edition features:

Vote Now in the 2009 ASCO Election

October 2008 Issue of ASCO News & Forum Available Online

Letters of Intent for 2009 ACRAs in Breast Cancer and Glioma Due December 4

Application Deadline Approaching for 2009 ASCO State Affiliate Grants

Apply for the 2009 Susan G. Komen for the Cure®/ASCO Loan Repayment Program

Early Registration Deadline Approaching for 2009 GI Cancers Symposium

Submit an Abstract for the 2009 ASCO Annual Meeting

Abstracts from the 2008 Annual Meeting on Molecular Markers in Cancer Now Available

Virtual Meeting for the 2008 Annual Meeting on Molecular Markers in Cancer Now Available for Free

Slide Revision: 2008 Annual Meeting Plenary Session

Register and Reserve Housing for the 2009 GU Cancers Symposium

Apply for the 2009 IDEA Grant

Review ASCO State/Regional Affiliates Calendar of Events

Spotlight on State Affiliates: Medical Oncology Association of Southern California

Cancer Policy Alert: ASCO Issues Comments on ICD-10 Proposed Regulations; CMS Issues Instructions on the Compendia for Off-label Anti-cancer Drug Coverage; ASCO Reaches Out to Presidential Campaigns

Cancer.Net Podcasts: Mammography-What to Expect

For Your Patients: Dental Health During Cancer Treatment

What's New in JCO: Early Release Articles Published

Monday, November 10, 2008

CMS News

The following information has been received by ANCO.


****CMS NEWS****
Reminder - ICD-10-CM/PCS National Provider Conference Call for Other Part A and Part B Providers

Other Part A and Part B providers may now register for the Centers for Medicare & Medicaid Services ICD-10-CM/PCS National Provider Conference Call that will be conducted on November 12, 2008 from 12:30 p.m. – 2:30 p.m. EST. Registration will close at 12:30 p.m. EST on November 11, 2008 or when available space has been filled. To register for this call, go to http://www.cms.hhs.gov/icd10/Downloads/ICD10_otherproviders.pdf. To find additional information about this conference call and to access the ICD-10 Overview Presentation that will be discussed during the call, go to http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp.


September 18, 2008 Ask the Contractor Teleconference PowerPoint Presentation

On September 18, 2008, the Centers for Medicare & Medicaid Services (CMS) hosted an ‘Ask the Contractor’ teleconference for Medicare Part B Drug Competitive Acquisition Program (CAP) physicians to discuss the postponement of the CAP for 2009 and to assist participating CAP physicians in planning for the transition out of the program. This event was moderated by Noridian Administrative Services (NAS), the CAP Designated Carrier.

The PowerPoint slide presentation for this teleconference is available in the ‘Training and Events’ section on the NAS website at: https://www.noridianmedicare.com/cap_drug/train/act.html

Additional information about the CAP and the 2009 CAP Postponement is available on the following CMS website at: http://www.cms.hhs.gov/CompetitiveAcquisforBios/.


Medicare Part B Drug Competitive Acquisition Program (CAP): Feedback about the CAP – A Special Open Door Forum (ODF) Teleconference on the 2009 CAP Postponement and How to Submit E-mail Comments

The Centers for Medicare & Medicaid Services (CMS) is soliciting public feedback about the CAP. CMS is interested in hearing 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
§ procedural changes that may increase the program's flexibility and appeal to potential vendors and physicians.

On December 3, 2008, CMS will host a Special ODF Teleconference to obtain feedback about the program. This teleconference will be a listening session and is intended for current and former participating CAP physicians, potential Approved CAP Vendors, and any other interested parties. CMS will assess the information that it receives as it considers implementing changes to the CAP.

