CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****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 1:30 p.m. – 3:30 p.m., EST, on Thursday, December 10, 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:

· Alternate feedback report request process;
· Update on incentive payments and feedback reports;
· Results from the 2008 PQRI and 2007 PQRI re-run; and
· Measures issues identified in 2008 PQRI.

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, as well as educational products are available on the e-prescribing dedicated web page located at http://www.cms.hhs.gov/ERxIncentive on the CMS website. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.

Conference call details:

Date: December 10, 2009

Conference Title: Physician Quality Reporting Initiative (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.

Registration will close at 1:30 p.m. EST on December 9, 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://www.eventsvc.com/palmettogba/121009

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 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.

The Centers for Medicare & Medicaid Services (CMS) is now accepting quality measure suggestions for consideration for possible inclusion in the proposed set of quality measures for use in the 2011 Physician Quality Reporting Initiative (PQRI).

Interested parties have an additional opportunity to submit measure suggestions for the 2011 PQRI program beyond the request for 2011 measure suggestions included in the Calendar Year (CY) 2010 Medicare Physician Fee Schedule (PFS) proposed rule published in theFederal Register (74 FR 33587) on July 13, 2009. Interested parties who have already submitted measure suggestions in response to the request for 2011 PQRI measures included in the CY 2010 PFS proposed rule do not need to re-submit their measure suggestions.

To learn more about the 2011 PQRI Call for Measures, visit the CMS Quality Measures Management Information System (QMIS) website at http://www.cms.hhs.gov/apps/QMIS/CallforMeasures.asp on the CMS website.

All suggestions must be received by CMS no later than 5:00 p.m. EST December 16, 2009.

Please note: Suggesting individual measures or measures for a new or existing measures group does not guarantee that the measure(s) will be included in the proposed or final sets of measures of any proposed or final rules that address the 2011 PQRI. CMS will determine what individual measures and measures group(s) to include in the proposed set of quality measures, and after a period of public comment, the agency will make the final determination with regard to the final set of quality measures for the 2011 PQRI.


****PALMETTO/J1MAC NEWS****
Claim Status Category Code and Claim Status Code Update
This J1 Part A/B MLN Matters article (CR6723) 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 September 2009 meeting of the national Code
Maintenance Committee and code changes approved at that meeting were posted
on the Internet on November 1, 2009. Please be sure to share with your
staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XXT8Q7657?opendocument


J1 Part B LCDs Update
Share with your staff - The J1 Part B LCDs, Ambulance Services L28235 and
Diagnostic Colonoscopy L28253 have been revised.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XYP9B7353?opendocument


Therapy Cap Values for Calendar Year (CY) 2010
This J1 Part A/B MLN Matters article (CR6660) describes the policy for
outpatient therapy caps for 2010 and announces that therapy caps for 2010
will be $1,860. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XWTJR5402?opendocument


Update to Medicare Deductible, Coinsurances and Premium Rates for 2010
This J1 Part A/B MLN Matters article (CR6690) provides the Medicare rates
for deductible, coinsurance and premium payment amounts for calendar year
(CY) 2010. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7XXTP96437?opendocument


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