The following information has been received by ANCO.
****CMS NEWS****
MM6407 – Medicare Claims Processing Manual Clarifications for Skilled Nursing Facility (SNF) and Therapy Billing
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6407.pdf
CMS has made available the Medicare Part B Drug and Biological Average Sales Price (ASP) Payment Amounts for April 1, 2009 to June 30, 2009 on the CMS website at http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a1_2009aspfiles.asp. The files are located in the "Downloads" section of this web page. Revised pricing files for January 2009, October 2008, July 2008 and April 2008 are also available for download. The 2008 revised pricing files are posted at http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a_2008aspfiles.asp.
****PALMETTO/J1MAC NEWS****
Access Unavailable during Significant System Updates This Weekend
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Access%20Unavailable%20during%20Significant%20System%20Updates%20This%20Weekend?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758900668577?opendocument
This weekend significant system updates are being implemented. The system
will go down at 7 p.m. PST on Friday, April 3, 2009. While updates are
being deployed, you may be unable to access claims information through the
IVR. Claims information will, once again, be obtainable on Monday, April 6,
2009.
April 2009 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~April%202009%20J1%20AB%20MAC%20Medicare%20Advisory?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257589004DD7B4?opendocument
The April 2009 J1 A/B MAC Medicare Advisory is now available to be viewed
on the Palmetto GBA Web site. It contains the latest updates and useful
information regarding Medicare. Please share this information with your
staff.
CMS Quarterly Provider Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Ohio%20Part%20B%20Carrier~Articles~General~CMS%20Quarterly%20Provider%20Update?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385256D3400525573?opendocument
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.
****UHC NEWS****
KRAS gene requirement for cetuximab and panitumumab in colorectal cancer
Effective April 1, 2009, UnitedHealthcare will require the submission of a pathology report documenting a wild type KRAS gene for coverage of Erbitux® (cetuximab J9055) and Vectibix® (panitumumab J9303) in the treatment of metastatic colorectal cancer. As always, final coverage is subject to the member’s benefit plan document.
UnitedHealthcare has contracts with two national laboratories (Genzyme Genetics and LabCorp) that provide KRAS testing. Specimens may be sent directly to these laboratories; claims for members that are paid on a fee for service basis (non capitated) will be paid directly to the laboratories by UnitedHealthcare. Both laboratories request that a copy of the pathology report be sent with the specimen. If your local participating laboratory provides this test it will also be covered.
Requirements:
The submission of a KRAS pathology report is required for members starting therapy using cetuximab or panitumumab after the implementation date. Only one pathology report per member ID is required.
Physicians will not be required to submit pathology reports for individuals that were on cetuximab or panitumumab prior to the effective date for the plan's policy.
The policy applies to those individuals where UnitedHealthcare or one of its affiliated entities is the primary payor.
Pathology reports are NOT required if UnitedHealthcare or one of its affiliated entities is the secondary payor.
For UnitedHealthcare patients: Fax a copy of the pathology report to (915) 231-1970 using the KRAS fax coversheet. The coversheet is available at UnitedHealthcareOnline.com >Cancer - Oncology > KRAS > KRAS Fax Coversheet. You may use this process and submit your claims electronically.
For Oxford patients: Oxford will also require the KRAS pathology report for individuals starting cetuximab and panitumumab therapy 4/1/09. Providers are required to obtain prior authorization for the use of cetuximab and panitumumab for patients with colorectal cancer. Prior authorization requirements include the submission of the laboratory report demonstrating the presence of the KRAS wild type gene. Providers should follow the standard prior authorization process.
Additional information regarding the implementation of this policy for UnitedHealthcare and its entities is available at UnitedHealthcareOnline.com and on the other health plan websites.
Lee Newcomer comments: UnitedHealthcare had a similar process for the HER2 gene and trastuzumab coverage. During the two years the edit was active we noted that the billing offices frequently sent the wrong clinical records. We only need the copy of the laboratory report documenting the KRAS gene type. Please do not send pathology reports, clinic notes, discharge summaries or other unrelated materials. It may be beneficial for the clinicians to teach the billing staff what document to send for this review.
