ASH, CMA, & 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/5774.aspx. This edition features:

• Health Reform Law Passes SIx-Month Milestone: Initial Reforms Begin to Take Effect

• Register for ASH Webinar Series on Thrombosis

• ASH Comments on Proposed HIPAA Modifications: Recommends Flexibility During Implementation

• AHRQ Technology Assessment on Off-Label Cancer Treatment Incorporates ASH Comments to Address Concerns

• CMS Introduces Webpage Dedicated to ICD-9/10 Transition in a CMS Version 5010 Environment

• CMS Publishes October 2010 ASP and NOC Pricing FIles and Crosswalks

• Register for the 52nd ASH Annual Meeting by November 4


****CMA NEWS****
The California Medical Association's (CMA) CMA Alert was published and is available online at http://www.calphys.org/html/news.asp. This edition features:

• CMA Files Lawsuit Against Blue Shield for Bogus Physician Rating System

• There's Still Time to Claim Your Share of the $350M UnitedHealth Settlement

• CMA Advocacy Results in Changes to UnitedHealthcare Coverage Determination Guideline

• CMA Receives Grant for Electronic Health Records Support

• Federal EHR Incentives: Do You Qualify?

• CMA Tells IOM That Medicare Rates Must Reflect Regional Costs


****PALMETTO/J1MAC NEWS****
PECOS Dark Days
Due to scheduled maintenance, the Internet-based Provider Enrollment, Chain
and Ownership System (PECOS) will be unavailable from Wednesday, September
29, 2010, through Sunday, October 3, 2010. Internet-based PECOS allows
physicians, non-physician practitioners, providers and other suppliers to
enroll or make a change to their existing Medicare enrollment information
over the Internet.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89CLB68565?opendocument


2011 Annual Update of Healthcare Common Procedure Code System (HCPCS) Codes
for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update
This J1 A/B MAC MLN Matters article (CR7159) provides the 2011 annual
update of Healthcare Common Procedure Coding System (HCPCS) Codes for
Skilled Nursing Facility Consolidated Billing (SNF CB) and how the updates
affect edits in Medicare claims processing systems. Physicians and
providers are advised that, by the first week in December 2010, new code
files will be posted on the Centers for Medicare & Medicaid Services (CMS)
Web site. Note that this site will include new Excel and PDF format files.
It is important and necessary for the provider community to view the
‘General Explanation of the Major Categories’ PDF file located at the
bottom of each year’s FI/A/B MAC update listed on the CMS Web site in order
to understand the Major Categories, including additional exclusions not
driven by HCPCS codes. Providers are encouraged to review the information
and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89BNAE2184?opendocument


Tenth National Education Call on Medicare Fee-for-Service (FFS)
Implementation of HIPAA Version 5010 and D.0 Transactions
The Centers for Medicare & Medicaid Services (CMS) will host its tenth
national education call on September 29, 2010, regarding implementation of
HIPAA Version 5010 and D.0 transaction standards for Medicare
Fee-for-Service (FFS). This session will focus on the TA1, 999 and 277CA
transactions. Subject matter experts will review Medicare FFS specific
changes as well as general information to help the audience prepare for the
transition. The presentation will be followed by a question and answer
session.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89DFW21218?opendocument


Update to the Healthcare Provider Taxonomy Codes (HPTC) - January 1, 2011
In this article, the Centers for Medicare and Medicaid Services (CMS) has
released the summary of changes reflected in the Health Care Provider
Taxonomy Code (HPTC) list. A/B MACs will update their HPTC tables with this
new version effective on January 1, 2011. Providers are encouraged to
review the information and to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89GLU94224?opendocument


Provider Medicare Voluntary Refunds: Immediate Offset Requests Terminated
This article announces that, as of October 1, 2010, Palmetto GBA will no
longer allow providers to request 'immediate offset' as a payment method
relating to voluntary/self-disclosed Medicare overpayments. Providers must
submit a check made payable to Palmetto GBA or Medicare with the
overpayment refund form. If the check payee is addressed differently, the
check will be returned to the provider. Overpayment refund forms received
without check payment will be processed under established collection
procedures mandated by the Centers for Medicare & Medicaid Services (CMS).
Providers are encouraged to review the information and to share with their
staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89DRTZ7213?opendocument


Further Instruction for Implementation of Health Insurance Portability and
Accountability Act of 1996 (HIPAA) version 5010 for Transaction 835 -
Health Care Claim Payment/Advice and Updated Standard Paper Remit (SPR)
Change Request (CR) 7032 provides additional instructions to clarify
instructions previously sent or not implemented correctly, and to set up a
process to follow when corrective actions must be developed and implemented
for Out Of Balance situations. This announces that the Centers for Medicare
& Medicaid Services (CMS) is in the process of implementing the next
version of the HIPAA Transaction 835 standard – referred to as 835v5010 in
this document. The Secretary of the Department of Health and Human Services
(DHHS) has adopted ASC X12 version 5010 and NCPDP version D.0 as the next
HIPAA standard for HIPAA covered transactions. The final rule was published
on January 16, 2009. Providers are encouraged to review the information and
to share with their staff.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~89HJL77718?opendocument


J1PCC to Close on September 24
The J1PCC will be closed for training on Friday, September 24, 2010, from
11 a.m. to 3 p.m. (PDT). The Call Center will re-open at 3 p.m. PDT.
Please be sure to share with your staff.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/89JR771328?opendocument


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