CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
MM6295 – Change in the Amount in Controversy Requirement for Administrative Law Judge Hearings andFederal District Court Appeals
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6295.pdf

MM6288 – January 2009 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6288.pdf

SE0833 – Medicare Part B Drug Competitive Acquisition Program (CAP) Postponed for 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0833.pdf


The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the second in a series of national provider conference calls on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 1:30 p.m. – 3:30 p.m., EST, on Wednesday, February 18, 2009.

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.

The topics covered on this National Provider Call will include a review of the aggregate level measure submission feedback report from PQRI 2008 and an update regarding 2009 PQRI measure submission. Following the presentation, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.

Educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website, in the Educational Resources section. 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: February 18, 2009
Conference Title: 2009 PQRI- National Provider Call
Time: 1:30 p.m. EST

In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.

Registration will close at 1:30 p.m. EST on February 17, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.

To register for the call participants need to go to: http://www2.eventsvc.com/palmettogba/021809

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 2/18/2009 until 11:59 p.m. EST 2/25/2009. The call in data for the replay is (800) 642-1687 and the passcode is 84543925.

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


****PALMETTO/J1MAC NEWS
2009 Coding & Reimbursement Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Publications~Medicare%20Advisory~2009%20Coding%20Reimbursement%20Update?opendocument

The 2009 Coding & Reimbursement Update contains a wealth of information
that will be helpful to your office. Some of the articles in this
publication include: Additions, Deletions and Changes for HCPCS, CDT, and
CPT codes and modifiers; Proper use of modifiers: bilateral, professional
and technical; Medicare Physician Fee Schedule Database Indicator Codes;
DMEPOS Fee Schedule; Drug & Biological Fee Schedule and more.


Reminder: A Tax Identification Number (TIN) will be Required for
Authentication as of March 1, 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~Reminder%20A%20Tax%20Identification%20Number%20(TIN)%20will%20be%20Required%20for%20Authentication%20as%20of%20March%201%202009?opendocument

This is a reminder that a Tax Identification Number (TIN) will be required
for authentication as of March 1, 2009.


Change in the Amount in Controversy Requirement for Administrative Law
Judge Hearings and Federal District Court Appeals
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Change%20in%20the%20Amount%20in%20Controversy%20Requirement%20for%20Administrative%20Law%20Judge%20Hearings%20and%20Federal%20District%20Court%20Appeals?opendocument

CR6295, Change in the Amount in Controversy Requirement for Administrative
Law Judge Hearings and Federal District Court Appeals, is an MLN article
for J1 Part A and B.


Important Information for Providers Serving Medicare Beneficiaries Enrolled
in Private Fee-for-Service Plans
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Important%20Information%20for%20Providers%20Serving%20Medicare%20Beneficiaries%20Enrolled%20in%20Private%20Fee-for-Service%20Plans?opendocument

MLN article SE0902, Important Information for Providers Serving Medicare
Beneficiaries Enrolled in Private Fee-for-Service Plans, details a new
process for handling payment disputes raised by providers who serve
Medicare patients enrolled in Medicare Advantage (MA) Private
Fee-for-Service Organizations (PFFS) plans.


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

The following J1 Part B LCDs will begin their notice period on 02/05/2009.
Revisions made during the comment period will become effective on
03/23/2009.