The following information has been received by ANCO.
****CMS NEWS****
SE0909 – Important Information Regarding the Centers for Medicare & Medicaid Services (CMS) National Claims Crossover Process
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0909.pdf
MM6311 – Adding a New Specialty Code for Hospice and Palliative Care
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6311.pdf
MM6386 – Revision to Processing Hospice Visit Charges on Remittance Advices and Medicare Summary Notices (MSNs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6386.pdf
****PALMETTO/J1MAC NEWS****
May 2009 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~May%202009%20J1%20AB%20MAC%20Medicare%20Advisory?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575A6004D6877?opendocument
The May 2009 J1 A/B MAC Medicare Advisory is now available to be viewed on
the Palmetto GBA Web site. It contains the latest updates and useful
information regarding Medicare. Please share this information with your
staff.
Adding a New Specialty Code for Hospice and Palliative Care
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Adding%20a%20New%20Specialty%20Code%20for%20Hospice%20and%20Palliative%20Care?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575A7005D51B6?opendocument
CR6311 adds specialty code is 17 for Hospice and Palliative Care. Medicare
specialty codes describe the specific types of medicine that physicians
practice and are used by CMS for programmatic and claims processing
purposes.
J1 Part B Local Coverage Determinations (LCDs) Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~J1%20Part%20B%20Local%20Coverage%20Determinations%20(LCDs)%20Update?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575A700664E46?opendocument
The following Part B LCDs have been revised: Free Prostate Specific Antigen
(PSA) Test, Pulmonary Function Testing, Bariatric Surgery and Radiologic
Examination for Chest.
****CORPORATE MEMBER NEWS****
Onmark, a McKesson Special Care Solutions Company, and ANCO Corporate Member, informs ANCO that its next CORE webcast will discuss cost-effective, creative solutions for marketing and branding your practice in the current fiscal environment. A previous attendee commented that this program provided “many simple ideas to implement.”
Enroll for this webcast to learn how to boost your marketing efforts and achieve maximum results within your current budget.
Agenda
• Reasons to Make Marketing a Priority in Your Practice
• Oncology Practice Specific Marketing Strategies
• Do’s & Don’ts for Marketing Communications
Dates & Times
• Tuesday, May 12, 2009 from 9:00-10:00am PT / noon-1:00pm ET
• Wednesday, May 13, 2009 from noon-1:00pm PT / 3:00-4:00pm ET
Presenters
• John Akscin, VP Government Relations, McKesson Specialty Care Solutions.
• Rosemarie Nelson, Principal Consultant, Medical Group Management Association.
Click here (http://www.elabs6.com/content/24791/April%202009/CORE%20Q2%20Mkt%20%20Brand.pdf) to learn more about this event or register online (https://onmarkevents.webex.com/onmarkevents/mywebex/default.php?Rnd4777=0.5385947847041572) today!
Wednesday, April 29, 2009
Tuesday, April 28, 2009
ASCO & CMS News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider was published and is available on line at http://view.exacttarget.com/?j=fe54157972610378741c&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2b16727c61037d741d71. ANCO is a state/regional affiliate of ASCO. This edition features:
2009 ASCO EHR Symposium
CMS Clarifies Use of Advance Beneficiary Notice with Medically Unlikely Edits
FDA Reverses Action to Pull Unapproved Liquid Morphine Off Market
Red Flags Rule Guidance Material Available for Physicians
Comment on Proposed Personal Health Record Breach Notification Rule
CMS Conference Call on ICD-10-CM/PCS Implementation and General Equivalence Mappings
NCVHS Meeting on "Meaningful Use"
From the practice manager's desk...
Billing and Coding Q&A
What do you think...?
Did you know...?
Good cancer care starts with good cancer information. Well-informed patients are their own best advocates and invaluable partners for physicians. ASCO’s patient website, Cancer.Net, provides trusted, authoritative information for people living with cancer and those who care for and about them. All of the information on Cancer.Net is reviewed by oncologists and other oncology professionals who are ASCO members, making Cancer.Net a current and trusted resource for cancer information.
Following is a list of information people will find on Cancer.Net:
Cancer.Net Guides to Cancer: Detailed guides about a specific type of cancer, including symptoms, risk factors, diagnosis, staging, treatment, clinical trials, follow-up care, and questions to ask the doctor.
Cancer.Net Features, including ASCO Expert Corner interviews: Weekly articles designed to provide in-depth information on topics of interest, as well as practical information on cancer care and treatment.
Find an Oncologist: Search the database of ASCO members who have made their contact information public.
Clinical Trials: Information on clinical trials and patient safety, steps involved in the research process, risks and benefits of participating in a clinical trial, questions to ask the research team, and links to find cancer clinical trials.
Cancer.Net Podcasts: Information on cancer research, treatment, coping, and many other topics through audio podcast.
Medical Illustrations Gallery: Full-color anatomical and staging illustrations organized by cancer type, including a version that can be downloaded and printed on an 8.5" x 11" page.
Cancer.Net En Español: Information in Spanish on 25 cancer types, side effects, patient guides based on ASCO clinical practice guidelines, clinical trials, and information on tobacco and cancer.
Cancer Advances: News for Patients: Summaries of cancer research presented each year at ASCO's Annual Meeting.
What to Know: ASCO’s Guidelines for Patients: Patient-friendly guides based on ASCO's Clinical Practice Guidelines for physicians.
For free Cancer.Net promotional materials to share with patients, including referral cards, leaflets, cancer information prescription pads, or posters call 888-651-3038 or send an email to contactus@cancer.net.
****CMS NEWS****
CMS will hold a Special Open Door Forum (ODF) on April 30, 2009 (11AM PT) to discuss the availability of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) and the implementation of regulatory provisions. During this call CMS staff will discuss the:
· Internet-based PECOS for physicians, non-physician practitioners and provider and supplier organizations
· Provider and supplier reporting responsibilities
· Final Adverse Actions
· Change of Practice Locations
· Change of Ownership
· Other Reportable Events
· Effective date of Medicare billing privileges and retrospective billing for physicians, certain non-physician practitioners, and physician and non-physician practitioner organizations
· Revalidation Efforts
Afterwards, there will be an opportunity for the public to ask questions.
We look forward to your participation.
Open Door Forum Instructions:
**Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.**
Dial: 1-800-837-1935
Reference Conference ID 94109369
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html. A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning Monday May 11, 2009 and available for 30 days.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at: http://www.cms.hhs.gov/OpenDoorForums/
SE0904 – An Introductory Overview of the HIPAA 5010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0904.pdf
MM6440 – Additional Data Collection on Hospice Claims
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6440.pdf
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider was published and is available on line at http://view.exacttarget.com/?j=fe54157972610378741c&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2b16727c61037d741d71. ANCO is a state/regional affiliate of ASCO. This edition features:
2009 ASCO EHR Symposium
CMS Clarifies Use of Advance Beneficiary Notice with Medically Unlikely Edits
FDA Reverses Action to Pull Unapproved Liquid Morphine Off Market
Red Flags Rule Guidance Material Available for Physicians
Comment on Proposed Personal Health Record Breach Notification Rule
CMS Conference Call on ICD-10-CM/PCS Implementation and General Equivalence Mappings
NCVHS Meeting on "Meaningful Use"
From the practice manager's desk...
Billing and Coding Q&A
What do you think...?
Did you know...?
Good cancer care starts with good cancer information. Well-informed patients are their own best advocates and invaluable partners for physicians. ASCO’s patient website, Cancer.Net, provides trusted, authoritative information for people living with cancer and those who care for and about them. All of the information on Cancer.Net is reviewed by oncologists and other oncology professionals who are ASCO members, making Cancer.Net a current and trusted resource for cancer information.
Following is a list of information people will find on Cancer.Net:
Cancer.Net Guides to Cancer: Detailed guides about a specific type of cancer, including symptoms, risk factors, diagnosis, staging, treatment, clinical trials, follow-up care, and questions to ask the doctor.
Cancer.Net Features, including ASCO Expert Corner interviews: Weekly articles designed to provide in-depth information on topics of interest, as well as practical information on cancer care and treatment.
Find an Oncologist: Search the database of ASCO members who have made their contact information public.
Clinical Trials: Information on clinical trials and patient safety, steps involved in the research process, risks and benefits of participating in a clinical trial, questions to ask the research team, and links to find cancer clinical trials.
Cancer.Net Podcasts: Information on cancer research, treatment, coping, and many other topics through audio podcast.
Medical Illustrations Gallery: Full-color anatomical and staging illustrations organized by cancer type, including a version that can be downloaded and printed on an 8.5" x 11" page.
Cancer.Net En Español: Information in Spanish on 25 cancer types, side effects, patient guides based on ASCO clinical practice guidelines, clinical trials, and information on tobacco and cancer.
Cancer Advances: News for Patients: Summaries of cancer research presented each year at ASCO's Annual Meeting.
What to Know: ASCO’s Guidelines for Patients: Patient-friendly guides based on ASCO's Clinical Practice Guidelines for physicians.
For free Cancer.Net promotional materials to share with patients, including referral cards, leaflets, cancer information prescription pads, or posters call 888-651-3038 or send an email to contactus@cancer.net.
****CMS NEWS****
CMS will hold a Special Open Door Forum (ODF) on April 30, 2009 (11AM PT) to discuss the availability of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) and the implementation of regulatory provisions. During this call CMS staff will discuss the:
· Internet-based PECOS for physicians, non-physician practitioners and provider and supplier organizations
· Provider and supplier reporting responsibilities
· Final Adverse Actions
· Change of Practice Locations
· Change of Ownership
· Other Reportable Events
· Effective date of Medicare billing privileges and retrospective billing for physicians, certain non-physician practitioners, and physician and non-physician practitioner organizations
· Revalidation Efforts
Afterwards, there will be an opportunity for the public to ask questions.
We look forward to your participation.
Open Door Forum Instructions:
**Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.**
Dial: 1-800-837-1935
Reference Conference ID 94109369
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html. A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning Monday May 11, 2009 and available for 30 days.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at: http://www.cms.hhs.gov/OpenDoorForums/
SE0904 – An Introductory Overview of the HIPAA 5010
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0904.pdf
MM6440 – Additional Data Collection on Hospice Claims
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6440.pdf
Monday, April 27, 2009
ACCC, ASCO, ASH, & Institutional Member 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/.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_4-27-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Physician Supervision Clarification: ACCC and ONS Send Concerns to CMS
NCCN Updates Kidney Cancer Clinical Guideline
ACCC Award Winner, Dr. Richard Frank, Publishes Guide for Cancer Patients
Minneapolis Is Site for ACCC's September Oncology Economics Conference
Webinar on Patient Navigation Planned for June 10, 2009
Medicare Legislation: Nursing Time and Educating Cancer Patients
Cincinnati Get Ready: ACCC's Symposium Is May 6
Q&A on ACCC's Listserve: Chemo Teaching Reimbursement
ACCC's CE Blackboard: A Full Range of Courses to Choose
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Express was published and is available online at http://view.exacttarget.com/?j=fe5615797260017a751c&m=ff2d16787160&ls=fdee1375776d077d7c107473&l=fe5d1575726004757c14&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe2816727c600778721576. ANCO is a state/regional affiliate of ASCO. This edition features:
The ASCO Cancer Foundation® Awards $6.1 Million to Further Progress Against Cancer
Abstract Submitter Now Open for the 2009 Breast Cancer Symposium
Apply for the Accelerating Anticancer Agent Development and Validation Workshop
Register and Reserve Housing for the Best of ASCO® Meetings in Los Angeles, Atlanta
Save the Date!
View, Purchase Electronic Resources from the 2009 GI and GU Cancers Symposia
NIH, NCI Announce Recovery Act Funding Opportunities; Recent New York Times Articles Highlight Cost of Cancer Drugs
Read the JCO Original Report "Adjuvant Therapy with the Monoclonal Antibody Edrecolomab Plus Fluorouracil-Based Therapy Does Not Improve Overall Survival of Patients With Stage III Colon Cancer”
ASCO Seeks Candidates for Upcoming JCO Editor-in-Chief Term
Cancer.Net Feature: Finding a Support Buddy
Cancer.Net Feature: Multigated Acquisition (MUGA) Scan—What to Expect
Special Cancer.Net Podcast: Planet Cancer, with Heidi Adams
JUST RELEASED! Practical Tips for the Oncology Practice
****ASH NEWS****
Take advantage of your last chance to register for the ASH webinar "PQRI and E-Prescribing: Nuts and Bolts" which takes place tomorrow, Tuesday, April 28th, 2009 from 5:00 p.m. – 6:15 p.m. Eastern Time. This webinar will focus on the basics of how to report the 2009 hematology-related Physician Quality Reporting Initiative measures and how to complete the E-Prescribing measure. It will help ensure that you follow the correct steps and receive the bonus for successful reporting.
Sylvia Publ, CMS Senior Quality Advisor, will discuss the basics of how to satisfactorily report the 2009 PQRI quality measures and to participate in the E-Prescribing program. Afterwards, there will be an opportunity to ask questions.
The webinar focuses on assisting hematologists as well as their office staff, and should help ensure that hematologists report appropriately and receive the incentive bonus. Please contact Matt Eckel at grassroots@hematology.org to sign up for this webinar.
To learn more about the PQRI program, visit the CMS PQRI Page and the ASH Web site. To learn more about the E-Prescribing program, visit the CMS Web site.
Be sure to register before April 28.
****INSTITUTIONAL MEMBER NEWS****
The following information is provided by Dr. Colevas at Stanford.
Two new clinical trials have opened and seek patients.
