Friday, May 30, 2008

Palmetto/J1MAC Website Update

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


PTT-2008-5-20-PartB.pdf
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/PTT-2008-5-20-PartB.pdf?opendocument

Palmetto GBA has posted the minutes from the Part B 5-20-08 Palmetto GBA
Transition Teleconference (PTT).

Applies to:
Part B Transition: General

Thursday, May 29, 2008

ASCO's Cancer Policy Today Published

The American Society of Clinical Oncology (ASCO) Cancer Policy Today was published. It may be viewed online at http://view.exacttarget.com/?j=fe5d15757362067b7215&m=ff311d707460&ls=fe0112707160057f72157377&l=fea516737564057975&s=fe1f15797d620479731d75&ju=fe1f157872630c78731674.

It features:

President Bush Signs the Genetic Information Nondiscrimination Act

FY 2009 Budget Update

NIH Enhances Peer Review Effort

Participate in the Physician Practice Information Survey

Wednesday, May 28, 2008

Palmetto/J1MAC Website Updates

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


New PTT Participant Numbers
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/New%20PTT%20Participant%20Numbers?opendocument

The participant dial in numbers and passcode have changed for both the Part
A and Part B Palmetto GBA Transition Teleconferences (PTT). This change is
effective Tuesday, June 3, 2008. Please remember to register to attend the
conferences. You can register by visiting our Web site and clicking on the
teleconference event under the Events section at www.PalmettoGBA.com/J1.

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

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Updated Electronic Funds Transfer (EFT) Information and FAQs
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Updated%20Electronic%20Funds%20Transfer%20(EFT)%20Information%20and%20FAQs?opendocument

Find out the latest EFT FAQs added to the J1 Web site and other helpful
information.

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

----------

ASCO E-News Published

The American Society of Clinical Oncology's (ASCO) e-News was published today and is available at http://view.exacttarget.com/?j=fe5e15757360077d7213&m=ff2d16787160&ls=fdf712727161057b721c7074&l=fe581574736d017a7513&s=fdf2157972640d79751d7073&ju=fe1f15787261037d7d1375.

It features:

Now Available: 2008 ASCO Annual Meeting Abstracts

ASCO Annual Meeting Program Online Now Available

Annual Meeting Virtual Meeting and Podcast Access Available for Purchase by Non-Attendees

The ASCO Cancer Foundation Awards $7.6 Million to Further Progress Against Cancer

ASCO Presents 2008 Gianni Bonadonna Award

Submit an Abstract for the ASCO-NCI-EORTC Annual Meeting on Molecular Markers in Cancer

Presentations from 2008 Genitourinary Cancers Symposium Now Available at No Cost

Attend 2008 UICC World Cancer Congress

Cancer Policy Alert: Senate HELP Committee Examines Cancer Challenges and Opportunities, House Passes Genetic Information Nondiscrimination Act, FDA Changes Acceptance Criteria for Foreign Clinical Trials

Submit Artwork for the 2009 "Expressions of Hope" Calendar

For Your Patients: News for Patients From the Upcoming 2008 ASCO Annual Meeting

JCO Early Release Articles Examine Rituximab with Autograft for High-risk Follicular and Diffuse Large B-cell Lymphoma; Significance of Nottingham Histologic Grade in Invasive Breast Carcinoma; Dual-agent Molecular Targeting of the ErbB2 Receptor; Lapatinib and Trastuzumab for Advanced ErbB2-positive Breast Cancer; Induction Therapy for Poor-prognosis Anal Canal Carcinoma

Future JCO Table of Contents

THIS WEEK AT ACCC: MAY 27-30, 2008

Dear ANCO Online ListServ Subscriber:

The following information is provided by the Association of Community Cancer Centers (ACCC) and is available at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCC_may27_08.html. ANCO is a member of ACCC.

This weeks features include:

ACCC Supports Coverage of Clinical Trials Bill

Oncology Practices: Survey on Off-Label Use to Arrive Soon

Innovative Prostate Cancer Programs: Do You Have One?

ACCC to Launch New Survey: "Benchmarking Trends in Cancer Care"

Heard on the ACCC Listserv: Genetic Counseling

ACCC's CE Blackboard: Colorectal Cancer Program, Other Offerings

FDA Approves Bayer's Reintroduction of Liquid Leukine

Oncology Drug Spending by Health Plans May Rise 50 Percent by 2010

ACCC Launches New Online Services and Database

State Medical Oncology Societies Host Upcoming Meetings

Tuesday, May 27, 2008

CMS/Medicare: 2008 Physician Quality Reporting Initiative (PQRI)--New Educational Product is Available

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce a new educational resource has been posted to the PQRI web page on the CMS website. The print version will be available shortly.

2008 PQRI Fact Sheet: Alternative Reporting Periods and Alternative Criteria for Satisfactorily Reporting for 2008: Measures Groups and Registry-Based Reporting- This Fact Sheet provides an overview of the changes to the 2008 Physician Quality Reporting Initiative Reporting options, such as, alternative reporting periods, and alternative criteria for satisfactorily reporting for 2008 measures groups, and registry-based reporting.

To access this new and all available educational resources, visit http://www.cms.hhs.gov/PQRI on the CMS website and click on the Educational Resources tab. Once on the Educational Resources page, scroll down to the “Downloads” section and click on the “2008 PQRI Reporting Fact Sheet” link.

CMS/Medicare Website Updates

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

MM5288 – Incident to Policy Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5288.pdf

MM5699 – Reporting of Hematocrit or Hemoglobin Levels on All Claims for the Administration of Erythropoiesis Stimulating Agents (ESAs), Implementation of New Modifiers for Non-ESRD ESA Indications, and Reporting of Hematocrit or Hemoglobin Levels on all Non-ESRD, Non-ESA Claims Requesting Payment for Anti-Anemia Drugs
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5699.pdf

NHIC/Medicare Website Updates

The following updates have been posted to the NHIC/Medicare website and are available at http://www.medicarenhic.com/cal_prov/updates.shtml

The June 2008 issue of the Medicare B Resource newsletter is now available.

The Interactive Voice Recognition (IVR) Instructions and Flow Chart have been updated.

The quarterly update to the ASC drug pricing files have been posted.

A new educational article is now available: DMEPOS Competitive Bidding News.

UCSF Reception at ASCO, Sunday, June 1

You and a guest(s) are invited to a reception during ASCO,
hosted by Margaret Tempero and Eric Small on behalf of the
UCSF Helen Diller Family Comprehensive Cancer Center

Please RSVP at:
http://cancer.ucsf.edu/asco2008

Sunday, June 1
5:00 – 7:00 PM

The Hilton Chicago, Waldorf Room (3rd fl)


The Hilton Chicago is on ASCO shuttle route 11, gate 26 - north bldg., level 1 lobby.