Access to the NCCN Compendium for UnitedHealthcare coverage
The National Comprehensive Cancer Network (NCCN) has announced that effective April 1, 2009 they will require a paid subscription for access to the NCCN Drugs and Biologics Compendium. As you already know, UnitedHealthcare uses this document as a reference for coverage decisions.
UHC recognizes the value of the NCCN Drugs and Biologics Compendium in physician practices and has purchased a group rate. We are pleased to offer FREE access to the NCCN compendium to our UHC participating physicians and their office staff.
To access the NCCN Drugs and Biologics Compendium under the UHC agreement, you will need to be a registered user of UnitedHealthcareonline. Once you are logged into our website, proceed to the NCCN Compendium page. From there, you can log in to www.NCCN.org for free access to the NCCN Drugs and Biologics Compendium.
If you are not a registered user of UnitedHealthcareonline, go to the New User link in the upper right corner of the home page and register.
Tuesday, March 31, 2009
Sunday, March 29, 2009
Corporate Member News
The following information has been received by ANCO.
All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available online at http://anco-online.blogspot.com/.
****CORPORATE NEWS****
Bristol-Myers Squibb Oncology is hosting State of the Art Management of Chronic Myeloid Leukemia with Neil Shah, M.D., UCSF, on April 23rd at the Hyatt Regency San Francisco. For more information and to register, visit www.dwrite.com/CMLSanFrancisco.
All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available online at http://anco-online.blogspot.com/.
****CORPORATE NEWS****
Bristol-Myers Squibb Oncology is hosting State of the Art Management of Chronic Myeloid Leukemia with Neil Shah, M.D., UCSF, on April 23rd at the Hyatt Regency San Francisco. For more information and to register, visit www.dwrite.com/CMLSanFrancisco.
Thursday, March 26, 2009
ASCO, ASH, CMA, CMS News; Institutional Member News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe5b1579716505747210&m=ff311d707460&ls=fdf8137271640478771d727d&l=fe62157570620c7d7615&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe221672706c0c75771d71. ANCO is a state/regional affiliate of ASCO. This edition features:
ASCO President Testifies at Congressional Hearing on Funding for Cancer Research
House Small Business Committee Holds Hearing on Medicare's Impact on Providers
ASCO Member Testifies at IOM Public Hearing on Comparative Effectiveness Research
Update on Status of Prompt Pay Discount Legislation
Congressmen Introduce Bills that Allow for FDA Approval of Generic Biologics
Update on Tobacco Control Legislation
****ASH NEWS***
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/03262009.cfm#1. This edition features:
Register Now: Webinar to Ensure Hematologists Receive PQRI and E-Prescribing Bonuses for Participation
Average Sales Price Legislation Introduced in the House of Representatives
Senators Kennedy and Hutchison to Introduce Comprehensive Cancer Legislation
Health-Care Reform Debate Continues to Take Shape in Washington
Obama Administration Names Federal Coordinating Council for Comparative Effectiveness Research
ASH Signs On to Letter Urging Medicare Physician Payment Fix
ASH Signs On to Letter Expressing Concerns about RAC Program
Medicare Releases Quarterly CCI Update
New BCBS Predetermination Procedure for Red and White Cell Growth Factors
****CMA NEWS****
The California Medical Association and the American Medical Association have joined individual physicians and other state medical groups to file a class action lawsuit against health insurance company WellPoint, Inc. The lawsuit, filed today in Los Angeles federal court, alleges that WellPoint colluded with Ingenix, a unit of United Health Group, on a price-fixing scheme that relied on an obscure database to set artificially low reimbursement rates for out-of-network care.
“Health insurers are data manipulating to set rates artificially low, forcing patients to pay more than they bargained for when they go to a doctor of their choice,” said Dr. Dev GnanaDev, CMA president. “This undermines the patient choice that insurers promise when they tout their PPO products and under-compensates doctors for the care they provide.”