1. A clinical trial of XL184 , a c-MET and VEGF inhibitor in Subjects With Unresectable, Locally Advanced, or Metastatic Medullary Thyroid Cancer.
Stanford Cancer Center is the only Northern California site for this trial.
Contact: A. Dimitrios Colevas MD or Ruth Lira at (650) 724-9707.
2 A Phase 2 Study of Docetaxel, Cisplatin, Fluorouracil, Bevacizumab, and Radiation Therapy for Patients With Advanced Nasopharyngeal Carcinoma (NPC).
This trial is building upon the backbone of INT 0099 and RTOG 0615. New components to the treatment plan include the use of induction rather than adjuvant chemotherapy, adding docetaxel and research hypoxia imaging.
Contact: A. Dimitrios Colevas MD or Ruth Lira at (650) 724 9707.
All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available online at http://anco-online.blogspot.com/.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_4-27-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Physician Supervision Clarification: ACCC and ONS Send Concerns to CMS
NCCN Updates Kidney Cancer Clinical Guideline
ACCC Award Winner, Dr. Richard Frank, Publishes Guide for Cancer Patients
Minneapolis Is Site for ACCC's September Oncology Economics Conference
Webinar on Patient Navigation Planned for June 10, 2009
Medicare Legislation: Nursing Time and Educating Cancer Patients
Cincinnati Get Ready: ACCC's Symposium Is May 6
Q&A on ACCC's Listserve: Chemo Teaching Reimbursement
ACCC's CE Blackboard: A Full Range of Courses to Choose
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Express was published and is available online at http://view.exacttarget.com/?j=fe5615797260017a751c&m=ff2d16787160&ls=fdee1375776d077d7c107473&l=fe5d1575726004757c14&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe2816727c600778721576. ANCO is a state/regional affiliate of ASCO. This edition features:
The ASCO Cancer Foundation® Awards $6.1 Million to Further Progress Against Cancer
Abstract Submitter Now Open for the 2009 Breast Cancer Symposium
Apply for the Accelerating Anticancer Agent Development and Validation Workshop
Register and Reserve Housing for the Best of ASCO® Meetings in Los Angeles, Atlanta
Save the Date!
View, Purchase Electronic Resources from the 2009 GI and GU Cancers Symposia
NIH, NCI Announce Recovery Act Funding Opportunities; Recent New York Times Articles Highlight Cost of Cancer Drugs
Read the JCO Original Report "Adjuvant Therapy with the Monoclonal Antibody Edrecolomab Plus Fluorouracil-Based Therapy Does Not Improve Overall Survival of Patients With Stage III Colon Cancer”
ASCO Seeks Candidates for Upcoming JCO Editor-in-Chief Term
Cancer.Net Feature: Finding a Support Buddy
Cancer.Net Feature: Multigated Acquisition (MUGA) Scan—What to Expect
Special Cancer.Net Podcast: Planet Cancer, with Heidi Adams
JUST RELEASED! Practical Tips for the Oncology Practice
****ASH NEWS****
Take advantage of your last chance to register for the ASH webinar "PQRI and E-Prescribing: Nuts and Bolts" which takes place tomorrow, Tuesday, April 28th, 2009 from 5:00 p.m. – 6:15 p.m. Eastern Time. This webinar will focus on the basics of how to report the 2009 hematology-related Physician Quality Reporting Initiative measures and how to complete the E-Prescribing measure. It will help ensure that you follow the correct steps and receive the bonus for successful reporting.
Sylvia Publ, CMS Senior Quality Advisor, will discuss the basics of how to satisfactorily report the 2009 PQRI quality measures and to participate in the E-Prescribing program. Afterwards, there will be an opportunity to ask questions.
The webinar focuses on assisting hematologists as well as their office staff, and should help ensure that hematologists report appropriately and receive the incentive bonus. Please contact Matt Eckel at grassroots@hematology.org to sign up for this webinar.
To learn more about the PQRI program, visit the CMS PQRI Page and the ASH Web site. To learn more about the E-Prescribing program, visit the CMS Web site.
Be sure to register before April 28.
****INSTITUTIONAL MEMBER NEWS****
The following information is provided by Dr. Colevas at Stanford.
Two new clinical trials have opened and seek patients.
1. A clinical trial of XL184 , a c-MET and VEGF inhibitor in Subjects With Unresectable, Locally Advanced, or Metastatic Medullary Thyroid Cancer.
Stanford Cancer Center is the only Northern California site for this trial.
Contact: A. Dimitrios Colevas MD or Ruth Lira at (650) 724-9707.
2 A Phase 2 Study of Docetaxel, Cisplatin, Fluorouracil, Bevacizumab, and Radiation Therapy for Patients With Advanced Nasopharyngeal Carcinoma (NPC).
This trial is building upon the backbone of INT 0099 and RTOG 0615. New components to the treatment plan include the use of induction rather than adjuvant chemotherapy, adding docetaxel and research hypoxia imaging.
Contact: A. Dimitrios Colevas MD or Ruth Lira at (650) 724 9707.
Sunday, April 26, 2009
ASH, CMS, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/04232009.cfm#1. This edition features:
ASH Webinar on PQRI Reporting - April 28
ASH Urges Physician Payment Reform
ASH Launches Patient Advocacy Campaign to Increase Federal Funding for Biomedical Research
Medicare Updates Online PQRI Participant Information
Medicare Releases Notice Regarding Medically Unlikely Edit Denials
AMA Guidance Available on Red Flags Rule for Physicians
****CMS NEWS****
CMS is pleased to announce that two (2) new section pages have been created on the 2009 Electronic Prescribing (E-Prescribing) Incentive Program web page on the CMS website.
E-Prescribing Measure Section page - This page contains several resources including: Measure Specifications; new Claims-Based Reporting Principles and a Sample E-Prescribing Claim. To access these resources, visit http://www.cms.hhs.gov/ERxIncentive/06_E-Prescribing_Measure.asp on the CMS website.
Educational Resources Section Page – This page contains MLN Matters articles; E-Prescribing Incentive Program fact sheets; a link to Medicare’s Practical Guide to the E-Prescribing Incentive Program, and information on how to receive continuing education credit related to the E-Prescribing Incentive Program. To access these resources and information, visit http://www.cms.hhs.gov/ERxIncentive/09_Educational_Resources.asp on the CMS website.
New and updated information will continually be added, so please visit the E-Prescribing Incentive Program web page at http://www.cms.hhs.gov/ERXIncentive on the CMS website on a frequent basis.
****PALMETTO/J1MAC NEWS****
Incorporation of Physician Fee Schedule Regulatory Changes into Chapter 10
of the Program Integrity Manual (PIM) revised
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~General~Incorporation%20of%20Physician%20Fee%20Schedule%20Regulatory%20Changes%20into%20Chapter%2010%20of%20the%20Program%20Integrity%20Manual%20(PIM)%20revised?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758A005FE2CF?opendocument
CR6310 incorporates changes to the physician fee schedule into Chapter 10
of the Program Integrity Manual (PIM). This article was revised on April
16, 2009.
****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/04232009.cfm#1. This edition features:
ASH Webinar on PQRI Reporting - April 28
ASH Urges Physician Payment Reform
ASH Launches Patient Advocacy Campaign to Increase Federal Funding for Biomedical Research
Medicare Updates Online PQRI Participant Information
Medicare Releases Notice Regarding Medically Unlikely Edit Denials
AMA Guidance Available on Red Flags Rule for Physicians
****CMS NEWS****
CMS is pleased to announce that two (2) new section pages have been created on the 2009 Electronic Prescribing (E-Prescribing) Incentive Program web page on the CMS website.
E-Prescribing Measure Section page - This page contains several resources including: Measure Specifications; new Claims-Based Reporting Principles and a Sample E-Prescribing Claim. To access these resources, visit http://www.cms.hhs.gov/ERxIncentive/06_E-Prescribing_Measure.asp on the CMS website.
Educational Resources Section Page – This page contains MLN Matters articles; E-Prescribing Incentive Program fact sheets; a link to Medicare’s Practical Guide to the E-Prescribing Incentive Program, and information on how to receive continuing education credit related to the E-Prescribing Incentive Program. To access these resources and information, visit http://www.cms.hhs.gov/ERxIncentive/09_Educational_Resources.asp on the CMS website.
New and updated information will continually be added, so please visit the E-Prescribing Incentive Program web page at http://www.cms.hhs.gov/ERXIncentive on the CMS website on a frequent basis.
****PALMETTO/J1MAC NEWS****
Incorporation of Physician Fee Schedule Regulatory Changes into Chapter 10
of the Program Integrity Manual (PIM) revised
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~General~Incorporation%20of%20Physician%20Fee%20Schedule%20Regulatory%20Changes%20into%20Chapter%2010%20of%20the%20Program%20Integrity%20Manual%20(PIM)%20revised?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758A005FE2CF?opendocument
CR6310 incorporates changes to the physician fee schedule into Chapter 10
of the Program Integrity Manual (PIM). This article was revised on April
16, 2009.
Wednesday, April 22, 2009
ASCO & Palmetto/J1MAC News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe5b15797264047b7d11&m=ff311d707460&ls=fdf8137271640478771d727d&l=fe62157570620c7d7615&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2916727d6d027d701270. ANCO is a state/regional affiliate of ASCO. This edition features.
Recent New York Times Articles Highlight Cost of Cancer Drugs
NIH and NCI Announce Recovery Act Funding Opportunities
President Obama Establishes the White House Office of Health Reform
CMS Clarifies Use of Advance Beneficiary Notice with Medically Unlikely Edits
FDA Reverses Action to Pull Unapproved Liquid Morphine Off Market
NIH Issues Draft Guidelines for Human Stem Cell Research
Coming Soon: ASCO Express
New Edition of Practical Tips for the Oncology Practice - JUST RELEASED!
Join ASCO's Advocacy Network
ASCO Extends Resources to Practice Administrators
****PALMETTO/J1MAC NEWS****
Revised: J1 Part B Local Coverage Determinations (LCDs)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Coverage~Medical%20Policies~Revised%20J1%20Part%20B%20Local%20Coverage%20Determinations%20(LCDs)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525759F005D1826?opendocument
Share with your staff - The following Part B Local Coverage Determinations
(LCDs) have been revised: Category III CPT Codes, External Counterpulsation
(ECP) and Physical Medicine and Rehabilitation Policy.
CMS to Host Sessions on the Recovery Audit Contractor Program in May
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201~CMS%20to%20Host%20Sessions%20on%20the%20Recovery%20Audit%20Contractor%20Program%20in%20May?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525759E005CBD75?opendocument
The Centers for Medicare & Medicaid Services (CMS) is offering several
informational sessions on the Recovery Audit Contractor (RAC) program in
San Francisco and Los Angeles in May.
Filing Requirements for Providers Responding to Additional Documentation
Requests (ADR)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~Filing%20Requirements%20for%20Providers%20Responding%20to%20Additional%20Documentation%20Requests%20(ADR)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525759E0067ABA8?opendocument
When responding to a medical record request or Additional Documentation
Requests (ADR) from Palmetto GBA, providers are now required to submit a
copy of each ADR request accompanying each set of medical record, insert an
ADR Separator Sheet and use rubber bands and/or clips to distinctly
separate different medical records.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe5b15797264047b7d11&m=ff311d707460&ls=fdf8137271640478771d727d&l=fe62157570620c7d7615&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2916727d6d027d701270. ANCO is a state/regional affiliate of ASCO. This edition features.
Recent New York Times Articles Highlight Cost of Cancer Drugs
NIH and NCI Announce Recovery Act Funding Opportunities
President Obama Establishes the White House Office of Health Reform
CMS Clarifies Use of Advance Beneficiary Notice with Medically Unlikely Edits
FDA Reverses Action to Pull Unapproved Liquid Morphine Off Market
NIH Issues Draft Guidelines for Human Stem Cell Research
Coming Soon: ASCO Express
New Edition of Practical Tips for the Oncology Practice - JUST RELEASED!
Join ASCO's Advocacy Network
ASCO Extends Resources to Practice Administrators
****PALMETTO/J1MAC NEWS****
Revised: J1 Part B Local Coverage Determinations (LCDs)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Coverage~Medical%20Policies~Revised%20J1%20Part%20B%20Local%20Coverage%20Determinations%20(LCDs)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525759F005D1826?opendocument
Share with your staff - The following Part B Local Coverage Determinations
(LCDs) have been revised: Category III CPT Codes, External Counterpulsation
(ECP) and Physical Medicine and Rehabilitation Policy.
CMS to Host Sessions on the Recovery Audit Contractor Program in May
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201~CMS%20to%20Host%20Sessions%20on%20the%20Recovery%20Audit%20Contractor%20Program%20in%20May?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525759E005CBD75?opendocument
The Centers for Medicare & Medicaid Services (CMS) is offering several
informational sessions on the Recovery Audit Contractor (RAC) program in
San Francisco and Los Angeles in May.
Filing Requirements for Providers Responding to Additional Documentation
Requests (ADR)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~Filing%20Requirements%20for%20Providers%20Responding%20to%20Additional%20Documentation%20Requests%20(ADR)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525759E0067ABA8?opendocument
When responding to a medical record request or Additional Documentation
Requests (ADR) from Palmetto GBA, providers are now required to submit a
copy of each ADR request accompanying each set of medical record, insert an
ADR Separator Sheet and use rubber bands and/or clips to distinctly
separate different medical records.