RSVPs can also be directed to Victoria Karno, vkarno@medicine.ucsf.edu or (415)885-3846.

Invitation to Financial Management of Your Oncology Practice Webcast- June 5, 2008

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

Financial Management of Your Oncology Practice
presented by Ricky Newton, CPA
Thursday, June 5, 2008
at 2:00 P.M. GMT-05 Central Daylight Savings Time (US/Canada)

Whether you’re a physician or practice administrator, managing the financial aspect of an oncology practice is becoming increasingly challenging due to the escalating costs and the ever changing reimbursement rules. Discovering effective ways to lower disbursements and improve the overall financial performance is necessary in order to focus on delivering the best health care to patients.

Join presenter Ricky Newton, CPA, as he highlights tools to improve the financial management of an oncology practice. During this webcast he will address changes practices can make to improve the bottom line, including drug purchasing, missed drug billings and maximizing contracts. He will also review regimens and the impact of the Medicare reimbursement on these regimens, he will also discuss other areas within the practice that may help you improve efficiencies.

To register, please visit
https://compx08.eventcenterlive.com/cfmx/ec/register/reg.cfm?BID=1&RegID=532974EF

Friday, May 23, 2008

CMS/Medicare: Medicare Remit Easy Print (MREP) Software Version 2.4 is Available!

Version 2.4 of the MREP software is available for download at http://www.cms.hhs.gov/AccesstoDataApplication/02_MedicareRemitEasyPrint.asp on the CMS website. For a description of the minor changes in this version, see the “What’s New” section of the MREP User Guide – Version 2.4 at http://www.cms.hhs.gov/AccesstoDataApplication/Downloads/EasyPrintUserGuide.pdf.

Note: The latest Codes.ini file is now available. This file is necessary when the MREP software is distributed.

CMS/Medicare: The Medicare Remit Easy Print Brochure

The Medicare Remit Easy Print brochure has been updated and is now available to order print copies or to download as a PDF file. This brochure provides an overview of free software that enables physicians and suppliers to view and print remittance information. To view the PDF file, go to http://www.cms.hhs.gov/MLNProducts/downloads/MedicareRemit_0408.pdf. Print copies may be ordered by visiting the MLN Product Ordering Page at http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident=kc0001&loc=5on the CMS Website.

NHIC/Medicare: NPI News for Medicare FFS Providers: It's May 22nd - Are you Ready?

The NPI is here. The NPI is now. Are you using it?
NPI News for Medicare FFS Providers

It's May 22nd - Are you Ready?
As of May 23, Medicare FFS will require and send NPI-Only in ALL provider identifier fields for all HIPAA and paper transactions where a provider identifier is required. If you send Medicare a transaction with a Medicare legacy identifier in any of the provider fields, your claim will be rejected. These transactions include all electronic and paper claims (837I, 837P, NCPDP, DDE and paper CMS-1500 and UB-04), the 276/277 claims status transaction, the 270/271 eligibility transaction, 835 remittance advice and SPR paper remittance.

NPIs for Secondary Providers
If the entity that is required to be identified in the secondary provider field (i.e., the ordering/referring/attending/operating/supervising/purchased service/other/service facility provider or prescriber) does not furnish an NPI, the billing provider must attempt to obtain that NPI in order to enter it on the claim. The billing provider may use the NPI Registry (https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do) to obtain the secondary provider's NPI or it may need to directly contact the ordering/referring/attending/operating/supervising/purchased service/other/service facility or prescriber in order to obtain the NPI.

If the billing provider has exhausted all possibilities of finding the NPI of the ordering/referring/attending/operating/supervising/purchased service/other or prescriber, Medicare FFS is permitting the billing provider (in the X12N 837 transactions) or the service provider (in the NCPDP 5.1 transaction) to use their own NPI as the identifier for those secondary providers. Medicare will reject claims if Medicare policy requires a secondary identifier and there is no NPI present.
For service facility location loop, if the billing provider is still unable to obtain the NPI of the entity, no identifier should be reported in that loop.
Transcript for April 17th NPI Roundtable Now Available
View the transcript on the CMS website.


Need More Information?
Still not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found through the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand on the CMS website. 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.

Thursday, May 22, 2008

Overview of US Oncology Physician Services

ANCO Members are invited to join us for an informational webcast

Overview of US Oncology Physician Services
Featuring the Role of the Pharmacist

Tuesday, June 24, 2008 at 12:00 PM PST

To register for this free event please visit http://www.opspharmacist.com/anco

Due to the recent shifting reimbursement rules and ESA issues, community-based oncology practices are facing more challenges than ever before. With decreasing revenue levels, practices struggle to maintain viable business and therefore, it is vital that they leverage resources that offer support from both a clinical and business perspective.

Join presenter Sean Taylor to learn about the services offered by US Oncology for the independent oncology practice. This presentation will feature a discussion of how an oncology-trained pharmacist works with practice staff to provide solutions for overall process improvement that include:

Regimen Analysis
Charge Capture/ Inventory Roll Forward
Admixture Services
Billing & Coding Education/Support
Cash flow management

For more information, please contact us 866-216-5053 or email ops@usoncology.com.

CMS/Medicare: 2008 Physician Quality Reporting Initiative (PQRI) ~ National Provider Call to held on May 28th

The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the third 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 Wednesday, May 28, 2008.

This call will provide an overview of the alternative reporting periods and alternative criteria for satisfactorily reporting quality measures for the 2008 PQRI as authorized by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) (P.L. 110-173) which was enacted on December 29, 2007.

MMSEA requires that for 2008 and 2009 the Secretary establish alternative reporting periods and alternative criteria for satisfactorily reporting groups of measures. It also requires that for 2008 and 2009 the Secretary establish alternative reporting periods and alternative criteria for satisfactorily reporting quality measures data through registries.

In 2008, eligible professionals may earn an incentive payment of 1.5 percent of their total allowed charges for Physician Fee Service covered professional services furnished during the respective alternative reporting periods based on data submitted via these mechanisms. While TRHCA established a cap on incentive payments for 2007, based on an average per measure payment amount, there is no cap on incentive payments under MMSEA for 2008 and 2009.

These provisions provide increased opportunities for eligible professionals to report PQRI quality measures and the possibility to earn incentive payments for satisfactory reporting.