Call Details:

Date and Time: December 3, 2008 from 2:00-3:30PM EST
Toll Free Call Number: (800) 837-1935
Conference ID: 66307647

Interested parties can also submit comments to the CAP e-mailbox at MMA303DDrugBid@cms.hhs.gov

Thursday, November 6, 2008

NEW IMPORTANT CLINICAL ADVANCES IN THE MANAGEMENT OF CHEMOTHERAPY INDUCED NEUTROPENIA

Association of Northern California Oncologists

presents a talk for oncologists and oncology nurses entitled

NEW IMPORTANT CLINICAL ADVANCES IN THE MANAGEMENT OF
CHEMOTHERAPY INDUCED NEUTROPENIA
with
Gary Herbert Lyman, M.D., M.P.H.
Professor of Medicine
Duke University School of Medicine

Objectives

Discuss the potential clinical and economic consequences
associated with chemotherapy-induced neutropenia.

Assess the impact of first-cycle neutropenic events.

Review national guideline recommendations for febrile neutropenia (FN)
risk assessment and colony-stimulating factor (CSF) use.

This talk is scheduled for

6:30PM Reception & 7:00PM Dinner/Lecture
December 8th, 2008
Hyatt at Fisherman’s Wharf
555 North Point Street • San Francisco • (415) 563-1234

This meeting is supported by AMGEN. In adherence with PhRMA guidelines, this medical education program is for healthcare professionals only. Inclusion of a healthcare professional’s spouse or other guests is not appropriate.

For directions, please call the meeting locations. FAX your RSVP(s) to José Luis González, ANCO Executive Director, at (415) 472-3961 no later than December 4th.

Download the meeting announcement/registration form at http://www.anco-online.org/Lyman.pdf

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
2008 Physician Quality Reporting Initiative
National Provider Question & Answer Session

The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the eighth in a series of national provider conference calls that began in November of 2007 on the 2008 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 1:30 p.m. – 3:30 p.m., EST, on Thursday, November 20, 2008.

Following a short 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. Feel free to download the resources prior to the call so that you may ask questions of the presenters, Dr. Michael Rapp and Dr. Daniel Green.

Conference call details:

Date: November 20, 2008
Conference Title: 2008 Physician Quality Reporting Initiative National Provider Call
Time: 1:30-3:30 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. If you cannot attend the call, replay information is available below.

Registration will close at 1:30 p.m. EST on November 19, 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/112008

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 2:30 p.m. EST 11/20/2008 until 11:59 p.m. EST 11/27/2008. The call in data for the replay is (800) 642-1687 or (706) 645-9291 and the passcode is 69793299.

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


****PALMETTO/J1MAC NEWS****
Laboratory National Coverage Determination (NCD) Edit Software for October 2008
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~Lab~Laboratory%20National%20Coverage%20Determination%20(NCD)%20Edit%20Software%20for%20October%202008%20?opendocument

This article is based on Change Request (CR) 6213 which announces the
changes that will be included in the October 2008 release of the edit
module for clinical diagnostic Laboratory National Coverage Determinations
(NCDs). The last quarterly release of the edit module was issued in July
2008. CR 6213 incorporates all changes from July 2008 to the present and
has no other changes.

New 2008 Medicare Physician Fee Schedule (MPFS) Payment Rates Effective for
Dates of Service July 1, 2008, through December 31, 2008
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Publications~Fee%20Schedules~New%202008%20Medicare%20Physician%20Fee%20Schedule%20(MPFS)%20Payment%20Rates%20Effective%20for%20Dates%20of%20Service%20July%201,%202008,%20through%20December%2031,%202008%20?opendocument

CMS directed Palmetto GBA to revert back to the 0.5 percent payment rates
that were previously in place until June 30, 2008, and to use those rates
through December 31, 2008. Those same rates were to be used for January 1
through June 30, 2008, to make payments, where appropriate, to Ambulatory
Surgical Centers (ASCs) for services rendered from July 1 through December
31, 2008. This reflects a continuation of the payment policy for
brachytherapy services and priced amounts and the prospective rates for
other ASC services. CMS also provided revised fees for selected mental
health codes that had an increase in their fee schedule amounts. The
effective date for the increase for the mental health codes was for dates
of service on and after July 1, 2008.