Monday, April 20, 2009
ACCC, ASCO, CMA, CMS, Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_4-20-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
CMS Attempts to Clarify RAC Review Process of Provider Claims
Medicare Legislation: Nursing Time and Educating Cancer Patients
Cincinnati Get Ready: ACCC's Symposium Is May 6
Ovarian Cancer Screening Resulted in Many Unnecessary Surgeries
Tomorrow's the Deadline to Apply for ACCC's Prostate Cancer Care Project
Q&A on ACCC's Listserv: Chemo Double-Checks
ACCC's CE Blackboard: A Full Range of Courses to Choose
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider was published and available online at http://view.exacttarget.com/?j=fe6115797365007d741c&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe251672726d0d7f731772. ANCO is a state/regional affiliate of ASCO. This edition features:
1. Informed Consent for Chemotherapy Administration
2. ASCO Annual Meeting Program Announcement
3. AMA Announces Physician Class Action Against WellPoint/Anthem
4. NCCN Compendium
5. Availability of Internet-Based PECOS
6. Medicare Expands Coverage of PET Scans
7. ASP Drug Pricing Files April 2009 Update
8. From the practice manager's desk...
9. CORRECTION: AMA Resource: "Internal collections in the physician practice
10. Billing and Coding Q&A
The American Society of Clinical Oncology's (ASCO) e-news was published and is available online at http://view.exacttarget.com/?j=fe5a1579736407757613&m=ff2d16787160&ls=fde91374706d077d7c1c717d&l=fe6915757264077d7617&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe231672726c0378711776. ANCO is a state/regional affiliate of ASCO. This edition features:
Abstract Submitter Now Open for the 2009 Breast Cancer Symposium
View the 2007-2008 ASCO Annual Report
ASCO Urges House Members to Co-sponsor ASP Legislation; Reps. Capps and Boustany Introduce the Comprehensive Cancer Care Improvement Act of 2009; ASCO Sends IOM Comparative Effectiveness Research Priorities
Don't Miss Out on the 2009 Annual Meeting in Orlando
ASCO Seeks Candidates for Upcoming JCO Editor-in-Chief Term
ASCO is All a-Twitter!
Interact with Colleagues on OncologyEHR
2009 ASCO Special Awards Recognize Society Leaders
Read the JCO Original Report "FOXP3 Expression and Overall Survival in Breast Cancer"
ASCO Publishes 5th Edition of Practical Tips
Virtual Meeting, Podcast Access Available from the 2009 GU Cancers Symposium
View, Purchase Electronic Resources from the 2009 GI Cancers Symposium
For Your Patients
Cancer.Net Feature: Patient Navigation: Getting Help With Cancer Care
ASCO Expert Corner: Talking With the Doctor About PSA Screening
Reminders
Early Registration Rates for the 2009 ASCO Annual Meeting End April 24
Apply for the June 17-19 Accelerating Anticancer Agent Development and Validation Workshop
Register and Reserve Housing for the Best of ASCO® Meetings in Los Angeles and Atlanta
Deadline for Active and Emeritus Members to Vote on the ASCO Bylaws is May 18
****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:
Medical Board Changes Licensing Fees for Physicians
CMA Publishes Red Flag Rule Toolkit for Members Only
State Supreme Court Sides with CMA in Peer Review Case
Highlights from CMA's Annual “Doctor Day” in Sacramento
Sign Up for CMA's Legislative Hot List
CMA Webinar: Best Practices – Improving the Efficiency and Quality of Your Practice
Earn 17.75 Hours of CME at CMA's Health Care Leadership Academy
Family PACT Waiver Extended through September 30, 2009
Federal Officials Vow to Raise Medicare Reimbursement Rates in Several of California’s High-Cost Counties
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) will be offering several informational sessions on the Recovery Audit Contractor (RAC) Program. Presenting with CMS will be the RAC for California, HealthDataInsights, Inc. These sessions will take place at the CMS San Francisco Regional Office located at 90 7th Street in San Francisco, California.
On May 4, 2009, CMS will offer two sessions each with a capacity for 200 participants: one at 9:30 AM to 12:30 PM (PDT) and again at 2:00 PM to 5:00 PM (PDT).
On May 5, 2009, CMS will host an additional informational session from 9:30 AM to 12:30 PM (PDT) with a capacity of 90 participants.
The program will provide California hospitals, SNF’s, Rehabilitation Facilities, Home Health Agencies, DME Suppliers, and physicians with an opportunity to ask CMS officials and HealthDataInsights, Inc. questions regarding the RAC program. Space is limited to attend this program so register early for a session utilizing the following link:
http://www.cms.hhs.gov/apps/events/upcomingevents.asp?strOrderBy=1&type=3.
On May 11, 2009, the California Hospital Association (CHA) will host two additional informational sessions in the Los Angeles area. These sessions will be held at the Good Samaritan Hospital located at 1225 Wilshire Blvd., Los Angeles, CA 90017-1901. The first session is at 9:30 AM to 12:30 PM (PDT) and the second session is at 2:00 PM to 5:00 PM. (PDT). Registration will be handled by CHA. Further registration instructions will be sent by CHA to their members.
PLEASE NOTE THAT ALL OF THESE SESSIONS WILL CONTAIN THE SAME CONTENT; THEREFORE, YOU NEED ONLY REGISTER FOR ONE SESSION.
The permanent RAC Program was instituted as a result of Section 302 of the Tax Relief and Health Care Act of 2006 and requires the Secretary to expand the program to all 50 states by no later than January 1, 2010. The RACs are tasked with identifying improper payments paid on Medicare fee-for-service claims. Read the text of this legislation by going to Tax Relief and Health Care Act of 2006, Section 302 [pdf, 29kb].
If you have any questions please e-mail them to RAC@cms.hhs.gov
Please stay tuned for future Region D RAC Provider Outreach conferences in your area!
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the availability of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) and the implementation of regulatory provisions. During this call CMS staff will discuss the:
· Internet-based PECOS for physicians, non-physician practitioners and provider and supplier organizations
· Provider and supplier reporting responsibilities
· Final Adverse Actions
· Change of Practice Locations
· Change of Ownership
· Other Reportable Events
· Effective date of Medicare billing privileges and retrospective billing for physicians, certain non-physician practitioners, and physician and non-physician practitioner organizations
· Revalidation Efforts
Afterwards, there will be an opportunity for the public to ask questions.
We look forward to your participation.
Open Door Forum Instructions:
**Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.**
Dial: 1-800-837-1935
Reference Conference ID 94109369
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html. A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning Monday May 11, 2009 and available for 30 days.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at: http://www.cms.hhs.gov/OpenDoorForums/
MM6400 – Hospice Cap Calculations Letters and Administrative Appeals
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6400.pdf
MM6310 – Billing Routine Costs of Clinical Trials
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6310.pdf
Providers may now register for the Centers for Medicare & Medicaid Services’ ICD-10-CM/PCS Implementation and General Equivalence Mappings (Crosswalks) National Provider Conference Call that will be conducted on May 19, 2009 from 1:00 p.m. – 2:30 p.m. Eastern Daylight Time.
This conference call will include a discussion of the following topics:
· An overview of the ICD-10 final rule, which requires the implementation of ICD-10-CM/PCS on October 1, 2013;
· The differences between ICD-9-CM and ICD-10-CM/PCS codes;
· The use of the General Equivalence Mappings that have been created to assist in converting policies, edits, and trend data from ICD-9-CM to ICD-10-CM/PCS; and
· The resources that are available to assist in planning for the transition from ICD-9-CM to ICD-10-CM/PCS.
Conference call discussion materials and registration information can be accessed at http://www.cms.hhs.gov/ICD10/07a_2009_CMS_Sponsored_Calls.asp .
****PALMETTO/J1MAC NEWS****
Medicare Remit EasyPrint (MREP) Software for J1 Part B
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~Software%20Manuals~Medicare%20Remit%20EasyPrint%20(MREP)%20Software%20for%20J1%20Part%20B?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852574B800674EB2?opendocument
Medicare Remit EasyPrint (MREP) version 2.6 is available for download. You
can save time and money by taking advantage of FREE Medicare Remit
EasyPrint software now available to view and print the HIPAA compliant 835!
Please visit our Web site at www.palmettogba.com for downloading and
researching the MREP changes for the 2.6 Version.
CMS Notice of New Interest Rate for Medicare Overpayments and
Underpayments: 3rd Notification for FY 2009
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~CMS%20Notice%20of%20New%20Interest%20Rate%20for%20Medicare%20Overpayments%20and%20Underpayments%203rd%20Notification%20for%20FY%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257597006F6AF7?opendocument
This Change Request (CR) 6240, provides the quarterly update of the 2009
interest rate for Medicare overpayments and underpayments.
Drugs & Biologicals: Maximum Allowed Units (MAUs)
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Ohio%20Part%20B%20Carrier~Articles~Drugs%20Biologicals~Drugs%20Biologicals%20Maximum%20Allowed%20Units%20(MAUs)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525750B007275E3?opendocument
Palmetto GBA has implemented automated system edits for all HCPCS drug
codes. These edits are designed to reduce entry and math errors, not to
limit utilization. Drugs and biologicals submitted with quantities that
exceed the Palmetto GBA established maximum limits will be denied unless
additional supporting documentation is submitted for consideration. We
encourage you to refer to the attached MAU Table before submitting claims
to Palmetto GBA.
Directory of Participating Physicians and Suppliers Now Available
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~MEDPARD~Directory%20of%20Participating%20Physicians%20and%20Suppliers%20Now%20Available?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257597005DBE6C?opendocument
You can now find a directory of the physicians and suppliers who
participate in Jurisdiction 1 Part B Medicare on the Palmetto GBA Web site.
You can search for participating physicians by county or by zip code.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_4-20-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
CMS Attempts to Clarify RAC Review Process of Provider Claims
Medicare Legislation: Nursing Time and Educating Cancer Patients
Cincinnati Get Ready: ACCC's Symposium Is May 6
Ovarian Cancer Screening Resulted in Many Unnecessary Surgeries
Tomorrow's the Deadline to Apply for ACCC's Prostate Cancer Care Project
Q&A on ACCC's Listserv: Chemo Double-Checks
ACCC's CE Blackboard: A Full Range of Courses to Choose
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider was published and available online at http://view.exacttarget.com/?j=fe6115797365007d741c&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe251672726d0d7f731772. ANCO is a state/regional affiliate of ASCO. This edition features:
1. Informed Consent for Chemotherapy Administration
2. ASCO Annual Meeting Program Announcement
3. AMA Announces Physician Class Action Against WellPoint/Anthem
4. NCCN Compendium
5. Availability of Internet-Based PECOS
6. Medicare Expands Coverage of PET Scans
7. ASP Drug Pricing Files April 2009 Update
8. From the practice manager's desk...
9. CORRECTION: AMA Resource: "Internal collections in the physician practice
10. Billing and Coding Q&A
The American Society of Clinical Oncology's (ASCO) e-news was published and is available online at http://view.exacttarget.com/?j=fe5a1579736407757613&m=ff2d16787160&ls=fde91374706d077d7c1c717d&l=fe6915757264077d7617&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe231672726c0378711776. ANCO is a state/regional affiliate of ASCO. This edition features:
Abstract Submitter Now Open for the 2009 Breast Cancer Symposium
View the 2007-2008 ASCO Annual Report
ASCO Urges House Members to Co-sponsor ASP Legislation; Reps. Capps and Boustany Introduce the Comprehensive Cancer Care Improvement Act of 2009; ASCO Sends IOM Comparative Effectiveness Research Priorities
Don't Miss Out on the 2009 Annual Meeting in Orlando
ASCO Seeks Candidates for Upcoming JCO Editor-in-Chief Term
ASCO is All a-Twitter!
Interact with Colleagues on OncologyEHR
2009 ASCO Special Awards Recognize Society Leaders
Read the JCO Original Report "FOXP3 Expression and Overall Survival in Breast Cancer"
ASCO Publishes 5th Edition of Practical Tips
Virtual Meeting, Podcast Access Available from the 2009 GU Cancers Symposium
View, Purchase Electronic Resources from the 2009 GI Cancers Symposium
For Your Patients
Cancer.Net Feature: Patient Navigation: Getting Help With Cancer Care
ASCO Expert Corner: Talking With the Doctor About PSA Screening
Reminders
Early Registration Rates for the 2009 ASCO Annual Meeting End April 24
Apply for the June 17-19 Accelerating Anticancer Agent Development and Validation Workshop
Register and Reserve Housing for the Best of ASCO® Meetings in Los Angeles and Atlanta
Deadline for Active and Emeritus Members to Vote on the ASCO Bylaws is May 18
****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:
Medical Board Changes Licensing Fees for Physicians
CMA Publishes Red Flag Rule Toolkit for Members Only
State Supreme Court Sides with CMA in Peer Review Case
Highlights from CMA's Annual “Doctor Day” in Sacramento
Sign Up for CMA's Legislative Hot List
CMA Webinar: Best Practices – Improving the Efficiency and Quality of Your Practice
Earn 17.75 Hours of CME at CMA's Health Care Leadership Academy
Family PACT Waiver Extended through September 30, 2009
Federal Officials Vow to Raise Medicare Reimbursement Rates in Several of California’s High-Cost Counties
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) will be offering several informational sessions on the Recovery Audit Contractor (RAC) Program. Presenting with CMS will be the RAC for California, HealthDataInsights, Inc. These sessions will take place at the CMS San Francisco Regional Office located at 90 7th Street in San Francisco, California.
On May 4, 2009, CMS will offer two sessions each with a capacity for 200 participants: one at 9:30 AM to 12:30 PM (PDT) and again at 2:00 PM to 5:00 PM (PDT).
