The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2010/ACCConnect-7-28-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• ACCC Summary and Analysis of Proposed 2011 Medicare HOPPS Rule and Physician Fee Schedule
• Looking for Continuing Education Credits? Go to the ACCC Blackboard
• Podcast Available: Highlights of ACCC's 2010 Survey--Cancer Care Trends in Community Cancer Centers
• New Computer-based Tool Helps Survivors Move Forward After Cancer
****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
• High school mentoring program helps turn medical career dreams into reality
• New aerosol transmissible disease standards take effect September 1
• Public health officials broaden recommendations for pertussis vaccination
• Bills implementing federal health reform move through state legislature
• CMA's POLST kit now available in Spanish
• CMS releases "meaningful use" requirements for EHRs
• Webinar: Meaningful use of EHRs
****PALMETTO/J1MAC NEWS****
Due to an adverse reaction to Rituximab, an infusion scheduled for over one
hour was discontinued after 10 minutes. The physician conducted an
examination and returned the patient to the care of the nurse for an
additional hour of monitoring. Can we be reimbursed for the entire hour?
Since the intent was for an infusion, CPT code 9XXXX (chemotherapy
administration, intravenous infusion technique; up to 1 hour, single or
initial substance/drug) would be more appropriate than billing as a push.
Please note that documentation in the medical record of all time spent with
the patient is critical.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87RQCJ2085?opendocument
Claim Status Category and Claim Status Code Update
This J1 A/B MAC MLN Matters article (CR7052) explains that the Claim Status
Codes and other items were updated during the June 2010 meeting of the
national Code Maintenance Committee and code changes approved at that
meeting were posted to the Web on or about July 1, 2010. Included in the
code lists are specific details, including the date when a code was added,
changed or deleted. Medicare Contractors will implement these changes on
October 4, 2010. Providers are encouraged to review the information and to
share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87SLHY4764?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Friday, July 30, 2010
Monday, July 26, 2010
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
Magnetic Resonance Angiography (MRA)
This J1 A/B MAC MLN Matters article (CR7040) announces that, effective for
claims with dates of services on or after June 3, 2010, Medicare
Contractors will have the discretion to cover or not cover all indications
of MRA (and magnetic resonance imaging (MRI)) that are not specifically
nationally covered or nationally non-covered. Existing national coverage
for both MRI and MRA will be maintained. Providers are encouraged to review
the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87LKR34723?opendocument
August 2010 J1 A/B MAC Medicare Advisory
The August 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/87MRBX3556?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****PALMETTO/J1MAC NEWS****
Magnetic Resonance Angiography (MRA)
This J1 A/B MAC MLN Matters article (CR7040) announces that, effective for
claims with dates of services on or after June 3, 2010, Medicare
Contractors will have the discretion to cover or not cover all indications
of MRA (and magnetic resonance imaging (MRI)) that are not specifically
nationally covered or nationally non-covered. Existing national coverage
for both MRI and MRA will be maintained. Providers are encouraged to review
the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87LKR34723?opendocument
August 2010 J1 A/B MAC Medicare Advisory
The August 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/87MRBX3556?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Monday, July 19, 2010
ACCC, CMA, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2010/ACCConnect-7-14-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• ACCC Conference Call on Proposed HOPPS Rule and Physician Fee Schedule
• ACCC Efforts Pay Off: Drug Reimbursement in Hospital Outpatient Departments Set to Increase in 2011
• ACCC Releases 2010 Survey on Cancer Care Trends
• CMS Posts Proposed 2011 Physician Fee Schedule
• Final Rules Released on Meaningful Use of EHR
• How Much Do You Know About CML?