A PowerPoint slide presentation will be posted to the PQRI webpage at http://www.cms.hhs.gov/PQRI/30_EducationalResources.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, Dr. Daniel Green and Rachel Nelson.

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

Conference call details:

Date: May 28, 2008
Conference Title: 2008 Physician Quality Reporting Initiative National Provider Call
Time: 3:30 p.m. -5:00 p.m. 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 May 27, 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/052808

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 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 5/28/2008 until 11:59 p.m. EDT 6/5/2008. The call-in data for the replay is (800) 642-1687 and the passcode is 46870023.

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

Wednesday, May 21, 2008

CMS/Medicare Coverage of CTC for Colorectal Cancer

CMS/Medicare has posted a new tracking sheet for the coverage of screening Computed Tomography Colonlgraphy (CTC) for Colorectal Cancer at https://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=220

Tuesday, May 20, 2008

Stanford Head & Neck Clinical Trials

The Head & Neck Oncology Program of the Stanford Cancer Center seeks patients for three new clinical trials:

• Lapatinib plus radiation is for potentially curable previously untreated patients with advanced non-metastatic head and neck squamous cell cancer (HNSCC) who are not candidates for standard cisplatin-based chemoradiation.

• BIBW2992 is an orally available inhibitor of EGFR. This trial is for patients with recurrent or metastatic HNSCC.

• XL880 is an orally available inhibitor of both MET and VEGF that has been shown to have anti-cancer activity in several tumor types.

Details and contact information for these trials is available at http://cancer.stanford.edu/trials/adult/
Head_and_Neck_Cancer
.

Palmetto/J1MAC Website Updates

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


Electronic Funds Transfer (EFT) Web-based Training at 3:00 EST on May 21,
2008
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Electronic%20Funds%20Transfer%20(EFT)%20Web-based%20Training%20at%203%3A00%20EST%20on%20May%2021%2C%202008?opendocument

Find out how to register for and attend the EFT Web-based training on May
21, 2008 at 3:00 p.m. EST.

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

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Palmetto GBA Announces Transition Workshops!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Palmetto%20GBA%20Announces%20Transition%20Workshops!?opendocument

Palmetto GBA will be conducting workshops throughout the J1 region and will
be available to answer your questions concerning the transition. You will
have an opportunity to hear directly from your Medicare Administrative
Contractor (MAC) regarding such topics as transition dates, what is needed
to continue to bill electronically, how the Local Coverage Determination
process will work, address any differences in claims processing guidelines
and much more. Additional information, as well as the capability to
register for the workshops, will be provided as we near the dates of the
workshops.

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

----------


Part B - A/B MAC J1- PTT Call - May 20, 2008 at 3:30 p.m. EST
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B%20-%20AB%20MAC%20J1-%20PTT%20Call%20-%20May%2020%2C%202008%20at%203%3A30%20p.m.%20EST?opendocument

Throughout the Jurisdiction 1 (J1) implementation, Palmetto GBA will host a
series of Medicare Part B transition teleconference calls for Part B
providers in Hawaii, Nevada, California, Guam, American Samoa and the
Northern Mariana Islands. These one-hour sessions will provide you with the
most recent transition information and will address the questions you have
about the implementation. This is your opportunity to speak with the J1 A/B
MAC and to discuss the implementation topic of your choice. The
teleconferences are similar to the “Ask-the-Contractor Teleconferences”
(ACT) offered by the Medicare fee-for-service contractors but will be
focused on J1 transition issues.

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

----------


Provider Resource Checklist and Implementation Timeline
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Provider%20Resource%20Checklist%20and%20Implementation%20Timeline?opendocument

Palmetto GBA has posted a Provider Resource Checklist and an Implementation
Timeline in order to provide important implementation resource links and to
communicate critical implementation activities and dates. The Timeline
will be updated as new implementation activities, dates and information
becomes available.

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

----------

DHS/MediCal NPI Update

Beginning May 24, 2008, Medi-Cal and the Child Health and Disability Prevention (CHDP) program will no longer accept claims billed with a Medi-Cal legacy provider number. Providers who have registered their National Provider Identifiers (NPIs) but have not submitted claims using their NPI are strongly encouraged to start submitting NPI claims now to avoid interruption in claim payments. Providers who have not already registered their NPI with Medi-Cal may have their claims rejected.

Medi-Cal previously announced that providers would no longer need to use both sets of identifiers on claims because the Department of Health Care Services (DHCS) was able to accept an NPI only, effective December 17, 2007. Providers who were not ready to transition to the NPI were informed they could continue to submit their Medi-Cal provider number until instructed otherwise.

In February 2008, providers were reminded that once a claim was submitted with an NPI, the associated Medi-Cal “legacy” provider number(s) would be end-dated. In other words, effective for dates of service beyond the date of a claim submitted with an NPI, the Medi-Cal provider number would no longer be valid. Using the associated Medi-Cal provider number(s) following a claim submission with an NPI results in claim denials for subsequent dates of service.

DHCS plans to deactivate all Medi-Cal and CHDP legacy provider numbers as early as May 23, 2008. The only exception is atypical providers: Multipurpose Senior Services Program (MSSP), Christian Science Practitioners and blood banks. These providers may continue to use only their nine-digit Medi-Cal provider numbers.

This information is available on the Medi-Cal web site in the following link: http://files.medi-cal.ca.gov/pubsdoco/npi/articles/npi_9364.asp

Should you have any questions or need additional information, please call the Telephone Service Center (TSC) at 1-800-541-5555 or visit the NPI page on the Medi-Cal Web site.

THIS WEEK AT ACCC, MAY 19-23, 2008

The Association of Community Cancer Center's (ACCC) This Week at ACCC was published today and can be viewed at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCC_may19_08.html. ANCO is a member of ACCC.

It features:

ACCC Launches New Online Services and Database

ACCC Signs on to ONS Letter, Urges Support for "Nurse Reinvestment Act"

Call for ACCC Annual Awards Nominations

Innovative Prostate Cancer Programs: Do You Have One?

ACCC to Launch New Survey: "Benchmarking Trends in Cancer Care"

Heard on the ACCC Listserv: Chemotherapy Mixing Policy and More

ACCC's CE Blackboard: Register for Multiple Myeloma Webcast, Other Offerings

Last-Minute Glitch Hampers Final NPI Implementation

State Medical Oncology Societies Host Upcoming Meetings

Transplanting Procurement Best Practices into Community Oncology

The Association of Northern California Oncologists is pleased to host two talks for oncology practices entitled

TRANSPLANTING PROCUREMENT BEST PRACTICES INTO COMMUNITY ONCOLOGY
with
Kyle Gilman, Esq., President & CEO, Forgefinder
&
Ben Favret, Co-Founder & Vice President, OneOncology

The speakers will provide concepts, examples, and tools with which to optimize procurement economies, effectiveness, and efficiencies. The speakers have worked to move several industries into more efficient and effective procurement methods that make transactions happen with far better financial results and better service for both buyers and sellers.