On May 5, 2009, CMS will host an additional informational session from 9:30 AM to 12:30 PM (PDT) with a capacity of 90 participants.
The program will provide California hospitals, SNF’s, Rehabilitation Facilities, Home Health Agencies, DME Suppliers, and physicians with an opportunity to ask CMS officials and HealthDataInsights, Inc. questions regarding the RAC program. Space is limited to attend this program so register early for a session utilizing the following link:
http://www.cms.hhs.gov/apps/events/upcomingevents.asp?strOrderBy=1&type=3.
On May 11, 2009, the California Hospital Association (CHA) will host two additional informational sessions in the Los Angeles area. These sessions will be held at the Good Samaritan Hospital located at 1225 Wilshire Blvd., Los Angeles, CA 90017-1901. The first session is at 9:30 AM to 12:30 PM (PDT) and the second session is at 2:00 PM to 5:00 PM. (PDT). Registration will be handled by CHA. Further registration instructions will be sent by CHA to their members.
PLEASE NOTE THAT ALL OF THESE SESSIONS WILL CONTAIN THE SAME CONTENT; THEREFORE, YOU NEED ONLY REGISTER FOR ONE SESSION.
The permanent RAC Program was instituted as a result of Section 302 of the Tax Relief and Health Care Act of 2006 and requires the Secretary to expand the program to all 50 states by no later than January 1, 2010. The RACs are tasked with identifying improper payments paid on Medicare fee-for-service claims. Read the text of this legislation by going to Tax Relief and Health Care Act of 2006, Section 302 [pdf, 29kb].
If you have any questions please e-mail them to RAC@cms.hhs.gov
Please stay tuned for future Region D RAC Provider Outreach conferences in your area!
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the availability of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) and the implementation of regulatory provisions. During this call CMS staff will discuss the:
· Internet-based PECOS for physicians, non-physician practitioners and provider and supplier organizations
· Provider and supplier reporting responsibilities
· Final Adverse Actions
· Change of Practice Locations
· Change of Ownership
· Other Reportable Events
· Effective date of Medicare billing privileges and retrospective billing for physicians, certain non-physician practitioners, and physician and non-physician practitioner organizations
· Revalidation Efforts
Afterwards, there will be an opportunity for the public to ask questions.
We look forward to your participation.
Open Door Forum Instructions:
**Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.**
Dial: 1-800-837-1935
Reference Conference ID 94109369
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html. A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning Monday May 11, 2009 and available for 30 days.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at: http://www.cms.hhs.gov/OpenDoorForums/
MM6400 – Hospice Cap Calculations Letters and Administrative Appeals
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6400.pdf
MM6310 – Billing Routine Costs of Clinical Trials
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6310.pdf
Providers may now register for the Centers for Medicare & Medicaid Services’ ICD-10-CM/PCS Implementation and General Equivalence Mappings (Crosswalks) National Provider Conference Call that will be conducted on May 19, 2009 from 1:00 p.m. – 2:30 p.m. Eastern Daylight Time.
This conference call will include a discussion of the following topics:
· An overview of the ICD-10 final rule, which requires the implementation of ICD-10-CM/PCS on October 1, 2013;
· The differences between ICD-9-CM and ICD-10-CM/PCS codes;
· The use of the General Equivalence Mappings that have been created to assist in converting policies, edits, and trend data from ICD-9-CM to ICD-10-CM/PCS; and
· The resources that are available to assist in planning for the transition from ICD-9-CM to ICD-10-CM/PCS.
Conference call discussion materials and registration information can be accessed at http://www.cms.hhs.gov/ICD10/07a_2009_CMS_Sponsored_Calls.asp .
****PALMETTO/J1MAC NEWS****
Medicare Remit EasyPrint (MREP) Software for J1 Part B
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~Software%20Manuals~Medicare%20Remit%20EasyPrint%20(MREP)%20Software%20for%20J1%20Part%20B?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852574B800674EB2?opendocument
Medicare Remit EasyPrint (MREP) version 2.6 is available for download. You
can save time and money by taking advantage of FREE Medicare Remit
EasyPrint software now available to view and print the HIPAA compliant 835!
Please visit our Web site at www.palmettogba.com for downloading and
researching the MREP changes for the 2.6 Version.
CMS Notice of New Interest Rate for Medicare Overpayments and
Underpayments: 3rd Notification for FY 2009
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~CMS%20Notice%20of%20New%20Interest%20Rate%20for%20Medicare%20Overpayments%20and%20Underpayments%203rd%20Notification%20for%20FY%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257597006F6AF7?opendocument
This Change Request (CR) 6240, provides the quarterly update of the 2009
interest rate for Medicare overpayments and underpayments.
Drugs & Biologicals: Maximum Allowed Units (MAUs)
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Ohio%20Part%20B%20Carrier~Articles~Drugs%20Biologicals~Drugs%20Biologicals%20Maximum%20Allowed%20Units%20(MAUs)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525750B007275E3?opendocument
Palmetto GBA has implemented automated system edits for all HCPCS drug
codes. These edits are designed to reduce entry and math errors, not to
limit utilization. Drugs and biologicals submitted with quantities that
exceed the Palmetto GBA established maximum limits will be denied unless
additional supporting documentation is submitted for consideration. We
encourage you to refer to the attached MAU Table before submitting claims
to Palmetto GBA.
Directory of Participating Physicians and Suppliers Now Available
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~MEDPARD~Directory%20of%20Participating%20Physicians%20and%20Suppliers%20Now%20Available?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257597005DBE6C?opendocument
You can now find a directory of the physicians and suppliers who
participate in Jurisdiction 1 Part B Medicare on the Palmetto GBA Web site.
You can search for participating physicians by county or by zip code.
Friday, April 10, 2009
ASH, CMS, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/04092009.cfm#1. This edition features:
Register Now: Join ASH Webinar on April 28 to Help Ensure You Receive PQRI and E-Prescribing Bonuses for Participation
ASH Works With NGS Regarding Coverage of Intravenous Palonosetron
CMS Open Door Call to Provide Information on Recovery Audit Contractor Program
ASH Urges Congress to Replace Current SGR Formula
Health-Care Reform Debate Continues in Washington
NQF Releases Updated Safe Practices for Better Healthcare
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination (NCD) to expand coverage for initial testing with positron emission tomography (PET) for Medicare beneficiaries who are diagnosed with and treated for most solid tumor cancers.
This NCD removes a clinical study requirement for PET scan use in these patients.
Since 2005, Medicare coverage of PET scans for diagnosing some forms of cancer and guiding treatment has been tied to a requirement that providers collect clinical information about how the scans have affected doctors’ treatment decisions. This information was gathered through the National Oncologic PET Registry (NOPR) observational study. Today’s decision removes the requirement to report data to the NOPR when the PET scan is used to support initial treatment (or diagnosis and “staging”) of most solid tumor cancers.
Medicare collects data from the NOPR under CMS’ Coverage with Evidence Development (CED) program. CED allows Medicare to develop evidence about how a medical technology is used in clinical practice so that Medicare can do the following:
(a) clarify the impact of these items and services on the health of Medicare beneficiaries;
(b) consider future changes in coverage for the technology; and
(c) generate clinical information that will improve the evidence base upon which providers base their recommendations to Medicare beneficiaries regarding the technology.
This decision is based, in part, on the information generated as a result of CMS’ 2005 decision to require NOPR reporting for many cancer PET scans. As a result of this evidence from NOPR, CMS reconsidered its 2005 coverage policy. This decision is the first time that CMS has reconsidered a coverage policy based on new evidence developed under the CED program.
“This expansion in coverage for PET scans shows that the Coverage with Evidence Development program is a success,” said CMS Acting Administrator Charlene Frizzera. “CED allowed us to cover an emerging technology, learn more about its usage in clinical practice, and adjust our coverage policies accordingly. Thanks to CED, Medicare beneficiaries have greater access to cutting edge medical technologies and treatments.”
This decision applies to PET scans used to support initial diagnosis and treatment for most types of solid tumor cancers. It also expands coverage of PET scans for subsequent follow up testing in beneficiaries who have cervical or ovarian cancer, or who are being treated for myeloma, a cancer that affects white blood cells. For these cancers, NOPR data collection will no longer be required.
It is important to note that today’s decision still requires clinicians to report data to the NOPR when using PET scans to monitor the progress of treatment or remission of cancer in some cases. Although the evidence generated by the NOPR study helped CMS determine that PET scans are useful in helping guide treatment when cancer is first diagnosed, scientific evidence is not as strong in showing that PET scans are as useful in making subsequent treatment decisions for some types of cancer.
A minimally invasive diagnostic imaging procedure, PET uses a radioactive tracer to evaluate glucose metabolism in tumors and in normal tissue. The test may provide important clinical information to guide the initial treatment approach (e.g., diagnosis and “staging”) for many cancers.
This additional information may help physicians to distinguish benign from cancerous lesions and better determine the extent of a tumor’s growth or metastasis. PET scans have also been used in subsequent testing for cancer patients, e.g., to monitor cancer progression or remission after cancer treatment has begun.
More information about the types of cancer covered by this new policy is available in CMS’ final decision memorandum. Read the final decision on the CMS Web site at http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=218.
Nearly $36 million in funding is being distributed to the 54 State Health Insurance Assistance Programs (SHIPs) to help people with Medicare get more information about their health care choices.
The $35.8 million in funding is the first installment of federal grant funds provided to SHIPs by the Centers for Medicare & Medicaid Services (CMS) for the grant year beginning April 1, 2009, and ending March 31, 2010. An additional $1.5 million in performance-based funding will be awarded in September 2009. SHIPs are state-based programs that use community-based networks to provide Medicare beneficiaries with local, personalized assistance on a wide variety of Medicare and health insurance topics.
“State Health Insurance Assistance Programs serve an important role in providing information and support to people with Medicare where they live,” said CMS Acting Administrator Charlene Frizzera. “These funds help ensure SHIPs continue their work with state and local governments, community-based organizations and others to meet the needs, beyond health care, of our Medicare beneficiaries.”
CMS expects the SHIPs to use the 2009 funding to conduct targeted community-based outreach to people with Medicare who may be unable to access other sources of information. SHIPs will also provide outreach and assistance to current and newly eligible Medicare beneficiaries and their caregivers, with a special emphasis on reaching people who will most likely be eligible for Medicare’s low-income subsidy if they enroll in Medicare prescription drug coverage.
CMS will continue to support the quality of services provided by SHIPs through training, technical assistance, theSHIP Resource Center, and the online tools at www.medicare.gov to help people with Medicare.
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the 2009 Data Submission Specifications for use in the 2009 PQRI Electronic Health Record (EHR) test are now posted on the QualityNet website.
As described in the Medicare Physician Fee Schedule (PFS) 2009 Final Rule, CMS is testing EHR data submission in cooperation with electronic health record vendors. These vendors were selected from those who self-nominated per a process described in the 2008 final PFS rule. The 2009 testing process will be similar to the testing process used for 2008. EHR vendors that are successful with the 2009 testing process will be "qualified" for possible PQRI data submission via EHRs if this means of data submission is used in a future PQRI reporting year. There is no incentive payment available through EHR-based data submission for 2009.
The Measure Specifications for the 2009 EHR test measures are also available on the QualityNet website by clicking on "PQRI" from the dropdown menu under the "Physician Offices" tab; then, click on the EHR Specifications link from the left navigation bar. The following link will take you to the QualityNet website on the internet: http://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1214232460333
A link to the QualityNet website is also available at http://www.cms.hhs.gov/PQRI on the CMS PQRI website under the “Related Links Outside CMS” tab. Additional information related to the EHR test is also available on the CMS PQRI website under the “Reporting” and “Measures/Codes” sections listed in the left navigation bar.
Detailed information on the 2009 PQRI program requirements may be found in the final 2009 Medicare PFS rule with comment period that was published in the Federal Register on November 19, 2008. A copy of the final rule with comment period is on display at the Federal Register and can be viewed at http://edocket.access.gpo.gov/2008/pdf/E8-14949.pdf on the internet. Additionally, the CMS PQRI web page http://www.cms.hhs.gov/PQRI on the CMS website is the primary resource for FAQs, helpful tools, and information on the PQRI program.
-----------------------------------------------------------------------------------------------------------------------------------------------
2009 Physician Quality Reporting Initiative
National Provider Call with Question & Answer Session
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host fourth in a series national provider conference calls 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 Wednesday, April 22, 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:
An update on the prostate cancer measures-2008: Measure #101; 2008-2009: Measure #102, #104, and #105;
An update on Medicare enrollment;
Tips for satisfactorily participating in the 2009 PQRI; and
Planning for the 2010 PQRI reporting options.
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. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: April 22, 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. If you cannot attend the call, replay information is available below.
Registration will close at 2:30 p.m. EDT on April 21, 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/042209
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 replay option will be available shortly following the end of the call. This replay will be accessible from 3:30 p.m. EDT 4/22/2009 until 11:59 p.m. EDT 4/29/2009. The call in data for the replay is (800) 642-1687 and the passcode is 90578004.
If you require services for the hearing impaired please send an email to: Medicare.TTT@PalmettoGBA.com.
****PALMETTO/J1MAC NEWS****
Incorporation of Physician Fee Schedule Regulatory Changes into Chapter 10
of the Program Integrity Manual (PIM) revised
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~General~Incorporation%20of%20Physician%20Fee%20Schedule%20Regulatory%20Changes%20into%20Chapter%2010%20of%20the%20Program%20Integrity%20Manual%20(PIM)%20revised?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758A005FE2CF?opendocument
CR6310b deletes the reference to electronic funds tranfer payments being
made only to a banking institution located in the state where the practice
is located. The original change request incorporates changes to the
physician fee schedule into Chapter 10 of the Program Integrity Manual
(PIM).