• The Best of ACCC's Educational Programs Featured in St. Louis
****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
• State ordered to retroactively pay providers $25.8M for 10% MediCal cut
• Preliminary list of certified EHRs expected this fall
• Legislation allowing hospitals to hire physicians moves to Senate
• New 2011 Medicare payment rule implements key provisions of reform law
• President Obama highlights insurance market reforms
• Webinar: Health Care Reform 2010
• CMS extends PECOS enrollment deadline
• How will Blue Cross contract amendments impact your practice
• FTC temporarily exempts physicians from "red flags" rule
• Deadline to opt out of United settlement is July 27
• EHR Best Practice Series Webinars
****PALMETTO/J1MAC NEWS****
Medicare Contractor Annual Update of the International Classification of
Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
This J1 A/B MAC MLN Matters article (CR7006) reminds the Medicare
Contractors and providers that the annual ICD-9-CM update will be effective
for dates of service on and after October 1, 2010, (for institutional
providers, effective for discharges on or after October 1, 2010). See the
new, revised and discontinued ICD-9-CM diagnosis codes on the Centers for
Medicare & Medicaid Services (CMS) Web site or at the National Center for
Health Statistics (NCHS) Web site in June of each year. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7N2SRQ1615?opendocument
Mailing To All Individual Practitioners, Medical Groups and Clinics and
Independent Diagnostic Testing Facilities (IDTF) Who Are Billing or Have
Billed For The Technical Component of Advanced Diagnostic Imaging Services
This J1 Part B MLN Matters article (CR6912) is for providers who bill the
Medicare program for the technical component of advanced diagnostic testing
services within the preceding six-month period and continue to have
Medicare billing privileges with Medicare Contractors. These providers will
receive a letter from your Medicare Contractor advising you of the need to
become accredited by January 1, 2012, in order to continue to provide these
services and bill Medicare. Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87AM5Q8243?opendocument
Mailing To All Individual Practitioners, Medical Groups and Clinics and
Independent Diagnostic Testing Facilities (IDTF) Who Are Billing or Have
Billed For The Technical Component of Advanced Diagnostic Imaging Services
This J1 Part B MLN Matters article (CR6912a) was revised on July 12, 2010,
to change the implementation date. In addition, the CR release date,
transmittal number and the Web address for accessing CR 6912 were revised.
In addition, this article is for providers who bill the Medicare program
for the technical component of advanced diagnostic testing services within
the preceding six-month period and continue to have Medicare billing
privileges with Medicare Contractors. These providers will receive a letter
from your Medicare Contractor advising you of the need to become accredited
by January 1, 2012, in order to continue to provide these services and bill
Medicare. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87CQSP0032?opendocument
2010 June Medicare Part B Fee Schedule Update: Northern California
The Northern California 2010 June Medicare Part B Fee Schedule Update is
now available and is effective for services performed on or after June 1,
2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87DMJ27675?opendocument
2010 June Medicare Part B Fee Schedule Update: Southern California
The Southern California 2010 June Medicare Part B Fee Schedule Update is
now available and is effective for services performed on or after June 1,
2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87DMJ50723?opendocument
2010 Revised Medicare Part B Fee Schedule: Northern California
The Northern California 2010 Revised Medicare Part B Fee Schedule is now
available and is effective for services performed on or after January 1,
2010 through May 31, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZDQMR7321?opendocument
2010 Revised Medicare Part B Fee Schedule: Southern California
The Southern California 2010 Revised Medicare Part B Fee Schedule is now
available and is effective for services performed on or after January 1,
2010 through May 31, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZDQMQ3850?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2010/ACCConnect-7-14-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• ACCC Conference Call on Proposed HOPPS Rule and Physician Fee Schedule
• ACCC Efforts Pay Off: Drug Reimbursement in Hospital Outpatient Departments Set to Increase in 2011
• ACCC Releases 2010 Survey on Cancer Care Trends
• CMS Posts Proposed 2011 Physician Fee Schedule
• Final Rules Released on Meaningful Use of EHR
• How Much Do You Know About CML?
