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 available online at http://www.calphys.org/html/alert111609.asp. This edition features:

Blue Shield Planning to Publish Physician Ratings Based on Faulty CPPI Data

U.S. House Introduces Bill that Would Exempt Small Health Care Organizations from Red Flags Rule

Are Your Payors in Good Financial Health?

2010 Medicare Payment Rule Cuts Physician Payments by 21.2%; Eliminates Payment for Consultations

U.S. House to Take Critical SGR Vote this Week; Physicians Urged to Call

Appeals Court Protects California’s Voter-Enacted Drug Treatment Program

Blue Cross Extends Healthy Families Continuity of Care Plan


****CMS NEWS****
Due to recent revisions that were made to the 2010 Medicare Physician Fee Schedule (MPFS), the Centers for Medicare & Medicaid Services (CMS) has extended the 2010 Annual Participation Enrollment Program end date from December 31, 2009, to January 31, 2010 – therefore, the enrollment period now runs from November 13, 2009, through January 31, 2010.

The effective date for any Participation status change during the extension, however, remains January 1, 2010; and will be in force for the entire year.

Contractors will accept and process any Participation elections or withdrawals, made during the extended enrollment period that are received or post-marked on or before January 31, 2010.

Note: This is an extension of the annual participation enrollment period dates in CR 6637 (Transmittal 1832 -- Calendar Year (CY) 2010 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures), dated October 16, 2009.

The Participation Agreement (CMS-Form 460) is available on the CD-ROM that is sent out annually by your Medicare contractor during the Annual Participation Enrollment period. Your contractor will also make the Participation Agreement available to you by placing it on their Websites with Participation enrollment (and termination) instructions.


MM6660 – Therapy Cap Values for Calendar Year (CY) 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6660.pdf

MM6690 – Update to Medicare Deductible, Coinsurance, and Premium Rates for 2010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6690.pdf

MM6723 – Claim Status Category Code and Claim Status Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6723.pdf

MM6708 – January 2010 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/MM6708.pdf

SE0929 – 2010 Annual Participation Enrollment Program Extension
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0929.pdf


****PALMETTO/J1MAC NEWS****
California Contractor Advisory Committee Meeting Minutes
The following are minutes from the California Contractor Advisory Committee
Meeting on October 13, 2009, in San Francisco, CA. Please be sure to share
with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XRT268315?opendocument


CMS No Longer Recognizes HCPCS Code for Payment of Non-Outpatient Hospital
Claims
The following article announces that, effective immediately, the Centers
for Medicare & Medicaid Services (CMS) will no longer recognize the
Healthcare Common Procedure Coding System (HCPCS) Code for payment of
non-outpatient hospital claims. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XVLYX8318?opendocument


J1 Provider Outreach and Education Event Calendar
What's new in November 2009? The updated Palmetto GBA J1 Event Calenar is
now available on our Web site!
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument


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