Kyle Gilman, Esq., is a leading expert on best practices, strategies, and technologies in procurement. Ben Favret, Co-Founder of OneOncology, is implementing digital marketplace technologies in the drug procurement marketplace.

Support for these meetings is provided by OneOncology.

These talks are scheduled for:

Tuesday, June 10, 2008, 9AM-12PM
Hyatt Regency
1209 L Street
Sacramento
(916) 443-1234

Wednesday, June 11, 2008, 9AM-12PM
San José Fairmont
170 South Market Street
San José
(408) 998-1900

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 June 6th. Registration will be available one-half hour prior to the program.

A copy of the meeting announcement and registration form is available at http://www.anco-online.org/procurement.html

Monday, May 19, 2008

Palmetto/J1MAC Website Updates

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



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

Palmetto GBA has posted the Billing Vendor Directory for Jurisdiction 1 A/B
Medicare Administrative Contractor (J1 A/B MAC). This list provides contact
information for software vendors with approved ANSI X12N 837 Health Care
Claim version 4010A1 Medicare EMC capabilities to submit claims to the J1
A/B MAC.

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

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Palmetto GBA Announces Transition Workshops!
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Palmetto%20GBA%20Announces%20Transition%20Workshops!?opendocument

Palmetto GBA will be conducting workshops throughout the J1 region and will
be available to answer your questions concerning the transition. You will
have an opportunity to hear directly from your Medicare Administrative
Contractor (MAC) regarding such topics as transition dates, what is needed
to continue to bill electronically, how the Local Coverage Determination
process will work, address any differences in claims processing guidelines
and much more. Additional information, as well as the capability to
register for the workshops, will be provided as we near the dates of the
workshops.

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

----------


Providers Affected by the Jurisdiction 1 (J1) Implementation
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Providers%20Affected%20by%20the%20Jurisdiction%201%20(J1)%20Implementation?opendocument

There has been some confusion regarding the providers that are affected by
the Jurisdiction 1 (J1) implementation. Palmetto GBA has been selected by
the Centers for Medicare and Medicaid Services (CMS) to serve as the new
A/B Medicare Administrative Contractor (A/B MAC) for Jurisdiction 1 (J1),
which includes the states of California, Hawaii and Nevada, the territories
of American Samoa and Guam, and the Northern Mariana Islands.

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

----------

NHIC/Medicare Website Updates

The following updates have been posted to the NHIC/Medicare website at http://www.medicarenhic.com/cal_prov/updates.shtml.

The website navigation guide has been updated: Web Navigation Interactive Guide (PDF version Web Navigation PDF Guide).

The Introduction to Medicare Billing Guide has been updated.

On June 25, 2008 there will be an Ask the Contractor Teleconference (ACT) on the topic of DMEPOS Competitive Bidding Program.

Thursday, May 15, 2008

ASCO's Cancer Policy Today Published

The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published.

View it at http://view.exacttarget.com/?j=fe6315757167077e7612&m=ff311d707460&ls=fe0112707160057f72157377&l=fea516737564057975&s=fe1f15797d620479731d75&ju=fe1d157870660d747c1370.

It features:

Senate HELP Committee Holds Hearing on Cancer Challenges and Opportunities

Sen. Brown Introduces Access to Cancer Clinical Trials Act

Senate Appropriations Committee To Include Increases to NIH and FDA in Supplemental Funding Bill

House Passes Genetic Information Nondiscrimination Act

FDA Plans To Add 1,300 Employees in Next Six Months

ASCO Provides Feedback on Biosimilars to House Subcommittee on Health

FDA Changes Acceptance Criteria for Foreign Clinical Trails

Scientists Form International Cancer Genome Consortium

Participate in the Physician Practice Information Survey

CMS/Medicare: National Provider Identifier (NPI) News for Medicare FFS Providers: May 23rd is Days Away - Are you Prepared?

May 23rd is Days Away – Are you Prepared?
As of May 23, Medicare FFS will require and send NPI-Only in ALL provider identifier fields for all HIPAA and paper transactions where a provider identifier is required. If you send Medicare a transaction with a Medicare legacy identifier in any of the provider fields, your claim will be rejected. These transactions include all electronic and paper claims (837I, 837P, NCPDP, DDE and paper CMS-1500 and UB-04), the 276/277 claims status transaction, the 270/271 eligibility transaction, 835 remittance advice and SPR paper remittance.

If your billing software is set up to continue to send both the NPI and the legacy identifier, and your clearinghouse or billing service will not be stripping the legacy identifier from your claim as of May 23rd, the responsibility falls to the provider to send in the Medicare claim with NPI-only, i.e., NO legacy identifiers.

NPIs for Secondary Providers
If the entity that is required to be identified in the secondary provider field (i.e., the ordering/referring/attending/operating/supervising/purchased service/other/service facility provider or prescriber) does notfurnish an NPI, the billing provider must attempt to obtain that NPI in order to enter it on the claim. The billing provider may use the NPI Registry (https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do) to obtain the secondary provider’s NPI or it may need to directly contact the ordering/referring/attending/operating/supervising/purchased service/other/service facility or prescriber in order to obtain the NPI.

· If the billing provider has exhausted all possibilities of finding the NPI of the ordering/referring/attending/operating/supervising/purchased service/other or prescriber, Medicare FFS is permitting the billing provider (in the X12N 837 transactions) or the service provider (in the NCPDP 5.1 transaction) to use their own NPI as the identifier for those secondary providers. Medicare will reject claims if Medicare policy requires a secondary identifier and there is no NPI present.

· For service facility location loop, if the billing provider is still unable to obtain the NPI of the entity, no identifier should be reported in that loop.

New FAQ Available Regarding Use of an NPI in the Prescriber ID field on NCPDP Transactions
View this FAQ at http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=9100&p_created=1208980030&p_sid=kyH43F3j&p_accessibility=0&p_lva=&p_sp=cF9zcmNoPTEmcF9zb3J0X2J5PSZwX2dyaWRzb3J0PSZwX3Jvd19jbnQ9MSZwX3Byb2RzPTAmcF9jYXRzPSZwX3B2PSZwX2N2PSZwX3NlYXJjaF90eXBlPWFuc3dlcnMuc2VhcmNoX25sJnBfcGFnZT0xJnBfc2VhcmNoX3RleHQ9OTEwMA**&p_li=&p_topview=1 on the CMS website.

