****ASCO NEWS****
Representatives Charlie Gonzalez (D-TX) and Mike Rogers (R-MI) are circulating a "Dear Colleague" letter (http://www.asco.org/ASCOv2/Department%20Content/Cancer%20Policy%20and%20Clinical%20Affairs/Downloads/Policy%20Issues/Medicare%20and%20Quality%20Care/Gonzalez%20Rogers%20Dear%20Colleague%20Letter%20073009.pdf ) to members of the House of Representatives, urging their colleagues to join them in signing a letter to U.S. Health and Human Services Secretary Kathleen Sebelius. The letter to Secretary Sebelius expresses deep concern about the proposed cuts to oncology and cardiology in the Medicare fee schedule and asks CMS to abstain from using the flawed data that justify the cuts.
Cancer and heart disease are the top two causes of death for Medicare patients. ASCO and the American College of Cardiology (ACC) - the professional organizations representing doctors who treat these diseases - are encouraging members of Congress to sign the letter to Secretary Sebelius.
ASCO is stating in no uncertain terms that the proposed cuts to oncology and cardiology will place vital patient care services, like chemotherapy, at risk.
The letter to Secretary Sebelius highlights the serious flaws in the American Medical Association (AMA) survey that was the basis for determining the proposed cuts, including:
The survey's findings that the cost of providing cardiology and oncology services has dropped substantially over the last five years defies logic and is inconsistent with recognized trends.
The sample sizes for oncology and cardiology were too small to be representative and do not capture the conditions faced by patients and providers throughout the United States, especially in rural and low-income urban areas.
The survey process lacked transparency. The public should have the opportunity to fully review the entire data set before such significant policy changes are implemented.
ASCO applauds Reps. Gonzalez and Rogers for their leadership and longstanding support of the cancer community.
WE NEED YOUR HELP IN THIS EFFORT. Please call (http://capwiz.com/asco/callalert/index.tt?alertid=13812581) or write your Representative and ask him or her to sign the letter to Secretary Sebelius. You can find everything you need to contact your member of Congress - including talking points, contact information and a draft email/letter - on ASCO's Grassroots Action Network (http://capwiz.com/asco/issues/alert/?alertid=13779296).
It is critical for you to call your Representative this week, before the House of Representatives recesses for the month of August.
Contact ASCO's Cancer Policy and Clinical Affairs Department with any questions, or to share your story about how this proposed cuts will harm your practice and your patients, at 571-483-1670 or publicpolicy@asco.org.
****COA NEWS****
On the COA website at www.communityoncology.org under the Immediate Action Needed section is a tool that will allow you to estimate the impact of changes proposed by CMS in the 2010 Medicare Physician Fee Schedule. We encourage you to use the tool to estimate the impact of the cuts on your practice. The leadership team of the COA Administrators’ Network used the tool and collectively found the following:
Oncology-specific cuts related to infusion room services are estimated to be 20.6% in 2010
The total impact of the cuts is 6.4%, factoring in an increase in E&M payments and the elimination of the consultation codes
Please note that these estimates assume that Congress will act in health care reform legislation to avert the 21.5% cut. If this does not happen, the total estimated impact of the Medicare cuts would be 26.5% for oncology practices. Run the estimates for your practice. If you have any questions about using the tool, please contact Ricky Newton
****CMS NEWS****
IMPORTANT NOTICE regarding the National Correct Coding Initiative (NCCI) Edits for Physicians (version number 15.2, effective 7/1/09 – 9/30/09) posted on the Centers for Medicare & Medicaid Services (CMS) website:
The Column 1 /Column 2 edits file for the CPT* code range 34000 – 39999 posted on July 2, 2009, was not updated with the July 2009 changes. The file has been corrected and is now available on the NCCI Edits web page at http://www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp. This was the only file that was not updated. The direct link to the corrected file is
http://www.cms.hhs.gov/apps/ama/license.asp?file=/NationalCorrectCodInitEd/downloads/ccigrp5b.zip
This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES). The Centers for Medicare & Medicaid Services (CMS) recommends that each health care provider, including individual physicians and non-physician practitioners:
· Secure and maintain their own NPPES account information (i.e., User ID, Password, and Secret Question/Answer) for safety and accessibility purposes. Health care providers should maintain the confidentiality of their User ID, password, and Secret Question/Answer in order to protect their NPPES information from unauthorized access.