• The Best of ACCC's Educational Programs Featured in St. Louis
****CMA NEWS****
The California Medical Association's (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:
• State ordered to retroactively pay providers $25.8M for 10% MediCal cut
• Preliminary list of certified EHRs expected this fall
• Legislation allowing hospitals to hire physicians moves to Senate
• New 2011 Medicare payment rule implements key provisions of reform law
• President Obama highlights insurance market reforms
• Webinar: Health Care Reform 2010
• CMS extends PECOS enrollment deadline
• How will Blue Cross contract amendments impact your practice
• FTC temporarily exempts physicians from "red flags" rule
• Deadline to opt out of United settlement is July 27
• EHR Best Practice Series Webinars
****PALMETTO/J1MAC NEWS****
Medicare Contractor Annual Update of the International Classification of
Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
This J1 A/B MAC MLN Matters article (CR7006) reminds the Medicare
Contractors and providers that the annual ICD-9-CM update will be effective
for dates of service on and after October 1, 2010, (for institutional
providers, effective for discharges on or after October 1, 2010). See the
new, revised and discontinued ICD-9-CM diagnosis codes on the Centers for
Medicare & Medicaid Services (CMS) Web site or at the National Center for
Health Statistics (NCHS) Web site in June of each year. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7N2SRQ1615?opendocument
Mailing To All Individual Practitioners, Medical Groups and Clinics and
Independent Diagnostic Testing Facilities (IDTF) Who Are Billing or Have
Billed For The Technical Component of Advanced Diagnostic Imaging Services
This J1 Part B MLN Matters article (CR6912) is for providers who bill the
Medicare program for the technical component of advanced diagnostic testing
services within the preceding six-month period and continue to have
Medicare billing privileges with Medicare Contractors. These providers will
receive a letter from your Medicare Contractor advising you of the need to
become accredited by January 1, 2012, in order to continue to provide these
services and bill Medicare. Providers are encouraged to review the
information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87AM5Q8243?opendocument
Mailing To All Individual Practitioners, Medical Groups and Clinics and
Independent Diagnostic Testing Facilities (IDTF) Who Are Billing or Have
Billed For The Technical Component of Advanced Diagnostic Imaging Services
This J1 Part B MLN Matters article (CR6912a) was revised on July 12, 2010,
to change the implementation date. In addition, the CR release date,
transmittal number and the Web address for accessing CR 6912 were revised.
In addition, this article is for providers who bill the Medicare program
for the technical component of advanced diagnostic testing services within
the preceding six-month period and continue to have Medicare billing
privileges with Medicare Contractors. These providers will receive a letter
from your Medicare Contractor advising you of the need to become accredited
by January 1, 2012, in order to continue to provide these services and bill
Medicare. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87CQSP0032?opendocument
2010 June Medicare Part B Fee Schedule Update: Northern California
The Northern California 2010 June Medicare Part B Fee Schedule Update is
now available and is effective for services performed on or after June 1,
2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87DMJ27675?opendocument
2010 June Medicare Part B Fee Schedule Update: Southern California
The Southern California 2010 June Medicare Part B Fee Schedule Update is
now available and is effective for services performed on or after June 1,
2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/87DMJ50723?opendocument
2010 Revised Medicare Part B Fee Schedule: Northern California
The Northern California 2010 Revised Medicare Part B Fee Schedule is now
available and is effective for services performed on or after January 1,
2010 through May 31, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZDQMR7321?opendocument
2010 Revised Medicare Part B Fee Schedule: Southern California
The Southern California 2010 Revised Medicare Part B Fee Schedule is now
available and is effective for services performed on or after January 1,
2010 through May 31, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7ZDQMQ3850?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Tuesday, July 13, 2010
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/5460.aspx. This edition features:
• President Signs Physician Payment Adjustment
• CMS Releases Proposed Rule on Medicare Physician Fee Schedule for CY 2011
• Medicare Releases 2011 Proposed Rule for Hospital Outpatient Services
• President Obama Appoints Donald Berwick to Be CMS Administrator
• CMS Addresses Concerns About PECOS Enrollment – Delays Automatic Rejection of Claims