Transcript for April 17th NPI Roundtable Now Available
View the transcript at http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/Transcript_for_April_17th_NPI_Roundtable.pdf on the CMS website.

CMS will Host NPI National Roundtable Q&A Session on May 19, 2008
CMS will host a national NPI Roundtable Q&A session to address questions from the Medicare provider community prior to May 23rd. This Roundtable will be on May 19th from 2-3:30PM EDT. Questions will not be collected during the registration process for this call. There will be no presentations during this call; we will open the lines to take questions following a brief introduction. For registration details, visit http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/listserv_wording_5-19-08_call.pdf on the CMS website.


Need More Information?
Still not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found through the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand on the CMS website. 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: 2008 Physician Quality Reporting Initiative (PQRI) ~ National Provider Call Announcement

The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the third 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 Wednesday, May 28, 2008.

This call will provide an overview of the alternative reporting periods and alternative criteria for satisfactorily reporting quality measures for the 2008 PQRI as authorized by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) (P.L. 110-173) which was enacted on December 29, 2007.

MMSEA requires that for 2008 and 2009 the Secretary establish alternative reporting periods and alternative criteria for satisfactorily reporting groups of measures. It also requires that for 2008 and 2009 the Secretary establish alternative reporting periods and alternative criteria for satisfactorily reporting quality measures data through registries.

In 2008, eligible professionals may earn an incentive payment of 1.5 percent of their total allowed charges for Physician Fee Service covered professional services furnished during the respective alternative reporting periods based on data submitted via these mechanisms. While TRHCA established a cap on incentive payments for 2007, based on an average per measure payment amount, there is no cap on incentive payments under MMSEA for 2008 and 2009.

These provisions provide increased opportunities for eligible professionals to report PQRI quality measures and the possibility to earn incentive payments for satisfactory reporting.

A PowerPoint slide presentation will be posted to the PQRI webpage at http://www.cms.hhs.gov/PQRI/30_EducationalResources.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, Dr. Daniel Green and Rachel Nelson.

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

Conference call details:

Date: May 28, 2008
Conference Title: 2008 Physician Quality Reporting Initiative National Provider Call
Time: 3:30 p.m. -5:00 p.m. 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 May 27, 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/052808

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 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 5/28/2008 until 11:59 p.m. EDT 6/5/2008. The call-in data for the replay is (800) 642-1687 and the passcode is 46870023.

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

Palmetto/J1MAC Website Updates

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

Electronic Data Interchange (EDI) Webinars
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Electronic%20Data%20Interchange%20(EDI)%20Webinars?opendocument

The Electronic Data Interchange (EDI) Webinar scheduled for Thursday, May
15th, is almost at capacity. The next EDI Webinar will be held on May 19,
2008 at 4:00 PM EST. Please register to attend.

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

----------


Submit Your CMS 588 Form Early
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Submit%20Your%20CMS%20588%20Form%20Early?opendocument

Upon receipt of your CMS 588 form, our process validates your information
to that supplied by your outgoing Medicare contractor. Should any fields be
completed incorrectly or the submitted information differ from that of your
outgoing contractor, your CMS 588 form will be returned for corrections.
Due to the volume of CMS 588 forms we are receiving, submitting your form
early will ensure that your information is validated quickly. Should you
require any corrections that we have identified during our validation
process, this will also allow you time to make those corrections and return
to us by the deadline. This will ensure that you have no disruption to your
payments after conversion to Palmetto GBA.


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

----------

CMS/Medicare Website Updates

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


MM5288 – Incident to Policy Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5288.pdf

MM5950 – Medicare Shared Systems Modifications Necessary to Capture and Crossover Medicaid Drug Rebate Data Submitted on Form UB 04 Paper Claims and Direct Data Entry (DDE) Claims
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5950.pdf


MM6009 – July Quarterly Update to 2008 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6009.pdf

An Invitation to ANCO Members Attending ASCO

Dr. Margaret Tempero and Dr. Eric Small
Invite ANCO and MOASC Members Attending the ASCO Annual Meeting
to a Cocktail Reception Sponsored by the
UCSF Helen Diller Family Comprehensive Cancer Center

Sunday, June 1
5 – 7 PM
The Hilton Chicago
Waldorf Room, 3rd Floor

Shuttle Route 11, Gate 26 - North Bldg., Level 1 Lobby

Please RSVP online:

http://cancer.ucsf.edu/asco2008

We hope to see you there.

Wednesday, May 14, 2008

Stanford's 2nd Annual GI Cancers Conference

Stanford's 2nd Annual GI Cancers Conference takes place August 22-24, 2008 in Hawaii. Visit http://www.stanfordhospital.com/PDF/cme/GICancers08CME_r8aFnl.pdf for more information and to register.

Palmetto/J1MAC Website Updates

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


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

Palmetto GBA has posted the Billing Vendor Directory for Jurisdiction 1 A/B
Medicare Administrative Contractor (J1 A/B MAC). This list provides contact
information for software vendors with approved ANSI X12N 837 Health Care
Claim version 4010A1 Medicare EMC capabilities to submit claims to the J1
A/B MAC.

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

----------


Electronic Funds Transfer (EFT) Web-Based Training
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Electronic%20Funds%20Transfer%20(EFT)%20Web-Based%20Training%20?opendocument

The first J1 A/B MAC Electronic Data Interchange (EDI) Web-based
training session is scheduled for May 15, 2008 at 2:00 p.m. EST /11:00 a.m.
PST. The presentation materials are now available to view and/or download.

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

----------

NHIC/Medicare: ESACoverage_0108.pdf

NHIC/Medicare has asked ANCO to recirculate ESA claims instructions for reporting hemoglobin levels. These instructions are available at http://www.medicarenhic.com/providers/articles/esacoverage_0108.pdf.

ASCO e-News Published

The American Society of Clinical Oncology's (ASCO) e-News was published today and is available at http://view.exacttarget.com/?j=fe5a1575766d037f7217&m=ff2d16787160&ls=fdf812717c6d057f76107071&l=fe57157473610d7b7612&s=fdf2157972640d79751d7073&ju=fe1a1578716d047a721c79.