****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/04092009.cfm#1. This edition features:
Register Now: Join ASH Webinar on April 28 to Help Ensure You Receive PQRI and E-Prescribing Bonuses for Participation
ASH Works With NGS Regarding Coverage of Intravenous Palonosetron
CMS Open Door Call to Provide Information on Recovery Audit Contractor Program
ASH Urges Congress to Replace Current SGR Formula
Health-Care Reform Debate Continues in Washington
NQF Releases Updated Safe Practices for Better Healthcare
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination (NCD) to expand coverage for initial testing with positron emission tomography (PET) for Medicare beneficiaries who are diagnosed with and treated for most solid tumor cancers.
This NCD removes a clinical study requirement for PET scan use in these patients.
Since 2005, Medicare coverage of PET scans for diagnosing some forms of cancer and guiding treatment has been tied to a requirement that providers collect clinical information about how the scans have affected doctors’ treatment decisions. This information was gathered through the National Oncologic PET Registry (NOPR) observational study. Today’s decision removes the requirement to report data to the NOPR when the PET scan is used to support initial treatment (or diagnosis and “staging”) of most solid tumor cancers.
Medicare collects data from the NOPR under CMS’ Coverage with Evidence Development (CED) program. CED allows Medicare to develop evidence about how a medical technology is used in clinical practice so that Medicare can do the following:
(a) clarify the impact of these items and services on the health of Medicare beneficiaries;
(b) consider future changes in coverage for the technology; and
(c) generate clinical information that will improve the evidence base upon which providers base their recommendations to Medicare beneficiaries regarding the technology.
This decision is based, in part, on the information generated as a result of CMS’ 2005 decision to require NOPR reporting for many cancer PET scans. As a result of this evidence from NOPR, CMS reconsidered its 2005 coverage policy. This decision is the first time that CMS has reconsidered a coverage policy based on new evidence developed under the CED program.
“This expansion in coverage for PET scans shows that the Coverage with Evidence Development program is a success,” said CMS Acting Administrator Charlene Frizzera. “CED allowed us to cover an emerging technology, learn more about its usage in clinical practice, and adjust our coverage policies accordingly. Thanks to CED, Medicare beneficiaries have greater access to cutting edge medical technologies and treatments.”
This decision applies to PET scans used to support initial diagnosis and treatment for most types of solid tumor cancers. It also expands coverage of PET scans for subsequent follow up testing in beneficiaries who have cervical or ovarian cancer, or who are being treated for myeloma, a cancer that affects white blood cells. For these cancers, NOPR data collection will no longer be required.
It is important to note that today’s decision still requires clinicians to report data to the NOPR when using PET scans to monitor the progress of treatment or remission of cancer in some cases. Although the evidence generated by the NOPR study helped CMS determine that PET scans are useful in helping guide treatment when cancer is first diagnosed, scientific evidence is not as strong in showing that PET scans are as useful in making subsequent treatment decisions for some types of cancer.
A minimally invasive diagnostic imaging procedure, PET uses a radioactive tracer to evaluate glucose metabolism in tumors and in normal tissue. The test may provide important clinical information to guide the initial treatment approach (e.g., diagnosis and “staging”) for many cancers.
This additional information may help physicians to distinguish benign from cancerous lesions and better determine the extent of a tumor’s growth or metastasis. PET scans have also been used in subsequent testing for cancer patients, e.g., to monitor cancer progression or remission after cancer treatment has begun.
More information about the types of cancer covered by this new policy is available in CMS’ final decision memorandum. Read the final decision on the CMS Web site at http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=218.
Nearly $36 million in funding is being distributed to the 54 State Health Insurance Assistance Programs (SHIPs) to help people with Medicare get more information about their health care choices.
The $35.8 million in funding is the first installment of federal grant funds provided to SHIPs by the Centers for Medicare & Medicaid Services (CMS) for the grant year beginning April 1, 2009, and ending March 31, 2010. An additional $1.5 million in performance-based funding will be awarded in September 2009. SHIPs are state-based programs that use community-based networks to provide Medicare beneficiaries with local, personalized assistance on a wide variety of Medicare and health insurance topics.
“State Health Insurance Assistance Programs serve an important role in providing information and support to people with Medicare where they live,” said CMS Acting Administrator Charlene Frizzera. “These funds help ensure SHIPs continue their work with state and local governments, community-based organizations and others to meet the needs, beyond health care, of our Medicare beneficiaries.”
CMS expects the SHIPs to use the 2009 funding to conduct targeted community-based outreach to people with Medicare who may be unable to access other sources of information. SHIPs will also provide outreach and assistance to current and newly eligible Medicare beneficiaries and their caregivers, with a special emphasis on reaching people who will most likely be eligible for Medicare’s low-income subsidy if they enroll in Medicare prescription drug coverage.
CMS will continue to support the quality of services provided by SHIPs through training, technical assistance, theSHIP Resource Center, and the online tools at www.medicare.gov to help people with Medicare.
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the 2009 Data Submission Specifications for use in the 2009 PQRI Electronic Health Record (EHR) test are now posted on the QualityNet website.
As described in the Medicare Physician Fee Schedule (PFS) 2009 Final Rule, CMS is testing EHR data submission in cooperation with electronic health record vendors. These vendors were selected from those who self-nominated per a process described in the 2008 final PFS rule. The 2009 testing process will be similar to the testing process used for 2008. EHR vendors that are successful with the 2009 testing process will be "qualified" for possible PQRI data submission via EHRs if this means of data submission is used in a future PQRI reporting year. There is no incentive payment available through EHR-based data submission for 2009.
The Measure Specifications for the 2009 EHR test measures are also available on the QualityNet website by clicking on "PQRI" from the dropdown menu under the "Physician Offices" tab; then, click on the EHR Specifications link from the left navigation bar. The following link will take you to the QualityNet website on the internet: http://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier3&cid=1214232460333
A link to the QualityNet website is also available at http://www.cms.hhs.gov/PQRI on the CMS PQRI website under the “Related Links Outside CMS” tab. Additional information related to the EHR test is also available on the CMS PQRI website under the “Reporting” and “Measures/Codes” sections listed in the left navigation bar.
Detailed information on the 2009 PQRI program requirements may be found in the final 2009 Medicare PFS rule with comment period that was published in the Federal Register on November 19, 2008. A copy of the final rule with comment period is on display at the Federal Register and can be viewed at http://edocket.access.gpo.gov/2008/pdf/E8-14949.pdf on the internet. Additionally, the CMS PQRI web page http://www.cms.hhs.gov/PQRI on the CMS website is the primary resource for FAQs, helpful tools, and information on the PQRI program.
-----------------------------------------------------------------------------------------------------------------------------------------------
2009 Physician Quality Reporting Initiative
National Provider Call with Question & Answer Session
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host fourth in a series national provider conference calls 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 Wednesday, April 22, 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:
An update on the prostate cancer measures-2008: Measure #101; 2008-2009: Measure #102, #104, and #105;
An update on Medicare enrollment;
Tips for satisfactorily participating in the 2009 PQRI; and
Planning for the 2010 PQRI reporting options.
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. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: April 22, 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. If you cannot attend the call, replay information is available below.
Registration will close at 2:30 p.m. EDT on April 21, 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/042209
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 replay option will be available shortly following the end of the call. This replay will be accessible from 3:30 p.m. EDT 4/22/2009 until 11:59 p.m. EDT 4/29/2009. The call in data for the replay is (800) 642-1687 and the passcode is 90578004.
If you require services for the hearing impaired please send an email to: Medicare.TTT@PalmettoGBA.com.
****PALMETTO/J1MAC NEWS****
Incorporation of Physician Fee Schedule Regulatory Changes into Chapter 10
of the Program Integrity Manual (PIM) revised
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~General~Incorporation%20of%20Physician%20Fee%20Schedule%20Regulatory%20Changes%20into%20Chapter%2010%20of%20the%20Program%20Integrity%20Manual%20(PIM)%20revised?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758A005FE2CF?opendocument
CR6310b deletes the reference to electronic funds tranfer payments being
made only to a banking institution located in the state where the practice
is located. The original change request incorporates changes to the
physician fee schedule into Chapter 10 of the Program Integrity Manual
(PIM).
Thursday, April 9, 2009
ASCO, CMS, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe4f157970610c7b701d&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe3216727260007d751579. ANCO is a state/regional affiliate of ASCO. This edition features:
House and Senate Approve Budget Resolutions for FY 2010
ASCO Urges House Members to Co-Sponsor ASP Legislation
Reps. Capps and Boustany Introduce the Comprehensive Cancer Care Improvement Act of 2009
Urge Your Senators to Co-Sponsor Clinical Trials Legislation
Sens. Kennedy and Hutchison Introduce 21st Century Cancer ALERT Act
Sen. Schumer Introduces Bill to Allow for FDA Approval of Generic Biologics
House Approves Tobacco Control Legislation
Dr. Lichter Meets with White House on Health Reform
ASCO Sends IOM Comparative Effectiveness Research Priorities
CMS Issues National Coverage Determination to Expand PET Coverage
New Edition of Practical Tips for the Oncology Practice - JUST RELEASED!
NCI Announces Clinical Trials Awareness Tools for Patients
Join ASCO's Advocacy Network
ASCO Extends Resources to Practice Administrators
****CMS NEWS****
The General Equivalence Mappings – ICD-9-CM To and From ICD-10-CM and ICD-10-PCS Fact Sheet (March 2009), which provides information and resources regarding the General Equivalence Mappings that were developed as a tool to assist with the conversion of International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) codes to International Classification of Diseases, 10th Edition (ICD-10) and the conversion of ICD-10 codes back to ICD-9-CM, is now available in downloadable format from the Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10_GEM_factsheet.pdf . The General Equivalence Mappings information discussed in this fact sheet has also been posted in the CMS Frequently Asked Questions database at https://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_alp.php?p_sid=l2s5Zouj . If you are unable to access any of the hyperlinks in this message, please copy and paste the
URL into your Internet browser.
****PALMETTO/J1MAC NEWS****
CMS: Getting Started With Internet-based Provider Enrollment, Chain and
Ownership System (PECOS) April 1, 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~General~CMS%20Getting%20Started%20With%20Internet-based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)%20April%201%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257591005E9C46?opendocument
This J1 article provides a informational guide for provider and supplier
organizations who wish to use Internet-based Provider Enrollment, Chain and
Ownership System (PECOS). A detailed explanation on user eligibility and
program procedures and answers to some frequently asked questions are also
included.
Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Provider%20Enrollment~Internet-Based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900046941E?opendocument
This J1 Internet based PECOS article assists providers to determine when to
contact the Centers for Medicare & Medicaid Services (CMS) External User
Services (EUS) Help Desk and when to contact the Medicare Provider
Enrollment Contractors.
Provider Contact Center to be Closed Four Hours on Friday
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~Provider%20Contact%20Center%20to%20be%20Closed%20Four%20Hours%20on%20Friday?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257591005E7CB0?opendocument
The J1 Provider Contact Center will be closed for training Friday from 11
a.m. to 3 p.m. PST. The call center will reopen at 3 p.m. PST on Friday.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe4f157970610c7b701d&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe3216727260007d751579. ANCO is a state/regional affiliate of ASCO. This edition features:
House and Senate Approve Budget Resolutions for FY 2010
ASCO Urges House Members to Co-Sponsor ASP Legislation
Reps. Capps and Boustany Introduce the Comprehensive Cancer Care Improvement Act of 2009
Urge Your Senators to Co-Sponsor Clinical Trials Legislation
Sens. Kennedy and Hutchison Introduce 21st Century Cancer ALERT Act
Sen. Schumer Introduces Bill to Allow for FDA Approval of Generic Biologics
House Approves Tobacco Control Legislation
Dr. Lichter Meets with White House on Health Reform
ASCO Sends IOM Comparative Effectiveness Research Priorities
CMS Issues National Coverage Determination to Expand PET Coverage
New Edition of Practical Tips for the Oncology Practice - JUST RELEASED!
NCI Announces Clinical Trials Awareness Tools for Patients
Join ASCO's Advocacy Network
ASCO Extends Resources to Practice Administrators
****CMS NEWS****
The General Equivalence Mappings – ICD-9-CM To and From ICD-10-CM and ICD-10-PCS Fact Sheet (March 2009), which provides information and resources regarding the General Equivalence Mappings that were developed as a tool to assist with the conversion of International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) codes to International Classification of Diseases, 10th Edition (ICD-10) and the conversion of ICD-10 codes back to ICD-9-CM, is now available in downloadable format from the Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10_GEM_factsheet.pdf . The General Equivalence Mappings information discussed in this fact sheet has also been posted in the CMS Frequently Asked Questions database at https://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_alp.php?p_sid=l2s5Zouj . If you are unable to access any of the hyperlinks in this message, please copy and paste the
URL into your Internet browser.
****PALMETTO/J1MAC NEWS****
CMS: Getting Started With Internet-based Provider Enrollment, Chain and
Ownership System (PECOS) April 1, 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~General~CMS%20Getting%20Started%20With%20Internet-based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)%20April%201%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257591005E9C46?opendocument
This J1 article provides a informational guide for provider and supplier
organizations who wish to use Internet-based Provider Enrollment, Chain and
Ownership System (PECOS). A detailed explanation on user eligibility and
program procedures and answers to some frequently asked questions are also
included.
Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Provider%20Enrollment~Internet-Based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900046941E?opendocument
This J1 Internet based PECOS article assists providers to determine when to
contact the Centers for Medicare & Medicaid Services (CMS) External User
Services (EUS) Help Desk and when to contact the Medicare Provider
Enrollment Contractors.
Provider Contact Center to be Closed Four Hours on Friday
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~Provider%20Contact%20Center%20to%20be%20Closed%20Four%20Hours%20on%20Friday?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257591005E7CB0?opendocument
The J1 Provider Contact Center will be closed for training Friday from 11
a.m. to 3 p.m. PST. The call center will reopen at 3 p.m. PST on Friday.
Wednesday, April 8, 2009
The Oncologist's 6th Vital Sign--A Context of Vulnerability
Oncology Pharmaceutical Services, an ANCO Corporate Member, is supporting a webcast entitled The Oncologist's 6th Vital SIgn--A Context of Vulnerability, with Daniel Von Hoff, MD, on April 17th at 10AM.
Visit www.cancercareresearch.com for more information and to register.
Visit www.cancercareresearch.com for more information and to register.
Tuesday, April 7, 2009
ACCC, ASH, CMA, CMS, NCI, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_4-6-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Comprehensive Cancer Legislation Introduced, Make Your Voice Heard
CMS Revises NCD About FDG PET, Expands Coverage
Has Your Program Applied for ACCC's Prostate Cancer Care Project?
NCCN Drug Compendium No Longer Free
Upcoming Meeting to Highlight Planning and Designing a Cancer Center
Afinitor® Approved for Patients with Advanced Kidney Cancer
Phoenix, Cincinnati, Houston: ACCC's Regional Oncology Symposia
ACCC News Articles Get New Search Engine
NCI to Host Free Telephone Workshop Series for Cancer Survivors
Q&A on ACCC's Listserv: Unofficial Survey of Radiation Departments
ACCC's CE Blackboard: A Full Range of Courses to Choose
State Medical Oncology Societies Host Membership Meetings
****ASH NEWS****
The American Society of Hematology's (ASH) webinar "PQRI and E-Prescribing: Nuts and Bolts" is scheduled for Tuesday, April 28th, 2009 from 5:00 p.m. – 6:15 p.m. Eastern Time. This webinar will focus on the basics of how to report the 2009 hematology-related Physician Quality Reporting Initiative measures and how to complete the E-Prescribing measure. It will help ensure that practitioners follow the correct steps and receive the bonus for successful reporting.
Sylvia Publ, CMS Senior Quality Advisor, will discuss the basics of how to satisfactorily report the 2009 PQRI quality measures and to participate in the E-Prescribing program. Afterwards, there will be an opportunity to ask questions.
The webinar focuses on assisting hematologists as well as their office staff who may benefit from a greater understanding of the PQRI and E-Prescribing process. We encourage you to pass this information along to your members so that they may participate in this informative discussion. You may advise them to contact Matt Eckel at grassroots@hematology.org to sign up for this webinar and to get answers to any further questions they may have.
****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:
CMA Sues WellPoint for Ingenix Price-Fixing Scheme
Anthem Blue Cross Requires Physicians to Take Pay Cut for Treating Healthy Families Patients
State Budget Update: The Good, The Bad, and The Ugly
CMS Clarifies “Community Call Plan” Regulations
Assembly Passes COBRA Subsidy Bill
CMA’s Democratic Process at Work: Council on Legislation Sets Legislative Priorities for 2009
Webinar: Red Flag Rules
Physicians Encouraged to Donate to Ovarian Cancer Research
Benefit of the Week: 15% off Insurance Products
****CMS NEWS****
CMS is pleased to announce the scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set. These changes have been posted to the HCPCS web page at http://www.cms.hhs.gov/HCPCSReleaseCodeSets/02_HCPCS_Quarterly_Update.asp. Changes are effective on the date indicated on the update.
CMS is now accepting reporting options suggestions for consideration for possible inclusion in the proposed set of reporting options for use in the 2010 PQRI. For instructions on submitting suggestions, go to http://www.cms.hhs.gov/pqri and click on the “Overview” link on the left. All suggestions must be received by 5:00pm EST April 17, 2009.
Note: Suggesting reporting option(s) does not guarantee that the reporting option(s) will be included in the proposed or final sets of reporting options of any Proposed or Final Rules that address the 2010 PQRI. CMS will determine what reporting options to include in the proposed set of reporting options, and after a period of public comment, the agency will make the final determination with regard to the final set reporting options for the 2010 PQRI.
****NCI NEWS****
The Office of Advocacy Relations (OAR) is pleased to continue the Spring 2009 Understanding NCI: Toll-Free Teleconference with a discussion on NCI Community Cancer Centers Program (NCCCP): Translating Scientific Advances into the Community, Tuesday, April 21, from 2:00 to 3:00 p.m., ET. The NCCCP is a three-year pilot program to test the concept of a national network of community cancer centers to expand cancer research and deliver the latest, most advanced, cancer care to a greater number of Americans in their communities.
The featured speakers are Dr. Maureen Johnson, Project Officer in NCI’s Community Cancer Centers Program and Dr. Beverly Laird, Co-Chair NCI Directors Consumer Liaison Group. To join, please dial (800) 857-6584; the passcode is NCCCP. Toll-free playback will be available through May 21 at (866) 457-5714. For more information about NCCCP, visit http://ncccp.cancer.gov/.
****PALMETTO/J1MAC NEWS****
Change to Location of Eureka Workshop
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Learning%20Education~Workshops~Change%20to%20Location%20of%20Eureka%20Workshop?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900046E090?opendocument
The location of the Understanding the Rules and Using the Tools workshop
Thursday, April 9, in Eureka has changed. The workshop will be in the
community room of the Umpqua Bank Plaza, 2426 Sixth Street, Eureka.
Independent Diagnostic Testing Facility Table
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~IDTF~Independent%20Diagnostic%20Testing%20Facility%20Table?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257590006C0948?opendocument
This table shows the CPT codes, physician supervision levels and physician
and technician requirements for independent diagnostic testing facilities.
Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Provider%20Enrollment~Internet-Based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900046941E?opendocument
This J1 Internet based PECOS article assists providers to determine when to
contact the Centers for Medicare & Medicaid Services (CMS) External User
Services (EUS) Help Desk and when to contact the Medicare Provider
Enrollment Contractors.
Part B LCD New Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Coverage~Medical%20Policies~Part%20B%20LCD%20New%20Update?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257590006DE62A?opendocument
Share with your staff - some Local Coverage Determinations (LCDs) have been
revised and can be viewed at the Palemetto GBA J1 Part B Web site.
Reminder about Address Changes
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~General~Reminder%20about%20Address%20Changes?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900064C796?opendocument
If you are credentialed with Palmetto GBA as a Medicare provider, you must
notify Palmetto GBA within 90 days of any changes that occur to your
practice location.
Understanding the Rules and Using the Tools Workshops
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Learning%20Education~Workshops~Understanding%20the%20Rules%20and%20Using%20the%20Tools%20Workshops?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900046BBDE?opendocument
There's still time to register for Palmetto GBA's Understanding the Rules
and Using the Tools workshops being held this April and May for Part B
providers in California, Nevada and Hawaii.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_4-6-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Comprehensive Cancer Legislation Introduced, Make Your Voice Heard
CMS Revises NCD About FDG PET, Expands Coverage
Has Your Program Applied for ACCC's Prostate Cancer Care Project?
NCCN Drug Compendium No Longer Free
Upcoming Meeting to Highlight Planning and Designing a Cancer Center
Afinitor® Approved for Patients with Advanced Kidney Cancer
Phoenix, Cincinnati, Houston: ACCC's Regional Oncology Symposia
ACCC News Articles Get New Search Engine
NCI to Host Free Telephone Workshop Series for Cancer Survivors
Q&A on ACCC's Listserv: Unofficial Survey of Radiation Departments
ACCC's CE Blackboard: A Full Range of Courses to Choose
State Medical Oncology Societies Host Membership Meetings
****ASH NEWS****
The American Society of Hematology's (ASH) webinar "PQRI and E-Prescribing: Nuts and Bolts" is scheduled for Tuesday, April 28th, 2009 from 5:00 p.m. – 6:15 p.m. Eastern Time. This webinar will focus on the basics of how to report the 2009 hematology-related Physician Quality Reporting Initiative measures and how to complete the E-Prescribing measure. It will help ensure that practitioners follow the correct steps and receive the bonus for successful reporting.
Sylvia Publ, CMS Senior Quality Advisor, will discuss the basics of how to satisfactorily report the 2009 PQRI quality measures and to participate in the E-Prescribing program. Afterwards, there will be an opportunity to ask questions.
The webinar focuses on assisting hematologists as well as their office staff who may benefit from a greater understanding of the PQRI and E-Prescribing process. We encourage you to pass this information along to your members so that they may participate in this informative discussion. You may advise them to contact Matt Eckel at grassroots@hematology.org to sign up for this webinar and to get answers to any further questions they may have.
****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:
CMA Sues WellPoint for Ingenix Price-Fixing Scheme
Anthem Blue Cross Requires Physicians to Take Pay Cut for Treating Healthy Families Patients
State Budget Update: The Good, The Bad, and The Ugly
CMS Clarifies “Community Call Plan” Regulations
Assembly Passes COBRA Subsidy Bill
CMA’s Democratic Process at Work: Council on Legislation Sets Legislative Priorities for 2009
Webinar: Red Flag Rules
Physicians Encouraged to Donate to Ovarian Cancer Research
Benefit of the Week: 15% off Insurance Products
****CMS NEWS****
CMS is pleased to announce the scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set. These changes have been posted to the HCPCS web page at http://www.cms.hhs.gov/HCPCSReleaseCodeSets/02_HCPCS_Quarterly_Update.asp. Changes are effective on the date indicated on the update.
CMS is now accepting reporting options suggestions for consideration for possible inclusion in the proposed set of reporting options for use in the 2010 PQRI. For instructions on submitting suggestions, go to http://www.cms.hhs.gov/pqri and click on the “Overview” link on the left. All suggestions must be received by 5:00pm EST April 17, 2009.
Note: Suggesting reporting option(s) does not guarantee that the reporting option(s) will be included in the proposed or final sets of reporting options of any Proposed or Final Rules that address the 2010 PQRI. CMS will determine what reporting options to include in the proposed set of reporting options, and after a period of public comment, the agency will make the final determination with regard to the final set reporting options for the 2010 PQRI.
****NCI NEWS****
The Office of Advocacy Relations (OAR) is pleased to continue the Spring 2009 Understanding NCI: Toll-Free Teleconference with a discussion on NCI Community Cancer Centers Program (NCCCP): Translating Scientific Advances into the Community, Tuesday, April 21, from 2:00 to 3:00 p.m., ET. The NCCCP is a three-year pilot program to test the concept of a national network of community cancer centers to expand cancer research and deliver the latest, most advanced, cancer care to a greater number of Americans in their communities.
The featured speakers are Dr. Maureen Johnson, Project Officer in NCI’s Community Cancer Centers Program and Dr. Beverly Laird, Co-Chair NCI Directors Consumer Liaison Group. To join, please dial (800) 857-6584; the passcode is NCCCP. Toll-free playback will be available through May 21 at (866) 457-5714. For more information about NCCCP, visit http://ncccp.cancer.gov/.
****PALMETTO/J1MAC NEWS****
Change to Location of Eureka Workshop
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Learning%20Education~Workshops~Change%20to%20Location%20of%20Eureka%20Workshop?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900046E090?opendocument
The location of the Understanding the Rules and Using the Tools workshop
Thursday, April 9, in Eureka has changed. The workshop will be in the
community room of the Umpqua Bank Plaza, 2426 Sixth Street, Eureka.
Independent Diagnostic Testing Facility Table
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~IDTF~Independent%20Diagnostic%20Testing%20Facility%20Table?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257590006C0948?opendocument
This table shows the CPT codes, physician supervision levels and physician
and technician requirements for independent diagnostic testing facilities.
Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Provider%20Enrollment~Internet-Based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900046941E?opendocument
This J1 Internet based PECOS article assists providers to determine when to
contact the Centers for Medicare & Medicaid Services (CMS) External User
Services (EUS) Help Desk and when to contact the Medicare Provider
Enrollment Contractors.
Part B LCD New Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Coverage~Medical%20Policies~Part%20B%20LCD%20New%20Update?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257590006DE62A?opendocument
Share with your staff - some Local Coverage Determinations (LCDs) have been
revised and can be viewed at the Palemetto GBA J1 Part B Web site.
Reminder about Address Changes
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~General~Reminder%20about%20Address%20Changes?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900064C796?opendocument
If you are credentialed with Palmetto GBA as a Medicare provider, you must
notify Palmetto GBA within 90 days of any changes that occur to your
practice location.
Understanding the Rules and Using the Tools Workshops
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Learning%20Education~Workshops~Understanding%20the%20Rules%20and%20Using%20the%20Tools%20Workshops?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852575900046BBDE?opendocument
There's still time to register for Palmetto GBA's Understanding the Rules
and Using the Tools workshops being held this April and May for Part B
providers in California, Nevada and Hawaii.
National Practice Benchmark Survey
Oncology Metrics is pleased to invite you to participate in the National Practice Benchmark Survey for calendar year 2008. Results from the National Practice Benchmark will provide important and meaningful data for managing your oncology practice in today’s challenging practice environment. Benchmarking is widely recognized as the best, most efficient way to both find opportunities to improve your practice and then to monitor progress once corrective action is taken.
The National Practice Benchmark Survey is conducted by Oncology Metrics, a team of professionals who understand the oncology market and have many years of oncology practice, survey, and benchmarking experience.