• 2010 PQRI & Electronic Prescribing Incentive Program National Provider Call With Question & Answer Session
• CMS Updates Information About ICD-10
****PALMETTO/J1MAC NEWS****
Electronically Submitted Medicare Secondary Payer (MSP) Claims
Effective July 6, 2010, electronically submitted MSP claims will be
rejected if the Primary Payer’s Allowed Amount is not greater than or equal
to the Primary Payer’s Paid Amount.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/875RBN7285?opendocument
J1 Part B LCDs Revised
The following J1 Part B LCDs have been revised: Cataract Surgery in Adults
L30891, Intensity Modulated Radiation Therapy (IMRT) L28272, Noninvasive
Peripheral Venous Studies L28285, T-wave Alternans Testing L28305 and
Treatment of Ulcers & Symptomatic Hyperkeratoses L28308.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/876Q4K8456?opendocument
Ordering/Referring Provider Information in PECOS
At this time, Medicare contractors (including Palmetto GBA) will not
implement changes that would automatically reject claims based on orders,
certifications and referrals made by providers that have not yet had their
applications approved by July 6, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/876PNE0782?opendocument
Updated: Independent Diagnostic Testing Facilities - Availability of new
2010 Annual Procedure Codes
This Alert announces that a mass adjustment was completed on March 17, 2010
for Northern CA, Southern CA, HI and NV claims that were denied
incorrectly. Per the Contractor Medical Director (CMD) review, certain
services from the 2010 Annual Procedure Codes Update were generally
approved as allowable procedures to be performed in Independent Diagnostic
Testing Facilities (IDTF), as long as all other certifications and
requirements were accomplished. However, these services were not added as
approved in the system at that time. As a result, several claims were
denied incorrectly. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83UNAS7187?opendocument
Updates: Medicare Physician Fee Schedule
On June 23 and June 24, 2010, Palmetto GBA released some payments that werE
based on the reduced fee schedule. We will automatically process
adjustments to these claims. Palmetto GBA is currently processing claims
using the new 2.2 percent update rates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/876P2B4638?opendocument
J1 PCC to Close for Training on July 22
The J1 PCC will be closed for training on Thursday, July 22, 2010, from 7
a.m. to 5 p.m. PST. The Call Center will re-open on Friday, July 23, 2010,
at 7 a.m. PST. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/877QWY2338?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****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/5460.aspx. This edition features:
• President Signs Physician Payment Adjustment
• CMS Releases Proposed Rule on Medicare Physician Fee Schedule for CY 2011
• Medicare Releases 2011 Proposed Rule for Hospital Outpatient Services
• President Obama Appoints Donald Berwick to Be CMS Administrator
• CMS Addresses Concerns About PECOS Enrollment – Delays Automatic Rejection of Claims
• 2010 PQRI & Electronic Prescribing Incentive Program National Provider Call With Question & Answer Session
• CMS Updates Information About ICD-10
****PALMETTO/J1MAC NEWS****
Electronically Submitted Medicare Secondary Payer (MSP) Claims
Effective July 6, 2010, electronically submitted MSP claims will be
rejected if the Primary Payer’s Allowed Amount is not greater than or equal
to the Primary Payer’s Paid Amount.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/875RBN7285?opendocument
J1 Part B LCDs Revised
The following J1 Part B LCDs have been revised: Cataract Surgery in Adults
L30891, Intensity Modulated Radiation Therapy (IMRT) L28272, Noninvasive
Peripheral Venous Studies L28285, T-wave Alternans Testing L28305 and
Treatment of Ulcers & Symptomatic Hyperkeratoses L28308.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/876Q4K8456?opendocument
Ordering/Referring Provider Information in PECOS
At this time, Medicare contractors (including Palmetto GBA) will not
implement changes that would automatically reject claims based on orders,
certifications and referrals made by providers that have not yet had their
applications approved by July 6, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/876PNE0782?opendocument
Updated: Independent Diagnostic Testing Facilities - Availability of new
2010 Annual Procedure Codes
This Alert announces that a mass adjustment was completed on March 17, 2010
for Northern CA, Southern CA, HI and NV claims that were denied
incorrectly. Per the Contractor Medical Director (CMD) review, certain
services from the 2010 Annual Procedure Codes Update were generally
approved as allowable procedures to be performed in Independent Diagnostic
Testing Facilities (IDTF), as long as all other certifications and