It features:

The ASCO Cancer Foundation Awards $7.6 Million to Further Progress Against Cancer

Dr. Jay Harris to Receive 2008 Gianni Bonadonna Award

Annual Meeting Virtual Meeting and Podcast Access Available for Purchase by Non-Attendees

ASCO Annual Meeting Program Online Now Available

Register and Reserve Housing for 2008 Breast Cancer Symposium

Apply Online for 2008 Anticancer Agent Development Workshop

Submit an Abstract for the ASCO-NCI-EORTC Annual Meeting on Molecular Markers in Cancer

ASCO Seeks Editor for Journal of Oncology Practice

Attend State/Regional Affiliate Meetings

Attend 2008 UICC World Cancer Congress

Cancer Policy Alert: Senate Passes the Genetic Information Nondiscrimination Act; ASCO Sends Letter Supporting the Reagan-Udall Foundation; ASCO Co-sponsors Anticancer Agent Development Workshop

Submit Artwork for the 2009 "Expressions of Hope" Calendar

For Your Patients: New Cancer.Net Features Discuss Treatment and Research Updates for Melanoma; How to Work With a Specialty Pharmacy

For Your Patients: Cancer.Net Podcast Explores Magnetic Resonance Imaging

JCO Early Release Articles Examine Infiltrating Lobular Carcinoma of the Breast; Lapatinib as First-line Therapy for ErbB2-amplified Breast Cancer; Testicular Cancer Management and Surgical Expertise; Retroperitoneal Lymph Node Dissection with Chemotherapy for Testicular Germ Cell Tumors; Molecular Selection of Patients for First-line Treatment of NSCLC; First-Line Gefitinib for NSCLC

Future JCO Table of Contents

Tuesday, May 13, 2008

Palmetto/J1MAC Website Updates

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


J1 Early Boarding Now Open for Noridian Customers
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/J1%20Early%20Boarding%20Now%20Open%20for%20Noridian%20Customers?opendocument

Early Boarding is now open for those Part B customers from Hawaii, Nevada,
American Samoa, Guam and the Marianna Islands who are currently served by
Noridian. Palmetto GBA strongly encourages these submitters to begin
migrating to GPNet as soon as possible.

Applies to:
Part B Transition: EDI

Onmark CORE Webcast: Enroll to Learn the Impact of NPPs on Physician Productivity

Onmark's 2008 Benchmarking Survey revealed a three year trend that physicians who work with non-physician practitioners (NPPs) have more new patient visits per week than those who do not. Results from this survey, including three years of financial and operational benchmarking data from hundreds of practices nationwide, will be reviewed during Onmark's next CORE webcast on May 27 & 28.

In addition to the survey results, you will learn how to use benchmarking to enhance your practice efficiency and performance. Our panel of expert presenters will be:

• John Akscin, VP Government Relations, OTN
• Jan Palmer, Principal and Co-Founder, The Palomino Group
• Kent Butcher, CEO, Oklahoma Oncology

Don't miss this opportunity to learn more about benchmarking, a valuable tool for practices to compare themselves to national standards and evaluate performance over time. Enroll today via https://onmarkevents.webex.com/onmarkevents.

CMS/Medicare: Upcoming Training for the Medicare Part B Drugs Competitive Acquisition Program (CAP)

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 number of CAP topics and requirements such as billing for CAP claims, and NAS personnel are available to answer questions. Physicians and/or their staff are strongly encouraged to attend.

Interested parties may view additional information about and register for these workshops at https://www.noridianmedicare.com/cap_drug/train/workshops/index.html

Upcoming workshops will be held on the following dates:

§ 05/28/08 at 10:00 am CT

§ 06/24/08 at 2:00 pm CT

§ 07/24/08 at 10:00 am CT

THIS WEEK AT ACCC: MAY 12-16, 2008

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_ACCC_may12_08.html.

It features articles on:

ACCC Submits Comments to CMS About FDG-PET Coverage

PhRMA Report Says 750 New Medicines and Vaccines in Development

Call for ACCC Annual Awards Nominations

Heard on the ACCC Listserv: Sim-to-Treat Time and More

New Continuing Education Programs, Multiple Myeloma Webcast

State Medical Oncology Societies Host Upcoming Meetings

New AHFS Compendium Indication for Vidaza®

CMA Alert: Health Care Providers Sue State

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

It features articles on:

Medi-Cal: CMA Files Suit Against State over Medi-Cal Rate Cuts

FRONTLINE - HMOs: Your Oral Testimony or Written Comments Needed for DMHC ‘Balance Billing’ Proposal

MEDICARE - Northern California Physicians: Are Medicare Payments to Your Group At Risk?

PRACTICE MANAGEMENT – CONTRACTING: Physicians Urged to Read Carefully Before Signing New Blue Cross Contract Amendment

MEDICARE: New Medicare Contractor Hosting Conference Calls on Transition Issues

Monday, May 12, 2008

Cancer.Net Bulletin - May 2008

People Living With Cancer (plwc.org) is now Cancer.Net (http://www.cancer.net). Their May Bulletin is now available at http://view.exacttarget.com/?j=fe611575766603797215&m=ff2d17787264&ls=fdf1117674630179771c707d&l=fefa1c707c6705&s=fdf815727065077f7d16767c&ju=fe2b157871640575701174

ALERT: Food and Drug Administration (FDA) Heparin Recall for All Provider Types

Please help FDA spread the word about recalls of injectable heparin products and heparin flush solutions that may be contaminated with oversulfated chondroitin sulfate (OSCS). Affected heparin products have been found in medical care facilities in one state since the recall announcement. Although product recall instructions were widely distributed, they may not have been fully acted upon at all sites where heparin is used. There have been many reports of deaths associated with allergic or hypotensive symptoms after heparin administration (see FDA link at http://www.fda.gov/cder/drug/infopage/heparin/adverse_events.htm ).

We ask that health professionals and facilities please review and examine all drug/device storage areas, including emergency kits, dialysis units and automated drug storage cabinets to ensure that all of the recalled heparin products have been removed and are no longer available for patient use. In addition, FDA would like to inform health professionals about other types of medical devices that contain, or are coated with, heparin. To read this update, and to learn how to report these problems to FDA, please go to http://www.fda.gov/cdrh/safety/heparin-healthcare-update.html.

Please report to FDA adverse reactions associated with these devices, as well as any reactions associated with heparin or heparin flush solutions. If you have questions or would like more information about this request, please contact the Division of Drug Information at 301-796-3400.