All practices with complete responses will receive an electronic version of the survey report. To thank you for your time, the first 25 participants to complete all applicable questions also will receive a $25 American Express gift card; the next 100 participants will receive a $10 gift card. All complete surveys also will qualify for a drawing for an Apple iTouch.
Completing the Survey
To access the survey, click on this link https://www.surveymonkey.com/s.aspx?sm=tbB957SwlDpxJYoIX_2bRc0A_3d_3d
A .pdf of the survey instrument is available for download on the Oncology Metrics website at www.oncologymetrics.com. We recommend that you download and review the survey, then collect all data before logging on to the survey website. We estimate that it will take approximately 20 minutes to complete the survey once you have collected the necessary data.
Please note that you do not need to complete the survey all at once - it is easy to log in and out of the survey and begin to input new data where you left off. Instructions and definitions are included in the survey. If you have additional questions, please call Oncology Metrics at 817-333-0142. The survey will be open through Thursday, April 16, 2009. All surveys must be completed using the online survey tool and received by 12:00 midnight (Eastern) on April 16.
Individuals and practices may receive more than one invitation to participate in this survey: please submit only one survey per practice.
Data Confidentiality
All of the individual data provided in the survey is absolutely confidential and will never be disclosed. Access to the data file that Oncology Metrics creates from this survey will never be made available to any party. Oncology Metrics will create analytical reports including aggregated data from this survey, but will always publish in a manner that completely obscures the source of the data so that no reader can make any supported inference of data to any individual practice.
Thank you for your participation in this important study of our industry. We look forward to providing you with practical information to build your practice.
Tom Barr, MBA, Chief Operating Officer
Elaine Towle, CMPE, Director of Consulting Services
--------------------------------------------------
Oncology Metrics, llc
800 W. Magnolia Avenue
Fort Worth, TX 76104
Phone: 817.333.0142
www.oncomet.com
The National Practice Benchmark Survey is conducted by Oncology Metrics, a team of professionals who understand the oncology market and have many years of oncology practice, survey, and benchmarking experience.
All practices with complete responses will receive an electronic version of the survey report. To thank you for your time, the first 25 participants to complete all applicable questions also will receive a $25 American Express gift card; the next 100 participants will receive a $10 gift card. All complete surveys also will qualify for a drawing for an Apple iTouch.
Completing the Survey
To access the survey, click on this link https://www.surveymonkey.com/s.aspx?sm=tbB957SwlDpxJYoIX_2bRc0A_3d_3d
A .pdf of the survey instrument is available for download on the Oncology Metrics website at www.oncologymetrics.com. We recommend that you download and review the survey, then collect all data before logging on to the survey website. We estimate that it will take approximately 20 minutes to complete the survey once you have collected the necessary data.
Please note that you do not need to complete the survey all at once - it is easy to log in and out of the survey and begin to input new data where you left off. Instructions and definitions are included in the survey. If you have additional questions, please call Oncology Metrics at 817-333-0142. The survey will be open through Thursday, April 16, 2009. All surveys must be completed using the online survey tool and received by 12:00 midnight (Eastern) on April 16.
Individuals and practices may receive more than one invitation to participate in this survey: please submit only one survey per practice.
Data Confidentiality
All of the individual data provided in the survey is absolutely confidential and will never be disclosed. Access to the data file that Oncology Metrics creates from this survey will never be made available to any party. Oncology Metrics will create analytical reports including aggregated data from this survey, but will always publish in a manner that completely obscures the source of the data so that no reader can make any supported inference of data to any individual practice.
Thank you for your participation in this important study of our industry. We look forward to providing you with practical information to build your practice.
Tom Barr, MBA, Chief Operating Officer
Elaine Towle, CMPE, Director of Consulting Services
--------------------------------------------------
Oncology Metrics, llc
800 W. Magnolia Avenue
Fort Worth, TX 76104
Phone: 817.333.0142
www.oncomet.com
Sunday, April 5, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
The audio transcripts of the ICD-10-CM/PCS Conference Calls that were sponsored by the Centers for Medicare & Medicaid Services in 2008 for Hospital Staff (October 14), Other Part A and Part B Providers (November 12), and Physicians (November 17) are now available and can be accessed in the Downloads Section at http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp .
Now there is a better way for provider and supplier organizations to enroll in Medicare or make a change to their Medicare enrollment information. The Centers for Medicare & Medicaid Services (CMS) announces the availability of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) to provider and supplier organizations. They may use Internet-based PECOS to enroll in Medicare, make a change in their Medicare enrollment information, view their existing Medicare enrollment information, voluntarily withdraw from the Medicare program, or check on the status of an Internet-submitted Medicare enrollment application.
Internet-based PECOS is already available to physicians and non-physician practitioners in all 50 States and theDistrict of Columbia. (CMS expects to make Internet-based PECOS available to suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) in the future.)
FAST
By submitting an initial Medicare enrollment application through Internet-based PECOS, a provider or supplier organization’s enrollment application can be processed as much as 50 percent faster than by paper. This means that it will take less time to enroll or make a change in an existing enrollment record.
For information about the types of changes that enrolled Medicare provider and supplier organizations must report, go to the Downloads Section of the Medicare provider/supplier enrollment page: www.cms.hhs.gov/MedicareProviderSupEnroll.
SECURE
Internet-based PECOS meets all required Government security standards in terms of data entry, data transmission, and the electronic storage of Medicare enrollment information. Only individuals whose identities have been verified by CMS and who have been approved by a provider or supplier organization’s Authorized Official may use Internet-based PECOS on behalf of that provider or supplier organization. The PECOS User IDs and passwords that these individuals establish will protect the access to the given provider or supplier organization’s Medicare enrollment information. PECOS users should change their passwords frequently—at least once a year. By safeguarding their User IDs and passwords, PECOS users will be taking an important step in protecting the provider or supplier organization’s Medicare enrollment information. CMS does not disclose Medicare provider or supplier enrollment information to anyone except when authorized or required to do so by law.
EASY TO USE
Internet-based PECOS is a scenario-driven application process with front-end editing capabilities and built-in help screens. The scenario-driven application process ensures that provider and supplier organizations complete and submit only the information necessary to facilitate the action they wish to take. The CMS External User Services (EUS) Help Desk (1-866-484-8049) is available and staffed to respond to questions about using Internet-basedPECOS, such as navigating through the screens, and to receive reports of systems problems as noted by users.
Obtaining Approval to Use Internet-based PECOS for a Provider or Supplier Organization
There are several steps that must be completed before a provider or supplier organization can use Internet-basedPECOS. These steps are described in detail in the document entitled, “Getting Started with Internet-based Provider Enrollment, Chain and Ownership System (PECOS) – Information for Provider and Supplier Organizations,” which will soon be available in the Downloads Section on the Medicare provider/supplier enrollment page: http://www.cms.hhs.gov/MedicareProviderSupEnroll. Below is an overview of the process.
(1) The first step is taken by the Authorized Official (AO) of the provider or supplier organization. This is done only one time. He or she will register in the Internet-based PECOS Identification and Authentication System (PECOS I&A) by going to https://pecos.cms.hhs.gov. CMS will verify the information provided and the CMS EUS Help Desk will notify the AO of the verification.
(2) An individual who will use Internet-based PECOS to submit enrollment applications for the provider or supplier organization will also register in PECOS I&A. This individual may be an employee of the provider or supplier organization, or an employee of a separate organization. CMS will verify the information provided and the permission of the AO for that individual to use Internet-based PECOS on behalf of the provider or supplier organization. The individual will complete the Security Consent Form and have it signed by an official of his or her employer and by the AO of the provider or supplier organization. The individual will mail the signed and dated Security Consent Form to the CMS EUS Help Desk. The AO will need to periodically log on to Internet-based PECOS to see if there is a pending request for permission to access Internet-based PECOS on behalf of the provider or supplier organization. More than one person may be approved to use Internet-based PECOS on behalf of a given provider or supplier organization, but the Security Consent Form is completed only one time.
(3) Once the registration and verification processes are completed, the CMS EUS Help Desk will notify the AO of the establishment of the relationship between the provider or supplier organization and the organization that will be using Internet-based PECOS on its behalf.
It may take several weeks for the registration and verification processes to be completed. Therefore, we encourage the AO of a provider or supplier organization to begin the registration process now—before the provider or supplier organization has the need to use Internet-based PECOS to submit a Medicare enrollment application or enrollment update.
If a provider or supplier organization has an immediate need to submit a Medicare enrollment application to enroll or to report a change in enrollment information and the steps above have not been successfully completed, the provider or supplier organization should complete and submit the paper version of the Medicare enrollment application (CMS-855).
Submitting an Enrollment Application using Internet-based PECOS
After the steps above are successfully completed, the individual who will be using Internet-based PECOS is considered a PECOS user. If a PECOS user has not already done so, he or she should visit the Medicare provider enrollment web site (www.cms.hhs.gov/MedicareProviderSupEnroll) to download and read the documents relating to Internet-based PECOS. CMS advises PECOS users to avail themselves of this information before logging on to Internet-based PECOS.
After reading the informational documents referenced above, a PECOS user will log on to Internet-based PECOSat https://pecos.cms.hhs.gov. He or she will complete, review, and submit the Medicare enrollment application over the Internet to the designated Medicare contractor. Internet-based PECOS will guide the user through each of these processes. (Internet-based PECOS enables the user to print a copy of the enrollment application, if desired. We recommend this be done so the provider or supplier organization has a copy for its records.)
As part of the enrollment application submittal process, the AO of the provider or supplier organization must sign and date the 2-page Certification Statement that the user will print from Internet-based PECOS. The user must mail the signed and dated Certification Statement, along with any required supporting paper documentation, to the designated Medicare contractor. The Medicare contractor will not begin processing the application that was submitted over the Internet until it has received the signed and dated Certification Statement.
Limitations of Internet-based PECOS
At this time, Internet-based PECOS is unable to handle changes of ownership applications from provider and supplier organizations. Therefore, changes of ownership must be submitted using the paper Medicare enrollment application (CMS-855) process. Internet-based PECOS will be able to accommodate changes of ownership at a future date.
Additional Information
Several documents about Internet-based PECOS for provider and supplier organizations will soon be available in the Downloads Section of the Medicare provider/supplier enrollment web page: www.cms.hhs.gov/MedicareProviderSupEnroll.
CMS is hosting this Special Open Door Forum for Part B provider recovery audit contractors (RACs) on April 14, 2009. The purpose of this forum is to introduce providers to the new contractors and provide more information about the RAC program.
Section 302 of the Tax Relief and Health Care Act of 2006 makes the RAC Program permanent and requires the Secretary to expand the program to all 50 states by no later than 2010. On October 6, 2008, CMS announced awards for the four permanent RACs. Each RAC will be responsible for identifying overpayment and underpayments in approximately ¼ of the country. CMS has planned a gradual expansion to all 50 states. For further details, visit the website at http://www.cms.hhs.gov/RAC.
We look forward to your participation.
Open Door Forum Instructions:
**Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.**
Dial: 1-800-837-1935
Reference Conference ID 92489480
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services
dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here: http://www.consumer.att.com/relay/which/index.html. A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning April 22, 2009 and available for 30 days.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at: http://www.cms.hhs.gov/OpenDoorForums/
The following Medicare payment policy publications are now available in print format from the Medicare Learning Network. To place your order, visit http://www.cms.hhs.gov/MLNGenInfo/ , scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”
Outpatient Maintenance Dialysis – End-Stage Renal Disease Fact Sheet (revised February 2009), which provides general information about outpatient maintenance dialysis for End-Stage Renal Disease, the composite payment rate system, and separately billable items and services.
Medicare Physician Fee Schedule Fact Sheet (revised January 2009), which provides general information about the Medicare Physician Fee Schedule.
Hospital Outpatient Prospective Payment System Fact Sheet (revised January 2009), which provides general information about the Hospital Outpatient Prospective Payment System, ambulatory payment classifications, and how payment rates are set.
Hospice Payment System Fact Sheet (revised January 2009), which provides general information about the Medicare hospice benefit including coverage of hospice services, certification requirements, election periods, and how payment rates are set.
Clinical Laboratory Fee Schedule Fact Sheet (revised February 2009), which provides general information about the Clinical Laboratory Fee Schedule, coverage of clinical laboratory services, and how payment rates are set.
Acute Inpatient Prospective Payment System Fact Sheet (revised January 2009), which provides general information about the Acute Inpatient Prospective Payment System (IPPS) including IPPS payment rates and how IPPS payment rates are set.
Home Health Prospective Payment System Fact Sheet (revised December 2008), which provides information about coverage of home health services and elements of the Home Health Prospective Payment System.
Ambulance Fee Schedule Fact Sheet (revised January 2009), which provides general information about the Ambulance Fee Schedule.
Ambulatory Surgical Center Fee Schedule Fact Sheet (revised January 2009), which provides general information about the Ambulatory Surgical Center (ASC) Fee Schedule, ASC payments, and how ASC payment amounts are determined.
****PALMETTO/J1MAC NEWS****
Emergency Update to the 2009 Medicare Physician Fee Schedule Database
(MPFSDB)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~General~Emergency%20Update%20to%20the%202009%20Medicare%20Physician%20Fee%20Schedule%20Database%20(MPFSDB)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/EFEF1368EB5FEB608525758B006F0F18?opendocument
CR 6351 is a J1 Part A and B article titled Emergency Update to the 2009
Medicare Physician Fee Schedule Database (MPFSDB).