requirements were accomplished. However, these services were not added as
approved in the system at that time. As a result, several claims were
denied incorrectly. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83UNAS7187?opendocument
Updates: Medicare Physician Fee Schedule
On June 23 and June 24, 2010, Palmetto GBA released some payments that werE
based on the reduced fee schedule. We will automatically process
adjustments to these claims. Palmetto GBA is currently processing claims
using the new 2.2 percent update rates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/876P2B4638?opendocument
J1 PCC to Close for Training on July 22
The J1 PCC will be closed for training on Thursday, July 22, 2010, from 7
a.m. to 5 p.m. PST. The Call Center will re-open on Friday, July 23, 2010,
at 7 a.m. PST. Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/877QWY2338?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Tuesday, July 6, 2010
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
CMS Quarterly Provider Update
The Quarterly Provider Update is a comprehensive resource published by the
Centers for Medicare & Medicaid Services (CMS) on the first business day of
each quarter. It is a listing of all non-regulatory changes to Medicare
including Program Memoranda, manual changes and any other instructions that
could affect providers. Regulations and instructions published in the
previous quarter are also included in the Update.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86XG7Y7538?opendocument
CMS to Review PECOS Enrollment Process - Medicare Working with Ordering and
Referring Providers and Suppliers to Streamline Enrollment Process
As part of those efforts, CMS will, for the time being, not implement
changes that would automatically reject claims based on orders,
certifications and referrals made by providers that have not yet had their
applications approved by July 6, 2010. While more than 800,000 physicians
and other health professionals have enrolled and have approved applications
in the PECOS system, some providers have encountered problems. CMS is
continuing to update and streamline the process, and more providers have
been enrolled in the past few days.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86XJ6S3468?opendocument
J1 Provider Outreach and Education Event Calendar
J1 Event Calendar is now loaded with July events hosted by Palmetto GBA J1
Provider Outreach and Education. Look out for more details about our
upcoming MACtoberfest, the Palmetto GBA J1's largest educational and
networking event of the year, on our J1 Part A or Part B home page soon.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
July Update to the 2010 Medicare Physician Fee Schedule Database (MPFSDB)
This J1 A/B MAC MLN Matters article (CR6974) amends payment files that were
issued to Medicare contractors based on the 2010 Medicare Physician Fee
Schedule (MPFS) Final Rule. This article provides corrections and effective
for dates of service on or after January 1, 2010, to those files. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86YLPS0778?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****PALMETTO/J1MAC NEWS****
CMS Quarterly Provider Update
The Quarterly Provider Update is a comprehensive resource published by the
Centers for Medicare & Medicaid Services (CMS) on the first business day of
each quarter. It is a listing of all non-regulatory changes to Medicare
including Program Memoranda, manual changes and any other instructions that
could affect providers. Regulations and instructions published in the
previous quarter are also included in the Update.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86XG7Y7538?opendocument
CMS to Review PECOS Enrollment Process - Medicare Working with Ordering and
Referring Providers and Suppliers to Streamline Enrollment Process
As part of those efforts, CMS will, for the time being, not implement
changes that would automatically reject claims based on orders,
certifications and referrals made by providers that have not yet had their
applications approved by July 6, 2010. While more than 800,000 physicians
and other health professionals have enrolled and have approved applications
in the PECOS system, some providers have encountered problems. CMS is
continuing to update and streamline the process, and more providers have
been enrolled in the past few days.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86XJ6S3468?opendocument
J1 Provider Outreach and Education Event Calendar
J1 Event Calendar is now loaded with July events hosted by Palmetto GBA J1
Provider Outreach and Education. Look out for more details about our
upcoming MACtoberfest, the Palmetto GBA J1's largest educational and
networking event of the year, on our J1 Part A or Part B home page soon.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
July Update to the 2010 Medicare Physician Fee Schedule Database (MPFSDB)
This J1 A/B MAC MLN Matters article (CR6974) amends payment files that were