ASH Practice Update

The latest ASH Practice Update from the American Society of Hematology has been published and is available at http://www.hematology.org/policy/practice/05082008.cfm. It features:

Senate Finance Committee Engaged in On-Going Discussions About Action on Medicare Physician Payment Bill

Genetic Information Nondiscrimination Act (GINA) Passes Congress

Comments Due Next Week on J12 MAC Draft Local Coverage Determination (LCD)

Medicare Awards Contract in Western Region

Medicare Posts Notice of Proposed Rulemaking for Inpatient Prospective Payment System (IPPS)

ASH Supports an Extension of the National Provider Identification Phase-in

Medicare Offers More Clarification of its National Coverage Decision on ESAs

Medicare Medical Home Demonstration: Potential Impact for Cognitive Physicians

NHIC/Medicare Website Updates

The following updates have been posted to the NHIC/Medicare website at http://www.medicarenhic.com/cal_prov/updates.shtml.

Two revised educational articles have been posted: ICD-9-CM Coding on Claims and Item 24E of the CMS-1500 Claim Form.

The Educational Tools and Questions & Answers from the webinar on Bundled Services is now available.

Palmetto/J1MAC Website Updates

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

New J1 Web Site Navigation Job Aid
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/New%20J1%20Web%20Site%20Navigation%20Job%20Aid?opendocument



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

Friday, May 9, 2008

Palmetto/J1MAC Website Updates

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


J1 EDI Enrollment Form
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/J1%20EDI%20Enrollment%20Form?opendocument

The J1 EDI Enrollment Agreement has been posted to the J1 Transition Web
site.

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

----------


JI Statement on the PTT Call of 5/6/2008
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/JI%20Statement%20on%20the%20PTT%20Call%20of%20562008?opendocument

We apologize for the lack of dedicated telephone lines available for the J1
Part B Palmetto GBA Transition Teleconference on May 6. Our understanding
was that there were an unlimited number of available lines. In order to
correct the situation and ensure that we do not have access issues in the
future, Palmetto GBA has implemented the following process for the Palmetto
GBA Transition Teleconferences held bi-weekly. It is important that all
registrants adhere to this process to ensure you receive the benefit of the
teleconferences.

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

----------


PTT-2008-5-6-PartB.pdf
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/PTT-2008-5-6-PartB.pdf?opendocument

Read the minutes from the May 6, 2008 J1 A/B MAC Part B PTT call.

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

CMS/Medicare: Clarification for Identifying Secondary Providers in Medicare Claims & More NPI Roundtable Information

The following information is provided by CMS/Medicare.


In accordance with the NPI final rule, when an identifier is reported on a paper or electronically submitted claim for ordering/referring /attending/operating/supervising/purchased service/other/service facility provider (in the x12N 837 claims transactions) or for prescriber (in the NCPDP 5.1 retail drug claim transaction), that identifier must be an NPI. For Medicare purposes, this requirement is effective May 23, 2008. If the entity to be identified as the ordering/referring/attending/operating/supervising/purchased service/other/service facility provider or prescriber does not furnish an NPI at the time of the order/referral/purchase or time of service, the billing provider must attempt to obtain that NPI in order to use it in the claim. The billing provider may use the NPI Registry or may need to contact the ordering/referring/ attending/operating/supervising/purchased service/other/service facility or presciber in order to obtain the NPI. While the Implementation guides for the X12N claims transactions permit the reporting of the Social Security Number (SSN) for some secondary providers if there is no NPI, we do not believe the billing provider will be successful in the obtaining the SSN.


· If unable to obtain the NPI of the entity to be identified in the service facility location loop, no identifier should be reported in that loop.


· If unable to obtain the NPI of the ordering/referring/attending/operating/supervising/purchased service/other or prescriber, the billing provider (in the X12N 837 transactions) or the service provider (in the NCPDP 5.1 transaction) shall use its own NPI to identify those secondary providers. Medicare will not pay these claims if these secondary providers are not identified by NPIs.


CMS will Host NPI National Roundtable Q&A Session on May 19, 2008

CMS will host a national NPI Roundtable Q&A session to address questions from the Medicare provider community prior to May 23rd. This Roundtable will be on May 19th from 2-3:30PM EDT. Questions will not be collected during the registration process for this call. There will be no presentations during this call; we will open the lines to take questions following a brief introduction. For registration details, visit (http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/listserv_wording_5-19-08_call.pdf) on the CMS website.


REMINDER: CMS will Host NPI National Roundtable on May 14, 2008

Registration is still open for the Roundtable to be held on May 14th from 2-3:30PM EDT. Providers will be able to submit questions through the online registration system at the time of sign up for this call. Similar to the most recent NPI Roundtable, Subject Matter Experts will create presentations based on the questions submitted. For registration details, visit (http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/listserv_wording_5-14-08_call.pdf) the CMS website.

Need More Information?

Still not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found through the CMS NPI page (www.cms.hhs.gov/NationalProvIdentStand) on the CMS website. 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: NPI Roundtable--Medicare Implementation Q&A Session

The following information is provided by CMS/Medicare.

Conference call details:

Date: May 19, 2008
Conference Title: CMS NPI Roundtable: Medicare Implementation Q&A Session
Time: 2:00-3:30 p.m. 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 2:00 p.m. EDT on May 18, 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/051908)

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 they may have gotten caught in that.

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 3:30 p.m. EDT 5/19/2008 until 11:59 p.m. EDT 5/24/2008. The call in data for the replay is (800) 642-1687 and the passcode is 46175614.

Thursday, May 8, 2008

Palmetto/J1MAC Website Updates

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


Electronic Funds Transfer (EFT) Web-Based Training
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Electronic%20Funds%20Transfer%20(EFT)%20Web-Based%20Training%20?opendocument

The first J1 A/B MAC Electronic Data Interchange (EDI) Web-based
training session has been scheduled for May 15, 2008 at 2:00 p.m. EST
/11:00 a.m. PST.

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

Wednesday, May 7, 2008

CMS/Medicare Website Updates

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

MM5972 – Prolonged Services (Codes 99354 - 99359)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5972.pdf

Tuesday, May 6, 2008

4th Annual Oncology Congress

ANCO is a sponsoring organization of the 4th Oncology Congress and physician members and their nurses may register at discounted rates at http://www.oncologycongress.com/anco.

The Congress takes place in San Francisco on September 25-28th.

Palmetto/J1MAC Website Updates

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


Electronic Fund Transfer (EFT) FAQs
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Electronic%20Fund%20Transfer%20(EFT)%20FAQs?opendocument

Palmetto GBA has posted additional frequently asked questions
pertaining to Electronic Funds Transfer (EFT).

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

----------


Inquiring Minds Want to Know ...
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Inquiring%20Minds%20Want%20to%20Know%20...?opendocument

Palmetto GBA EDI is committed to making your EDI transition as seamless and
stress-free as possible. You can help us do that! Here’s how.

