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-8-11-2010.html. ANCO is an Institutional Member of ACCC. This edition features:

• Archived Webinar Now Available: Guide to Best Practices in a Comprehensive Prostate Cancer Program II

• Only a Limited Number of Hotel Rooms Remain: St. Louis Conference Hotel is Filling Up

• Expanded Enrollment for 340B Opens

• Podcast Available: Highlights of ACCC's 2010 Survey--Cancer Care Trends in Community Cancer Centers

• Nominations Open for ACCC's 2011 David King Community Clinical Scientist Award

• Heard on ACCC's ListServ: Supporting a Gynecologic Oncology Specialist

• National Coalition of Oncology Nurse Naviators (NCONN) to Host October Meeting


****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:

• 2011 Medicare fee schedule dramatically shifts funding from urban states to rural states

• Sacramento pediatrician receives physician humanitarian award

• Most major health plans will not delegate time access requirements

• U.S. Senate extends Medicaid assistance to states; California budget talks continue

• Rosy predictions for Medicare solvency are unrealistic, says Medicare actuary

• Medicare auditor identifies 131,000 overpaid claims

• CMA webinar: Health Care Reform 2010


****PALMETTO/J1MAC NEWS****
2010 MACtoberfest in Palm Springs, California October 27-29
Pack your bags and join us in the desert of Palm Springs, California from
October 27 to 29 to find your directions in the vast world of Medicare.
Registration opens soon. Look out for more details by clicking on the
MACtoberfest event icon from the J1 Part A or Part B home page in the next
few days.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/867R3X8418?opendocument


Implementation of New Statutory Provision Pertaining to Medicare Three-Day
Payment Window - Outpatient Services Treated as Inpatient
This article serves as notification of the implementation of the three-day
(or one-day) payment window provision under Section 102 of Publication L
111-192 of the 'Preservation of Access to Care for Medicare Beneficiaries
and Pension Relief Act of 2010'. It includes general instructions on
appropriate billing for compliance with the law. CMS will provide
conforming updates to the Medicare regulations and the Medicare Claims
Processing Manual (Publication 100-4) in the near future. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/886QRF3304?opendocument


Timely Claims Filing: Additional Instructions
This J1 A/B MAC MLN Matters article (CR7080) expands the Medicare
Fee-for-Service (FFS) reimbursement instructions outlined in change request
(CR) 6960 that specified the basic timely filing standards established for
FFS reimbursement. Those basic standards are a result of Section 6404 of
the Patient Protection and Affordable Care Act of 2010 (ACA) that states
that claims with dates of service on or after January 1, 2010, received
later than one calendar year beyond the date of service will be denied by
Medicare. CR 7080 lists the standards for dates of service used to
determine the timely filing of claims. Providers are encouraged to review
the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/886RHS0688?opendocument


Correction: 'Customer Service Representative (CSR) Conference Call' Article
There was a typo in a J1 article that was published in the Friday, August
6, 2010, listserv. The PCC closure time indicated in the article, Customer
Service Representative (CSR) Conference Call, was published as 7:30 a.m. to
11:30 p.m. on August 20. This is incorrect. The correct PCC closure time on
August 20 is from 7:30 a.m. to 11:30 a.m. This has been corrected in the
article that was published on the J1 Web site. We apologize for the
inconvenience.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/887KWU0785?opendocument


Revisions to Claims Processing Instructions for Services Rendered in Place
of Service Home
This J1 Part B MLN Matters article (CR6947) announces a requirement that
Contractors now enter the address of where services were performed,
including the ZIP code, on claims for anesthesia services and every service
payable under the Medicare Physician Fee Schedule (MPFS) for services
provided in all places of service, including Home. This change will be
effective for claims that are submitted on the 5010 version of the ANSI
X12N 837P electronic form that are processed by Medicare on or after
January 1, 2011, and on the paper Form CMS 1500 with dates of service on or
after January 1, 2011. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/886Q3Y1574?opendocument


Common Working File (CWF) Unsolicited Response Adjustments for Certain
Claims Denied Due to an Open Medicare Secondary Payer (MSP) Group Health
Plan (GHP) Record Where the GHP Record was Subsequently Deleted or
Terminated
This J1 A/B MAC MLN Matters article (CR6625) instructs Medicare Contractors
and shared system maintainers (SSM) to implement (effective April 1, 2011)
an automated process to reopen Group Health Plan (GHP) Medicare Secondary
Payer (MSP) claims when related MSP data is deleted or terminated after
claims were processed subject to the beneficiary record on Medicare’s
database. Providers are encouraged to review the information and to share
with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/887QS92045?opendocument


Medical Record Retention and Media Formats for Medical Records
This Special Edition (SE1022) is an informational article. This article
provides guidance for physicians, suppliers and providers on record
retention timeframes. State laws generally governs how long medical records
are to be retained. However, the Health Insurance Portability and
Accountability Act (HIPAA) of 1996 (HIPAA) administrative simplification
rules require a covered entity, such as a physician billing Medicare, to
retain required documentation for six years from the date of its creation
or the date when it last was in effect, whichever is later. Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/889N558127?opendocument


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 (CR7006a) was revised on August 4,
2010, to reflect the revised CR 7006. In this article, the CR release date
and transmittal number were changed and the Web address for accessing CR
7006 was also changed. The article 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). Providers are
encouraged to review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/887QZX2140?opendocument


J1 Alert: Audit 122
This Alert announces that, per Change Request 1252, effective March 2001,
Cancer Screening NCD coverage was implemented for CPT Codes G0102 and
G0103. Incorrect denials for these codes occurred from June 28, 2010, to
July 13, 2010. A mass adjustment was performed and the system has been
updated to allow these services for dates of service (DOS) on or after
March 1, 2001. Providers are encouraged to review the information and to
share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/889KFA3685?opendocument


J1 Alert: Super Rural Bonus ZIP Codes for Ambulance
This Alert announces that Change Request 6972 reinstated the 22.6 percent
bonus on super rural ZIP Codes performed by ambulance suppliers from
December 31, 2009, until December 31, 2010. Palmetto GBA will identify
claims that processed with dates of service (DOS) on or after July 7, 2010,
with January 1, 2010, DOS and after, which have been paid incorrectly.
Providers are encouraged to review the information and to share with their
staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/889KMR3508?opendocument


Electronic Prescribing (eRx) Incentive Program 2010 Updates
This Special Edition article (SE1021) alerts providers that it is not too
late to start participating in the electronic prescribing (eRx) Incentive
Program to potentially qualify to receive a full-year incentive payment.
Eligible professionals may begin reporting eRx at any time throughout the
2010 program year of January 1, 2010, through December 31, 2010, to be
incentive eligible. Providers are encouraged to review the information and
to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/889MWH4827?opendocument


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