issued to Medicare contractors based on the 2010 Medicare Physician Fee
Schedule (MPFS) Final Rule. This article provides corrections and effective
for dates of service on or after January 1, 2010, to those files. Providers
are encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86YLPS0778?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
Friday, July 2, 2010
ACCC, CMA, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2010/ACCConnect-6-30-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• President Obama Signs Physician-Fix Legislation
• CMS Posts Proposed 2011 Physician Fee Schedule
• Last Chance to Review and Comment on Proposed Changes to CoC Standards
• Heard on ACCC's ListServ: Drop in Radiation Therapy Numbers
• July 2010 Average Sales Price (ASP) Files Are Now Available
• Study Finds Poor Physician Adherence to Cervical Cancer Screening Guidelines
****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:
• State Facing Pertussis Epidemic: CDPH Urges Physicians to Vaccinate Patients Against Whooping Cough
• CMA Objects to Proposed Regulations Requiring Physician Participation in Lethal Injections
• President Signs Six-Month Medicare Patch
• Highlights from AMA's Annual Meeting
• CMA Publishes Payor Contract Amendment Action Guide
• The 2010 California Physician's Legal Handbook is Here
• Remember: PECOS Enrollment Deadline is July 6, 2010
• Physicians Must Now Comply With MBC Signage Regs
• July Issue of CMA Practice Resources (CPR) Now Available
****PALMETTO/J1MAC NEWS****
Clinical Review Judgment
This J1 A/B MAC MLN Matters article (CR6954a) was revised on June 16, 2010,
to include an additional reference to Chapter 3 of the Medicare Program
Integrity Manual on page 2. This article adds Section 3.14 (Clinical Review
Judgment) to the Medicare Program Integrity Manual, clarifying existing
language regarding clinical review judgments. It also requires that
Medicare claim review Contractors instruct their clinical review staffs to
use clinical review judgment 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/86RLFN7537?opendocument
CMS to Expand Medicare Preventive Services and Improve Access to Primary
Care in 2011
The Centers for Medicare & Medicaid Services (CMS) today issued a proposed
rule that would implement key provisions in the Affordable Care Act of 2010
that expand preventive services for Medicare beneficiaries, improve
payments for primary care services, and promote access to health care
services in rural areas. The proposed policies would apply to payments
under the Medicare Physician Fee Schedule for services furnished on or
after January 1, 2011.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86UKWZ8612?opendocument
Filing Requirements for Providers Responding to Additional Documentation
Requests (ADR)
Share with your staff - When responding to a medical record request or
Additional Documentation Requests (ADR) from Palmetto GBA, please make sure
the medical record is sent within 30 days from the date on the ADR letter.
For more detailed requirements for ADR submission, please read the article
link enclosed.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RAKLH0083?opendocument
How to Attend Webinars via WebEx
Share with your staff - The WebEx Tech Support phone number has been
changed. Please call (800) 508-8758 with the event number if you need any
technical assistance to attend our Webinars via WebEx.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83FQXB5711?opendocument
J1 PCC Closed In Observance of Independence Day July 5
The J1 Provider Contact Center (PCC) will be closed in observance of
Independence Day on Monday, July 5, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86URDM1328?opendocument
July 2010 J1 A/B MAC Medicare Advisory
The July 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/86USJG3150?opendocument
Opportunity for Nonparticipating Physicians/Practitioners to Become
Participating
In consideration of the recent enactment of the Preservation of Access to
Care for Medicare Beneficiaries and Pension Relief Act of 2010, which
established a 2.2 percent update to the Medicare Physician Fee Schedule
(MPFS), the Centers for Medicare & Medicare Services (CMS) is offering
physicians and other practitioners, whose current participation status is
non-participating, the opportunity to become participating (PAR). This
opportunity is being offered only to those physicians/practitioners whose
current PAR status is non-participating. This opportunity is available
through July 16, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86UMR82114?opendocument
The President Signs the Preservation of Access to Care for Medicare
Beneficiaries and Pension Relief Act of 2010 - 2.2 Percent Medicare
Physician Fee Schedule Update for June 1, 2010, Through November 30, 2010
This article announces that on June 25, 2010, President Obama signed into
law the 'Preservation of Access to Care for Medicare Beneficiaries and