Reset their NPPES passwords at least once a year. See the NPPES Application Help page at https://nppes.cms.hhs.gov/NPPES/Help.do and select the ‘Reset Password Page’ for applicable rules. Those rules indicate the length, format, content and requirements of NPPES passwords.
Review their NPPES records in order to ensure that the information reflects current and correct information. Covered health care providers are required to update their NPPES information within 30 days of the effective date of the change.
Viewing NPPES Information
Health care providers, including physicians and non-physician practitioners, can view their NPPES information in one of two ways:
(1) By accessing the NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created. *
* If the health care provider has forgotten the password, enter the User ID and click the “Reset Forgotten Password” button to navigate to the Reset Password Page. If the health care provider enters an incorrect User ID and Password combination three times, the User ID will be disabled. Please contact the NPI Enumerator at 1-800-465-3203 if the account is disabled or if the health care provider has forgotten the User ID.
OR
(2) By accessing the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do. The NPI Registry gives the health care provider an online view of Freedom of Information Act (FOIA)-disclosable NPPES data. The health care provider can search for its information using the name or NPI as the criterion. Information regarding NPPES data that are FOIA-disclosable can be found at http://www.cms.hhs.gov/NationalProvIdentStand/ by selecting ‘Data Dissemination’.
Please note: Business Mailing Address and Business Practice location information (full address and corresponding telephone numbers) are key data elements that are FOIA-disclosable. Health care providers should not report their residential address unless it is their Business Mailing Address or Business Practice location. The NPPES data appearing on the NPI Registry cannot be deleted; however, it can be updated or changed.
Updating NPPES Information
Health care providers, including physicians and non-physician practitioners, can correct, add, or delete information in their NPPES records by accessing their NPPES records at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.
Please note: Required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information. Certain information is inaccessible via the web, thus requiring the change/update to be made via paper application. The paper NPI Application/Update Form (CMS-10114) can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.
Deactivating the NPI
Health care providers, including physicians and non-physician practitioners, can deactivate their NPIs if the NPIs are no longer required or needed. Reasons for deactivation include retirement, business dissolved, or death of the health care provider. A request for deactivation must be submitted via paper application. The paper NPI Application/Update Form (CMS-10114) can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf. Health care providers should review the instructions located on the application regarding deactivations in order to properly complete the deactivation request. The Power of Attorney or Executor of the Will may complete the application for deactivation due to death of the health care provider.
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Physicians: Did your academic medical institution or medical school university obtain your NPI for you? If so, please be sure to read an upcoming special listserv message on this topic.
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Need More Information?
Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. Having trouble viewing any of the URLs in this message? If so, try to cut and paste any URL in this message into your web browser to view the intended information.
Visit CMS’ dedicated NPI web page at www.cms.hhs.gov/NationalProvIdentStand for additional NPI information.
****PALMETTO/J1MAC NEWS****
August 2009 J1 A/B MAC Medicare Advisory
The August 2009 J1 A/B MAC Mediare Advisory has been posted to the J1 Web
site.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7UDRMA1283?opendocument
Provider Specialty 87 as Provider Type 64 v.s. Provider Type 40 Update
Due to the different provider types (Provider Type 64 v.s. Provider Type
40) used in Palmetto GBA and the Outgoing Contractor (OGC) for Specialty
87 providers, some services were denied in error. A mass adjustment was
performed with 0 claims found for NCA, 22 claims for SCA and 53 claims for
HI/NV.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7RBS575234?opendocument
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