CMA, CMS, & Palmetto/J1MAC News

The following information has been received by ANCO.


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

CMA Fighting Cost-Cutting Health Reform Proposals that Would Punish Physicians in High-Cost Regions
Physicians Urged to Pre-Register for H1N1 Vaccine
Senate to Vote this Week on Bill to Stop Unjust Health Insurance Cancellations
We Need Your Help to Protect the Ban on the Corporate Practice of Medicine
Blue Cross Will Continue to Pay Claims from Physicians Who Have Not Signed New Healthy Families Contract

Important Information for Blue Cross Contracted Physicians

Best Practices: Hiring the Right Receptionist

Physician EHR Case Study Chapter 3: A Trip Up the Amazon


****CMS NEWS****
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host a national provider conference call on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 2:30 p.m. – 4:30 p.m., EDT, on Thursday, September 17, 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:

Status of the 2007 re-run and 2008 PQRI Incentive payments and feedback reports;
How to access the 2007 re-run and 2008 PQRI feedback reports; Resources to assist eligible professionals; and
PQRI and E-Prescribing Alternative Report Request Process
Following this 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, section, as well as educational products are available on the e-prescribing dedicated web page located at http://www.cms.hhs.gov/ERxIncentive. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.

Conference call details:

Date: 9/17/2009
Conference Title: 2009 Physician Quality Reporting Initiative National Provider Call
Time: 2:30 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. Registration will close at 2:30 p.m. EDT on 9/16/2009, 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/091709
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 transcript of the call will be available at least one week after the call at http://www.cms.hhs.gov/pqri on the CMS website.

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


Third National Medicare Fee-For-Service (FFS) Education Call on HIPAA Version 5010
Conference call details:

Date: September 9, 2009
Conference Title: Third National Medicare FFS Education Call on HIPAA Version 5010
Time: 2:00 p.m. – 3:30 p.m. ET

The Centers for Medicare & Medicaid Services (CMS) will present the third in a series of National Education Conference Calls focused on Medicare’s Fee-for-Service (FFS) implementation of HIPAA Version 5010. The presentation will cover Medicare FFS error handling transactions (TA1, 999, and 277CA), planned use of each transaction and applicable rules and exceptions for the Medicare FFS program. The presentation is geared to billing software programmers or developers that reside within provider organizations. A Question & Answer (Q&A) session will follow the presentation that will give participants an opportunity to ask questions of CMS’ subject matter experts.

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.

Registration will close at 2:00 p.m. ET on September 8, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
1. To register for the call participants need to go to:
http://www2.eventsvc.com/palmettogba/090909
2. Fill in all required data.
3. Verify your time zone is displayed correctly the drop down box.
4. Click "Register".
5. 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.
A few days prior to the call (not before September 6th), check the Educational Resources page on CMS’ 5010 web page at http://www.cms.hhs.gov/Versions5010andD0/40_Educational_Resources.asp to obtain a copy of the presentation that will be used during the call.
Learn more about 5010, visit CMS’ dedicated page at http://www.cms.hhs.gov/Versions5010andD0/ on the web.


****PALMETTO/J1MAC NEWS****
Addition/Deletion of HCPCS Codes – October 2009 Quarterly Update
This article explains updates, effective for dates of service on or after
October 1, 2009 (unless otherwise specified), to the Healthcare Common
Procedure Coding System (HCPCS) codes for certain drugs and biologicals.
Ensure that your staffs are aware of these changes.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VJJQU7208?opendocument


Claim Status Category Code and Claim Status Code Update
This article, based on CR6609, explains that the Claim Status Codes and
Claim Status Category Codes for use by Medicare contractors with the Health
Claim Status Request and Response ASC X12N 276/277 were updated during the
June 2009 meeting of the national Code Maintenance Committee and code
changes approved at that meeting were posted at
www.wpc-edi.com/content/view/180/223/ on the Internet on or about June 30,
2009. All providers should ensure that their billing staffs are aware of
the updated codes.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VJKDZ6257?opendocument


2009 PQRI National Call: September 17, 2009
CMS Provider Communications Group will host a national provider conference
call on the 2009 Physician Quality Reporting Initiative (PQRI). This
toll-free call will take place from 2:30 p.m. to 4:30 p.m. EDT, on
Thursday, September 17, 2009. The topics covered on this national provider
call will include: status of the 2007 re-run and 2008 PQRI Incentive
payments and feedback reports; how to access the 2007 re-run and 2008 PQRI
feedback reports; resources to assist eligible professionals and
PQRI/E-Prescribing Alternative Report Request Process.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VKJQ36061?opendocument


October Update to the 2009 Medicare Physician Fee Schedule Database
(MPFSDB)
This article is based on Change Request (CR) 6617 which amends payment
files that were issued to contractors based upon the 2009 Medicare
Physician Fee Schedule (MPFS) Final Rule. Billing staff should be aware of
these updates.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VJQ591522?opendocument


Webinar: Part B Top 10 Billing Errors on September 9
Please note the Palmetto GBA J1 Part B free Webinar on Top 10 Billing
Errors will be on Wednesday, September 9.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7UKT6J1472?opendocument


What You Don’t Know About A CERT Claim Review That May Have Consequences
For You And Your Peers
The CERT contractor’s review of your claims is the first of a cascade of
steps in Medicare’s global payment safeguard program process.
The Medicare global payment safeguard program process consists of the CERT
contractor, the Medicare administrative contractors (MACs), the payment
safeguard benefit integrity contractors (PSCs, but soon to be called ZPICs)
and the recovery audit contractors (RACs). Please review and share with
your staff.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7VJQZ50870?opendocument


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