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


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