ASH & Palmetto/J1MAC News

The following information has been received by ANCO.


****ASH NEWS****
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/Practice/Practice-Updates/5270.aspx. This edition features:

• Congress Scales Back Physician Payment Plan; Passage Needed Before June 1 to Avert Cuts

• PQRI Reporting Period Begins July 1, 2010 – ASH Encourages Participation

• CMS Provides PQRI 2008 Incentive Payment Adjustments

• Medicare Program Adjusts Payments for 2010


****PALMETTO/J1MAC NEWS****
2010 J1 Mammography Fee Schedule (XLS, 21 KB)
Share with your staff - The 2010 J1 Mammography Fee Schedule has been
updated on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZFTY68431?opendocument


June 2010 J1 A/B MAC Medicare Advisory
The June 2010 J1 A/B MAC Medicare Advisory is now available on the J1 Web
site. Providers are encouraged to review the information and to share with
their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/85TLBL6446?opendocument


Clinical Review Judgment
This J1 A/B MAC MLN Matters article (CR6954) updates the Medicare Program
Integrity Manual by adding a new section (3.14 - Clinical Review Judgment),
which clarifies existing language regarding clinical review judgments and
also requires that Medicare Claim Review Contractors instruct their
clinical review staffs to use the clinical review judgment process when
making complex review determinations about a claim. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/85UM5C8153?opendocument


Information Regarding the Holding of June 2010 Claims for Services Paid
Under the 2010 Medicare Physician Fee Schedule
The Continuing Extension Act of 2010, enacted on April 15, 2010, extended
the zero percent (0%) update to the 2010 Medicare Physician Fee Schedule
(MPFS) through May 31, 2010. The Centers for Medicare & Medicaid Services
(CMS) believes Congress is working to avert the negative update scheduled
to take effect June 1, 2010. To avoid disruption in the delivery of health
care services to beneficiaries and payment of claims for physicians,
non-physician practitioners, and other providers of services paid under the
MPFS, CMS has instructed its contractors to hold claims containing services
paid under the MPFS (including anesthesia services) for the first 10
business days of June.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/85UNF53517?opendocument


Medically Unlikely Edits (MUE): Change Request 6712
These are the updated instructions for Change Request 6712, Medically
Unlikely Edits (MUE). The instructions are being posted because there will
not be an MLN Matters article that addresses this subject matter. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZNTJ54702?opendocument


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