NPI Crosswalk Issues
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~EDI~General~NPI%20Crosswalk%20Issues?opendocument

Palmetto GBA has prepared an informative article on the steps you should
take if you receive error message “Y1K- BILLING PROVIDER SSN OR EIN NOT ON
CROSSWALK” on your GPNet Response Report.

2008 Physician Quality Reporting Initiative National Provider Question &
Answer Session
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Current%20News~2008%20Physician%20Quality%20Reporting%20Initiative%20National%20Provider%20Question%20Answer%20Session?opendocument

The Centers for Medicare & Medicaid Services' (CMS) Provider Communications
Group will host the eighth in a series of national provider conference
calls that began in November of 2007 on the 2008 Physician Quality
Reporting Initiative (PQRI). This toll-free call will take place from 1:30
pm - 3:30 pm, EST, on Thursday, November 20, 2008.

Tuesday, November 4, 2008

ACCC News

The following information has been received by ANCO.


****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week at ACCC was published and is available at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCCNEWSLETTER_11-3-2008.html. ANCO is an Institutional Member of ACCC. This edition features:

Final 2009 Hospital Outpatient Department Rule Released, ASP+4

Final 2009 Changes to Physician Fee Schedule Released

ACCC Launches Cancer Care Navigation Project: Seeks Pilot Sites

Make Your Cancer Service Line More Competitive: ACCC's Hospital Summit

CMS Clarifies Guidance on Standing Orders, Protocols for Drugs in Hospitals

Media Coverage of Lung Cancer Increasing, and Increasingly Negative

Treanda Approved for Relapsed Indolent Non-Hodgkin’s Lymphoma

President's Cancer Panel Releases Recommendations

Regional Symposia Coming to Tampa and Philadelphia

Call for Nominations for ACCC's Board

Q&A on ACCC's Listser: Home Infusion and Staging Standard

ACCC's CE Blackboard

State Medical Oncology Societies Host Upcoming Meetings

Monday, November 3, 2008

PAYER & PATIENT PAYMENTS FOR ONCOLOGY SERVICES

Association of Northern California Oncologists

is pleased to sponsor two talks for oncologists, oncology nurses, and oncology practice managers entitled

PAYER & PATIENT PAYMENTS FOR ONCOLOGY SERVICES

AN ONCOLOGY PAYER CHECKLIST
Brad Duke
Practice Manager, East Bay Partners in Cancer Care

PATIENT COLLECTIONS AND NAVIGATING PATIENT ASSISTANCE PROGRAMS
Michelle Weiss
President, Weiss Oncology Consulting

In an era of reduced reimbursement for oncology goods and services, maximizing payer and patient collection are imperative to the survival of oncology practices. Duke will provide an oncology payer checklist that practices can use to review, (re)negotiate, and monitor compliance with private payer contracts. Weiss will review issues related to the sensitive area of patient collections. She will provide recommendations for step-by-step methods for identifying delinquent accounts early, analyzing delinquent accounts, and setting collection goals. In addition, she will review Patient Assistance Programs (PAPs) explaining the differences between PAPs and co-pay foundations, the various eligibility requirements, and the rules around patient discounts and write offs.

These talks are scheduled for:

December 2nd, 9AM-12PM
The Claremont Resort
Ashby & Domingo Avenues
Oakland
(510) 843-3000

December 3rd, 9AM-12PM
The Fairmont
170 South Market Street
San Jose
(408) 998-1900

These meetings are supported by Genentech BioOncology and Sanofi-Aventis Oncology.

Please call the meeting location of your choice for directions. FAX your reservation(s) to José Luis González, ANCO Executive Director, at (415) 472-3961 no later than November 26th, 2008. Registration/continental breakfast will be available at 8:30AM.

Download the meeting announcement/registration form at www.anco-online.org/PayerPatient.pdf.

ASCO, CMS, & Palmetto/J1MAC News

The following information has been received by ANCO.


