CMA, CMS, Palmetto/J1MAC News

The following information has been received by ANCO.

All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available online at http://anco-online.blogspot.com/.


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

FTC Delays Enforcement of Red Flag Rules for Another 3 Months

Have You Corrected Your CPPI Quality Data?

Physician Case Study: To EHR or not EHR, that Is the Question

Best Practices: Building a Defensible Fee Schedule

Blue Shield Fee Schedule Changes Take Effect October 1

CMA Submits Brief to Appeals Court in Rescission Case

Health Reform – Much Undecided as Congress Goes on Recess

Gov. Schwarzenegger Deepens Health Care Cuts

Don’t Miss Your Chance to Influence CMA Policy

IMQ Receives Six-Year Recognition from ACCME

Nominate a Senior Physician for CMA’s Young-at-Heart Award


****CMS NEWS****
The Centers for Medicare & Medicaid Services reminds physicians and non-physician practitioners, and group practices that they are required to notify their designated Medicare contractor regarding (a) a change in ownership, (2) a change in practice location, including a change in reassignment of benefits, or (3) any final adverse action (e.g., license suspension/revocation or felony conviction) within 30 days of the reportable event. By reporting changes as soon as possible, but within 30 days of the reportable event, physicians, non-physician practitioners, and group practices will help to ensure that their claims are processed correctly.

Physicians, non-physician practitioners, and group practices are also encouraged to update their Medicare enrollment information on file with the Medicare contractor if the physician, non-physician practitioner, or group practice has not done so since November 2003.

Physicians, non-physicians practitioners, and group practices can use CMS’ electronic enrollment process, known as Internet-based Provider Enrollment, Chain and Ownership System (PECOS), to enroll or make a change in an existing enrollment record.

Information regarding physician, non-physician practitioner, and group practice reporting responsibility and other informational material regarding provider enrollment can be found on the Medicare Provider/Supplier Enrollment web site, www.cms.hhs.gov/MedicareProviderSupEnroll, and in the documents available for downloading in the Downloads section of each web page.


****PALMETTO/J1MAC NEWS****
Effective Date Changes: Provider Enrollment Applications
This table is to assist providers determine the effective date of Medicare
billing privileges based on the incorporation of physician fee schedule
regulatory changes into Chapter 10 of the Program Integrity Manual.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7UMQLW2758?opendocument


J1 Provider Outreach and Education Event Calendar
The Palmetto GBA J1 Learning and Education August 2009 Event Calendar is
now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument


Radiopharmaceutical Drugs that Require An Invoice for Pricing
The list of HCPCS codes for radiopharmaceutical drugs that require an
invoice for pricing has been updated. An invoice is required with each
claim in order for the service to be priced for radiopharmaceuticals that
Palmetto GBA does not have pricing available for.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RAQMD6147?opendocument