Pension Relief Act of 2010'. This law establishes a 2.2 percent update to
the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from
June 1 through November 30, 2010. The Centers for Medicare & Medicaid
Services (CMS) has directed Medicare claims administration contractors to
discontinue processing claims at the negative update rates and to
temporarily hold all claims for services rendered June 1, 2010, and later,
until the new 2.2 percent update rates are tested and loaded into the
Medicare contractors' claims processing systems. Providers are encouraged
to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86RL3M6255?opendocument
Guidelines to Allow Contractors to Develop and Utilize Procedures for
Accepting and Processing Appeals via Facsimile and/or via a Secure Internet
Portal, Application
This J1 A/B MAC MLN Matters article (CR6958) updates the current
instructions in the Medicare Claims Processing Manual, Chapter 29, to allow
Medicare contractors to accept claim appeal requests via facsimile and/or
via a secure Internet portal, application. CR 6958 provides guidance to
Medicare Contractors who have already modified or currently wish to modify
their procedures to allow for receipt and/or processing of redetermination
requests via facsimile and/or via a secure Internet portal/application. At
this time, Medicare contractors are not required to accept appeals via
facsimile or via secure Internet portal/application. Medicare contractors
wishing to utilize a secure Internet portal/application must seek approval
from the Centers for Medicare & Medicaid Services (CMS) prior to
implementation of that portal/application. Providers are encouraged to
review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86VP8N6611?opendocument
October Quarterly Update to 2010 Annual Update of Healthcare Common
Procedure Coding System (HCPCS) Codes Used for Skilled Nursing Facility
(SNF) Consolidated Billing (CB) Enforcement
This J1 Part A MLN Matters article (CR7002) provides the October quarterly
update to the 2010 Healthcare Common Procedure Coding System (HCPCS) codes
for Skilled Nursing Facility (SNF) consolidated billing (CB). Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86WQBX5053?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) Connect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2010/ACCConnect-6-30-2010.html. ANCO is an Institutional Member of ACCC. This edition features:
• President Obama Signs Physician-Fix Legislation
• CMS Posts Proposed 2011 Physician Fee Schedule
• Last Chance to Review and Comment on Proposed Changes to CoC Standards
• Heard on ACCC's ListServ: Drop in Radiation Therapy Numbers
• July 2010 Average Sales Price (ASP) Files Are Now Available
• Study Finds Poor Physician Adherence to Cervical Cancer Screening Guidelines
****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:
• State Facing Pertussis Epidemic: CDPH Urges Physicians to Vaccinate Patients Against Whooping Cough
• CMA Objects to Proposed Regulations Requiring Physician Participation in Lethal Injections
• President Signs Six-Month Medicare Patch
• Highlights from AMA's Annual Meeting
• CMA Publishes Payor Contract Amendment Action Guide
• The 2010 California Physician's Legal Handbook is Here
• Remember: PECOS Enrollment Deadline is July 6, 2010
• Physicians Must Now Comply With MBC Signage Regs
• July Issue of CMA Practice Resources (CPR) Now Available
****PALMETTO/J1MAC NEWS****
Clinical Review Judgment
This J1 A/B MAC MLN Matters article (CR6954a) was revised on June 16, 2010,
to include an additional reference to Chapter 3 of the Medicare Program
Integrity Manual on page 2. This article adds Section 3.14 (Clinical Review
Judgment) to the Medicare Program Integrity Manual, clarifying existing
language regarding clinical review judgments. It also requires that
Medicare claim review Contractors instruct their clinical review staffs to
use clinical review judgment 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/86RLFN7537?opendocument
CMS to Expand Medicare Preventive Services and Improve Access to Primary
Care in 2011
The Centers for Medicare & Medicaid Services (CMS) today issued a proposed
rule that would implement key provisions in the Affordable Care Act of 2010
that expand preventive services for Medicare beneficiaries, improve
payments for primary care services, and promote access to health care
services in rural areas. The proposed policies would apply to payments
under the Medicare Physician Fee Schedule for services furnished on or
after January 1, 2011.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86UKWZ8612?opendocument
Filing Requirements for Providers Responding to Additional Documentation
Requests (ADR)
Share with your staff - When responding to a medical record request or
Additional Documentation Requests (ADR) from Palmetto GBA, please make sure
the medical record is sent within 30 days from the date on the ADR letter.