****ASCO NEWS****
Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued its final Medicare physician fee schedule regulations for 2009.

The regulation announces that the Medicare physician conversion factor for 2009 will be $36.0666, which represents a decrease from the 2008 conversion factor ($38.0870). Congress took two actions in the Medicare Improvement for Patients and Providers Act (MIPPA) earlier this year which affected the conversion factor:

1) MIPPA provides for a 1.1% update (applied to the 2008 conversion factor) in 2009.
2) MIPPA requires that budget neutrality for the physician fee schedule be achieved through adjustments to the physician conversion factor, instead of negative adjustments across relative value units (RVUs) for individual services.

As a result of the last 5-Year Review of physician work, RVUs for certain codes increased. Mandated budget neutrality requirements provide that increased payments for some codes due to relative value changes must be offset by reductions in the values of other codes. Previously CMS achieved this offset by adjusting the RVUs. Now Congress has mandated that the adjustment be made to the conversion factor instead. While the 1.1% update was made and is reflected in the conversion factor, the impact of the budget neutrality adjustment is greater and therefore results in an overall reduction.

The final rule includes a number of provisions in other areas including imaging, e-prescribing, anti-markup, self-referral, and PQRI. We will be reviewing the entire regulation carefully and sending out a comprehensive summary of changes that will affect oncologists, and their estimated impact.

CMS also released the Medicare 2009 Hospital Outpatient Prospective Payment final rule yesterday. The rule finalizes CMS’ proposal to reduce drug payments in the outpatient department to ASP+4%. ASCO will also be reviewing and summarizing the hospital outpatient rules shortly.


****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) today announced a new initiative for physicians to trade in their prescription pads and improve efficiency and safety when ordering drugs for patients with Medicare. The initiative is included in the Medicare Physician Fee Schedule (MPFS) final rule for calendar year 2009. To view the Press Release, go to the web page at http://www.cms.hhs.gov/apps/media/press_releases.asp.

A copy of the final rule (CMS-1403-FC) is available at http://www.cms.hhs.gov/PhysicianFeeSched/PFSFRN/itemdetail.asp?filterType=none&filterByDID=0&sortByDID=4&sortOrder=descending&itemID=CMS1216674&intNumPerPage=10


MM6212 – New 2008 Medicare Physician Fee Schedule (MPFS) Payment Rates Effective for Dates of Service July 1, 2008, through December 31, 2008
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6212.pdf


MM6213 - Laboratory National Coverage Determination (NCD) Edit Software for October 2008
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6213.pdf


Release of the 2009 HCPCS Annual Update
The Centers for Medicare and Medicaid Services is pleased to announce the scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set. These changes have been posted to the HCPCS website at http://www.cms.hhs.gov/HCPCSReleaseCodeSets/ANHCPCS/
All changes are effective January 1, 2009, unless otherwise indicated in the effective date column.


ICD-10-CM/PCS National Provider Conference Call for Physicians
Physicians may now register for the Centers for Medicare & Medicaid Services (CMS) ICD-10-CM/PCS National Provider Conference Call that will be conducted on November 17, 2008 from 12:30 p.m. – 2:30 p.m. EST. To register for this call, go to http://www2.eventsvc.com/palmettogba/111708. To find additional information about this conference call and to access the ICD-10 Overview Presentation that will be discussed during the call, go to http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp.


****PALMETTO/J1MAC NEWS****
November 2008 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~November%202008%20J1%20AB%20MAC%20Medicare%20Advisory?opendocument

The November 2008 J1 A/B MAC Medicare Advisory is now available to be
viewed on the Palmetto GBA Web site. Click on the link to view this
advisory.


The Presentation is Now Available for the Part B November 3 and 12 Web
Safari
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~The%20Presentation%20is%20Now%20Available%20for%20the%20Part%20B%20November%203%20and%2012%20Web%20Safari?opendocument

Click the link to locate the presentation for the J1 Part B Web Safari on
November 3 and 12.