Incorrect Provider Option Combinations Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Incorrect%20Provider%20Option%20Combinations%20Update?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257571005BFF57?opendocument
This article has been updated for clarification. The following incorrect
provider option combinations will be rejected and must be resubmitted as
new claims with the correct information.
Medicare Claims Processing Manual Clarifications for Skilled Nursing
Facility (SNF) and Therapy Billing
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Medicare%20Claims%20Processing%20Manual%20Clarifications%20for%20Skilled%20Nursing%20Facility%20(SNF)%20and%20Therapy%20Billing?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758B00535476?opendocument
Share with your billing staff - CR6407 provides clarifications to the
Medicare Claims Processing Manual for Skilled Nursing Facility (SNF) and
therapy billing, which indicate that effective January 1, 2009, the new
Current Procedural Terminology (CPT) code 95992 is bundled under the
Medicare Physician Fee Schedule (MPFS).
Physician Supervision
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~IDTF~Physician%20Supervision?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758B0040A7B3?opendocument
Federal regulations require that diagnostic tests payable under the
physician fee schedule have to be performed under the supervision of an
individual meeting the definition of a physician in Section 1861(r) of the
Social Security Act to be covered under Medicare.
Internet-based Medicare Enrollment is Available in All States and the
District of Columbia
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Provider%20Enrollment~Internet-based%20Medicare%20Enrollment%20is%20Available%20in%20All%20States%20and%20the%20District%20of%20Columbia?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758C004BFF5E?opendocument
The Centers for Medicare & Medicaid Services (CMS) announces the
availability of Internet-based Provider Enrollment, Chain and Ownership
System (PECOS) to provider and supplier organizations.
Overview of Internet-based Provider Enrollment, Chain and Ownership System
(PECOS)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Provider%20Enrollment~Overview%20of%20Internet-based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758D006524EA?opendocument
This J1 article provides an overview of the Internet-based Provider
Enrollment, Chain and Ownership System (PECOS) and its limitations. Basic
information on how to access and navigate through the system, application
status check and standard processing timeframe is included.
****CMS NEWS****
The audio transcripts of the ICD-10-CM/PCS Conference Calls that were sponsored by the Centers for Medicare & Medicaid Services in 2008 for Hospital Staff (October 14), Other Part A and Part B Providers (November 12), and Physicians (November 17) are now available and can be accessed in the Downloads Section at http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp .
Now there is a better way for provider and supplier organizations to enroll in Medicare or make a change to their Medicare enrollment information. The Centers for Medicare & Medicaid Services (CMS) announces the availability of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) to provider and supplier organizations. They may use Internet-based PECOS to enroll in Medicare, make a change in their Medicare enrollment information, view their existing Medicare enrollment information, voluntarily withdraw from the Medicare program, or check on the status of an Internet-submitted Medicare enrollment application.
Internet-based PECOS is already available to physicians and non-physician practitioners in all 50 States and theDistrict of Columbia. (CMS expects to make Internet-based PECOS available to suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) in the future.)
FAST
By submitting an initial Medicare enrollment application through Internet-based PECOS, a provider or supplier organization’s enrollment application can be processed as much as 50 percent faster than by paper. This means that it will take less time to enroll or make a change in an existing enrollment record.
For information about the types of changes that enrolled Medicare provider and supplier organizations must report, go to the Downloads Section of the Medicare provider/supplier enrollment page: www.cms.hhs.gov/MedicareProviderSupEnroll.
SECURE
Internet-based PECOS meets all required Government security standards in terms of data entry, data transmission, and the electronic storage of Medicare enrollment information. Only individuals whose identities have been verified by CMS and who have been approved by a provider or supplier organization’s Authorized Official may use Internet-based PECOS on behalf of that provider or supplier organization. The PECOS User IDs and passwords that these individuals establish will protect the access to the given provider or supplier organization’s Medicare enrollment information. PECOS users should change their passwords frequently—at least once a year. By safeguarding their User IDs and passwords, PECOS users will be taking an important step in protecting the provider or supplier organization’s Medicare enrollment information. CMS does not disclose Medicare provider or supplier enrollment information to anyone except when authorized or required to do so by law.
EASY TO USE
Internet-based PECOS is a scenario-driven application process with front-end editing capabilities and built-in help screens. The scenario-driven application process ensures that provider and supplier organizations complete and submit only the information necessary to facilitate the action they wish to take. The CMS External User Services (EUS) Help Desk (1-866-484-8049) is available and staffed to respond to questions about using Internet-basedPECOS, such as navigating through the screens, and to receive reports of systems problems as noted by users.
Obtaining Approval to Use Internet-based PECOS for a Provider or Supplier Organization
There are several steps that must be completed before a provider or supplier organization can use Internet-basedPECOS. These steps are described in detail in the document entitled, “Getting Started with Internet-based Provider Enrollment, Chain and Ownership System (PECOS) – Information for Provider and Supplier Organizations,” which will soon be available in the Downloads Section on the Medicare provider/supplier enrollment page: http://www.cms.hhs.gov/MedicareProviderSupEnroll. Below is an overview of the process.
(1) The first step is taken by the Authorized Official (AO) of the provider or supplier organization. This is done only one time. He or she will register in the Internet-based PECOS Identification and Authentication System (PECOS I&A) by going to https://pecos.cms.hhs.gov. CMS will verify the information provided and the CMS EUS Help Desk will notify the AO of the verification.
(2) An individual who will use Internet-based PECOS to submit enrollment applications for the provider or supplier organization will also register in PECOS I&A. This individual may be an employee of the provider or supplier organization, or an employee of a separate organization. CMS will verify the information provided and the permission of the AO for that individual to use Internet-based PECOS on behalf of the provider or supplier organization. The individual will complete the Security Consent Form and have it signed by an official of his or her employer and by the AO of the provider or supplier organization. The individual will mail the signed and dated Security Consent Form to the CMS EUS Help Desk. The AO will need to periodically log on to Internet-based PECOS to see if there is a pending request for permission to access Internet-based PECOS on behalf of the provider or supplier organization. More than one person may be approved to use Internet-based PECOS on behalf of a given provider or supplier organization, but the Security Consent Form is completed only one time.
(3) Once the registration and verification processes are completed, the CMS EUS Help Desk will notify the AO of the establishment of the relationship between the provider or supplier organization and the organization that will be using Internet-based PECOS on its behalf.
It may take several weeks for the registration and verification processes to be completed. Therefore, we encourage the AO of a provider or supplier organization to begin the registration process now—before the provider or supplier organization has the need to use Internet-based PECOS to submit a Medicare enrollment application or enrollment update.
If a provider or supplier organization has an immediate need to submit a Medicare enrollment application to enroll or to report a change in enrollment information and the steps above have not been successfully completed, the provider or supplier organization should complete and submit the paper version of the Medicare enrollment application (CMS-855).
Submitting an Enrollment Application using Internet-based PECOS
After the steps above are successfully completed, the individual who will be using Internet-based PECOS is considered a PECOS user. If a PECOS user has not already done so, he or she should visit the Medicare provider enrollment web site (www.cms.hhs.gov/MedicareProviderSupEnroll) to download and read the documents relating to Internet-based PECOS. CMS advises PECOS users to avail themselves of this information before logging on to Internet-based PECOS.
After reading the informational documents referenced above, a PECOS user will log on to Internet-based PECOSat https://pecos.cms.hhs.gov. He or she will complete, review, and submit the Medicare enrollment application over the Internet to the designated Medicare contractor. Internet-based PECOS will guide the user through each of these processes. (Internet-based PECOS enables the user to print a copy of the enrollment application, if desired. We recommend this be done so the provider or supplier organization has a copy for its records.)
As part of the enrollment application submittal process, the AO of the provider or supplier organization must sign and date the 2-page Certification Statement that the user will print from Internet-based PECOS. The user must mail the signed and dated Certification Statement, along with any required supporting paper documentation, to the designated Medicare contractor. The Medicare contractor will not begin processing the application that was submitted over the Internet until it has received the signed and dated Certification Statement.
Limitations of Internet-based PECOS
At this time, Internet-based PECOS is unable to handle changes of ownership applications from provider and supplier organizations. Therefore, changes of ownership must be submitted using the paper Medicare enrollment application (CMS-855) process. Internet-based PECOS will be able to accommodate changes of ownership at a future date.
Additional Information
Several documents about Internet-based PECOS for provider and supplier organizations will soon be available in the Downloads Section of the Medicare provider/supplier enrollment web page: www.cms.hhs.gov/MedicareProviderSupEnroll.
CMS is hosting this Special Open Door Forum for Part B provider recovery audit contractors (RACs) on April 14, 2009. The purpose of this forum is to introduce providers to the new contractors and provide more information about the RAC program.
Section 302 of the Tax Relief and Health Care Act of 2006 makes the RAC Program permanent and requires the Secretary to expand the program to all 50 states by no later than 2010. On October 6, 2008, CMS announced awards for the four permanent RACs. Each RAC will be responsible for identifying overpayment and underpayments in approximately ¼ of the country. CMS has planned a gradual expansion to all 50 states. For further details, visit the website at http://www.cms.hhs.gov/RAC.
We look forward to your participation.
Open Door Forum Instructions:
**Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.**
Dial: 1-800-837-1935
Reference Conference ID 92489480
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services
dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here: http://www.consumer.att.com/relay/which/index.html. A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning April 22, 2009 and available for 30 days.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at: http://www.cms.hhs.gov/OpenDoorForums/
The following Medicare payment policy publications are now available in print format from the Medicare Learning Network. To place your order, visit http://www.cms.hhs.gov/MLNGenInfo/ , scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”
Outpatient Maintenance Dialysis – End-Stage Renal Disease Fact Sheet (revised February 2009), which provides general information about outpatient maintenance dialysis for End-Stage Renal Disease, the composite payment rate system, and separately billable items and services.
Medicare Physician Fee Schedule Fact Sheet (revised January 2009), which provides general information about the Medicare Physician Fee Schedule.
Hospital Outpatient Prospective Payment System Fact Sheet (revised January 2009), which provides general information about the Hospital Outpatient Prospective Payment System, ambulatory payment classifications, and how payment rates are set.
Hospice Payment System Fact Sheet (revised January 2009), which provides general information about the Medicare hospice benefit including coverage of hospice services, certification requirements, election periods, and how payment rates are set.
Clinical Laboratory Fee Schedule Fact Sheet (revised February 2009), which provides general information about the Clinical Laboratory Fee Schedule, coverage of clinical laboratory services, and how payment rates are set.
Acute Inpatient Prospective Payment System Fact Sheet (revised January 2009), which provides general information about the Acute Inpatient Prospective Payment System (IPPS) including IPPS payment rates and how IPPS payment rates are set.
Home Health Prospective Payment System Fact Sheet (revised December 2008), which provides information about coverage of home health services and elements of the Home Health Prospective Payment System.
Ambulance Fee Schedule Fact Sheet (revised January 2009), which provides general information about the Ambulance Fee Schedule.
Ambulatory Surgical Center Fee Schedule Fact Sheet (revised January 2009), which provides general information about the Ambulatory Surgical Center (ASC) Fee Schedule, ASC payments, and how ASC payment amounts are determined.
****PALMETTO/J1MAC NEWS****
Emergency Update to the 2009 Medicare Physician Fee Schedule Database
(MPFSDB)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~General~Emergency%20Update%20to%20the%202009%20Medicare%20Physician%20Fee%20Schedule%20Database%20(MPFSDB)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/EFEF1368EB5FEB608525758B006F0F18?opendocument
CR 6351 is a J1 Part A and B article titled Emergency Update to the 2009
Medicare Physician Fee Schedule Database (MPFSDB).
Incorrect Provider Option Combinations Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Incorrect%20Provider%20Option%20Combinations%20Update?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257571005BFF57?opendocument
This article has been updated for clarification. The following incorrect
provider option combinations will be rejected and must be resubmitted as
new claims with the correct information.
Medicare Claims Processing Manual Clarifications for Skilled Nursing
Facility (SNF) and Therapy Billing
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Medicare%20Claims%20Processing%20Manual%20Clarifications%20for%20Skilled%20Nursing%20Facility%20(SNF)%20and%20Therapy%20Billing?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758B00535476?opendocument
Share with your billing staff - CR6407 provides clarifications to the
Medicare Claims Processing Manual for Skilled Nursing Facility (SNF) and
therapy billing, which indicate that effective January 1, 2009, the new
Current Procedural Terminology (CPT) code 95992 is bundled under the
Medicare Physician Fee Schedule (MPFS).
Physician Supervision
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Resources~Provider%20Enrollment~IDTF~Physician%20Supervision?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758B0040A7B3?opendocument
Federal regulations require that diagnostic tests payable under the
physician fee schedule have to be performed under the supervision of an
individual meeting the definition of a physician in Section 1861(r) of the
Social Security Act to be covered under Medicare.
Internet-based Medicare Enrollment is Available in All States and the
District of Columbia
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Provider%20Enrollment~Internet-based%20Medicare%20Enrollment%20is%20Available%20in%20All%20States%20and%20the%20District%20of%20Columbia?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758C004BFF5E?opendocument
The Centers for Medicare & Medicaid Services (CMS) announces the
availability of Internet-based Provider Enrollment, Chain and Ownership
System (PECOS) to provider and supplier organizations.
Overview of Internet-based Provider Enrollment, Chain and Ownership System
(PECOS)
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Provider%20Enrollment~Overview%20of%20Internet-based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758D006524EA?opendocument
This J1 article provides an overview of the Internet-based Provider
Enrollment, Chain and Ownership System (PECOS) and its limitations. Basic
information on how to access and navigate through the system, application
status check and standard processing timeframe is included.
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