For more detailed requirements for ADR submission, please read the article
link enclosed.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7RAKLH0083?opendocument
How to Attend Webinars via WebEx
Share with your staff - The WebEx Tech Support phone number has been
changed. Please call (800) 508-8758 with the event number if you need any
technical assistance to attend our Webinars via WebEx.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/83FQXB5711?opendocument
J1 PCC Closed In Observance of Independence Day July 5
The J1 Provider Contact Center (PCC) will be closed in observance of
Independence Day on Monday, July 5, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86URDM1328?opendocument
July 2010 J1 A/B MAC Medicare Advisory
The July 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/86USJG3150?opendocument
Opportunity for Nonparticipating Physicians/Practitioners to Become
Participating
In consideration of the recent enactment of the Preservation of Access to
Care for Medicare Beneficiaries and Pension Relief Act of 2010, which
established a 2.2 percent update to the Medicare Physician Fee Schedule
(MPFS), the Centers for Medicare & Medicare Services (CMS) is offering
physicians and other practitioners, whose current participation status is
non-participating, the opportunity to become participating (PAR). This
opportunity is being offered only to those physicians/practitioners whose
current PAR status is non-participating. This opportunity is available
through July 16, 2010.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86UMR82114?opendocument
The President Signs the Preservation of Access to Care for Medicare
Beneficiaries and Pension Relief Act of 2010 - 2.2 Percent Medicare
Physician Fee Schedule Update for June 1, 2010, Through November 30, 2010
This article announces that on June 25, 2010, President Obama signed into
law the 'Preservation of Access to Care for Medicare Beneficiaries and
Pension Relief Act of 2010'. This law establishes a 2.2 percent update to
the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from
June 1 through November 30, 2010. The Centers for Medicare & Medicaid
Services (CMS) has directed Medicare claims administration contractors to
discontinue processing claims at the negative update rates and to
temporarily hold all claims for services rendered June 1, 2010, and later,
until the new 2.2 percent update rates are tested and loaded into the
Medicare contractors' claims processing systems. Providers are encouraged
to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86RL3M6255?opendocument
Guidelines to Allow Contractors to Develop and Utilize Procedures for
Accepting and Processing Appeals via Facsimile and/or via a Secure Internet
Portal, Application
This J1 A/B MAC MLN Matters article (CR6958) updates the current
instructions in the Medicare Claims Processing Manual, Chapter 29, to allow
Medicare contractors to accept claim appeal requests via facsimile and/or
via a secure Internet portal, application. CR 6958 provides guidance to
Medicare Contractors who have already modified or currently wish to modify
their procedures to allow for receipt and/or processing of redetermination
requests via facsimile and/or via a secure Internet portal/application. At
this time, Medicare contractors are not required to accept appeals via
facsimile or via secure Internet portal/application. Medicare contractors
wishing to utilize a secure Internet portal/application must seek approval
from the Centers for Medicare & Medicaid Services (CMS) prior to
implementation of that portal/application. Providers are encouraged to
review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86VP8N6611?opendocument
October Quarterly Update to 2010 Annual Update of Healthcare Common
Procedure Coding System (HCPCS) Codes Used for Skilled Nursing Facility
(SNF) Consolidated Billing (CB) Enforcement
This J1 Part A MLN Matters article (CR7002) provides the October quarterly
update to the 2010 Healthcare Common Procedure Coding System (HCPCS) codes
for Skilled Nursing Facility (SNF) consolidated billing (CB). Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/86WQBX5053?opendocument
The ANCO Online ListServ has moved and is now sent directly from the ANCO office computer. Please contact ListServ@anco-online.org if you wish to update or unsubscribe your e-mail address. Thanks!
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