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

----------

THIS WEEK AT ACCC: MAY 5-9, 2009

This Week at ACCC (Association of Community Cancer Centers) has been published and is available at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCC_May05_08.html.

ANCO is an Institutional Member of ACCC.

It features:

Call for ACCC Annual Awards Nominations

Costs of Cancer Care Estimated for Elderly Patients

Heard on the ACCC Listserv: OCN Retention Bonuses and More

New Continuing Education Programs on ACCC's Blackboard

State Medical Oncology Societies Host Upcoming Meetings

Monday, May 5, 2008

Palmetto/J1MAC Website Updates

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


EDI Hot Topics
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/EDI%20Hot%20Topics?opendocument

A review of incoming EDI support calls from transitioning customers
revealed that many customers called to ask about the following “hot”
topics.

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

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PC-ACE Pro32 Users Manual
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/PC-ACE%20Pro32%20Users%20Manual?opendocument

Palmetto GBA's PC-ACE Pro32 Users Manual may have slight differences from
the software manual provided by your outgoing contractor. We are posting
our manual for your convenience, so that we can reference universal
software concepts that have been identified as common questions from the
customer community.

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

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Palmetto/J1MAC: EDI - Technology Support Center Hours of Operation

The following information is provided by Palmetto/J1MAC.



We have received feedback from providers in the state of Hawaii, the
territories of American Samoa and Guam, and the Northern Mariana Islands that
there is concern regarding the hours of operation for the EDI Technology
Support Center. We are currently evaluating the hours of operation but also
wanted to ensure you were aware of the resources available to help resolve EDI
inquiries.

Please consult the EDI section of the J1 Web site, www.palmettogba.com/J1, which contains detailed and comprehensive EDI
information that will almost always answer your EDI questions. If your
question is not answered by a Web site visit, you may contact our Technology
Support Center (TSC) toll-free at 866-749-4301 for a quick response to your
EDI questions. The TSC hours are 8:00 a.m. to 5:00 p.m. PST. In addition, the
EDI email box, medicare.edi@PlamettoGBA.com can be used to resolve questions. If you
need to speak with a representative and the timeframe of 8:00 a.m. to 5:00
p.m. PST is not convenient, you may note a time that is good for you in an
email inquiry. We will do our best to meet your needs and call during a time
that works for your schedule.

Thank you, and welcome to J1 EDI

Palmetto/J1MAC: EDI - Technology Support Center Hours of Operation

The following information is provided by Palmetto/J1MAC.



We have received feedback from providers in the state of Hawaii, the
territories of American Samoa and Guam, and the Northern Mariana Islands that
there is concern regarding the hours of operation for the EDI Technology
Support Center. We are currently evaluating the hours of operation but also
wanted to ensure you were aware of the resources available to help resolve EDI
inquiries.

Please consult the EDI section of the J1 Web site, www.palmettogba.com/J1
, which contains detailed and comprehensive EDI
information that will almost always answer your EDI questions. If your
question is not answered by a Web site visit, you may contact our Technology
Support Center (TSC) toll-free at 866-749-4301 for a quick response to your
EDI questions. The TSC hours are 8:00 a.m. to 5:00 p.m. PST. In addition, the
EDI email box, medicare.edi@PlamettoGBA.com
can be used to resolve questions. If you
need to speak with a representative and the timeframe of 8:00 a.m. to 5:00
p.m. PST is not convenient, you may note a time that is good for you in an
email inquiry. We will do our best to meet your needs and call during a time
that works for your schedule.

Thank you, and welcome to J1 EDI

NHIC/Medicare Website Updates

The following updates have been posted to the NHIC/Medicare website and may be viewed at http://www.medicarenhic.com/cal_prov/updates.shtml

CMS updated the sections of the Medicare Claims Processing Manual that address prolonged services codes, in order to be consistent with changes/deletions in codes and changes in typical/average time units in the American Medical Association Current Terminology Procedural Terminology (CPT) coding system. (CR 5972)

The revised ABN was released on March 3, 2008, and providers are authorized to begin using the notice immediately. Beginning September 3, 2008, all providers, practitioners, and suppliers paid under Part B, must use the revised ABN in place of the ABN-G and ABN-L. The revised instructions are available here and can also be accessed at www.cms.hhs.gov/bni, along with the new form. (JSMTDL 08277)

This article has again been revised: CMS issued a Decision Memorandum (DM) that addressed Erythropoiesis Stimulating Agents (ESAs) use for cancer and related neoplastic conditions. (CR 5818)

The Draft LCD Open Meeting scheduled for July has been cancelled.

The latest issue of the CERT newsletter has been posted.

Palmetto/J1MAC Web Site Update

Part B J1 A/B MAC Transition Teleconference Calls
http://www.palmettogba.com/palmetto/j1.nsf/DocsCat/Part%20B%20J1%20AB%20MAC%20Transition%20Teleconference%20Calls%20?opendocument

Throughout the Jurisdiction 1 (J1) implementation, Palmetto GBA will host a
series of Medicare Part B transition teleconference calls for Part B
providers in Hawaii, Nevada, California, Guam, American Samoa and the
Northern Mariana Islands. These one-hour sessions will provide you with the
most recent transition information and will address the questions you have
about the implementation. This is your opportunity to speak with the J1 A/B
MAC and to discuss the implementation topic of your choice. The
teleconferences are similar to the “Ask-the-Contractor Teleconferences”
(ACT) offered by the Medicare fee-for-service contractors but will be
focused on J1 transition issues.

Applies to:
Part B Transition: General

Thursday, May 1, 2008

ASCO's Cancer Policy Today Published

ASCO's Cancer Policy Today was published and can be viewed at http://view.exacttarget.com/?j=fe6715757767047e7d16&m=ff311d707460&ls=fe0112707160057f72157377&l=fea516737564057975&s=fe1f15797d620479731d75&ju=fe2515787763007b771177.

It features:

Senate Passes the Genetic Information Nondiscrimination Act

ASCO Sends Letter Supporting the Reagan-Udall Foundation

Congress Focuses on FDA Oversight of Drugs Manufactured Abroad

CMS Announces Bonus Payment and Reporting Changes to 2008 PQRI Program

CPC Leadership Meets with Congressional Members

ASCO Co-sponsors Anticancer Agent Development Workshop

House Health Subcommittee Advances Conquer Childhood Cancer Act

Sen. Clinton Introduces Childhood Cancer Survivorship Act

Senate Passes the Genetic Information Nondiscrimination Act