WellPoint – which operates as Blue Cross in California – is legally bound to pay the usual and customary amount for care provided to their enrollees by an out of network physician. Patients pay any additional amounts over and above what WellPoint decides to pay for those services. To determine these rates, WellPoint uses a database run by Ingenix, a company owned and operated by United Health Group, another health insurance company.
A recent investigation by New York Attorney General Andrew Cuomo concluded that the Ingenix data is intentionally manipulated to allow health plans to scam physicians by shortchanging reimbursements on medical bills. A WellPoint executive acknowledged “conflicts of interest in the Ingenix database,” and the company agreed to pay $10 million to help fund a new database run by an independent non-profit organization to replace Ingenix. The company also agreed to quit feeding data into Ingenix and use the new system once it is up and running. The settlement with Cuomo did not seek redress for patients and doctors.
“As health care costs continue to rise, insurers appear to be scheming to find ways to shift resources to their bottom line rather than towards the health care of their enrollees. The CMA will continue fighting to obtain relief for patients and physicians who were harmed by the systemic flaws of the conflict ridden Ingenix database,” Dr. GnanaDev said.
The CMA and AMA have filed this litigation in partnership with the Medical Association of Connecticut, Georgia, North Carolina and the individual plaintiffs Dr. Stephen D. Henry and Dr. James G. Schwendig.
****CMS NEWS****
MM6394 – Program Overview: 2009 Physician Quality Reporting Initiative (PQRI) And The 2009 Electronic Prescribing (E-Prescribing) Incentive Program
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6394.pdf
MM6310 – Incorporation of Physician Fee Schedule Regulatory Changes into Chapter 10 of the Program Integrity Manual (PIM)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6310.pdf
CMS Provider Communications Group will host the fourth in a series national provider conference calls on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 2:30 p.m. – 4:30 p.m., EDT, on Wednesday, April 22, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
The topics covered on this national provider call will include:
An update on the prostate cancer measures-2008: Measure #101; 2008-2009: Measure #102, #104, and #105;
Tips for satisfactorily participating in the 2009 PQRI; and
Planning for the 2010 PQRI reporting options.
Following this presentation, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website, in the Educational Resources section. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: April 22, 2009
Conference Title: 2009 Physician Quality Reporting Initiative - National Provider Call
Time: 2:30 p.m. EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 2:30 p.m. EDT on April 21, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to: http://www2.eventsvc.com/palmettogba/042209
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 3:30 p.m. EDT 4/22/2009 until 11:59 p.m. EDT 4/29/2009. The call in data for the replay is (800) 642-1687 and the passcode is 90578004.
If you require services for the hearing impaired please send an email to:Medicare.TTT@PalmettoGBA.com.
PQRI Frequently Asked Question of the Week
Q: As required by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), the Centers for Medicare & Medicaid Services (CMS) established the criteria for satisfactorily reporting through the alternative reporting method using measures groups for the Physician Quality Reporting Initiative (PQRI). When referring to these measures groups, how is “consecutive” defined?
A: For Physician Quality Reporting Initiative (PQRI) measures groups, consecutive means in order by date of service. Patients are considered consecutive without regard to gender.
****INSTITUTIONAL MEMBER NEWS****
The University of California, San Francisco is organizing The 3rd International Symposium on Cancer Metastasis and the Lymphovascular System: Basis for Rational Therapy on May 6-9, 2009 at the Intercontinental San Francisco Hotel.
Visit www.ucsfcme.com/blast2009/MSU09002.htm for more information and to register.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe5b1579716505747210&m=ff311d707460&ls=fdf8137271640478771d727d&l=fe62157570620c7d7615&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe221672706c0c75771d71. ANCO is a state/regional affiliate of ASCO. This edition features:
ASCO President Testifies at Congressional Hearing on Funding for Cancer Research
House Small Business Committee Holds Hearing on Medicare's Impact on Providers
ASCO Member Testifies at IOM Public Hearing on Comparative Effectiveness Research
Update on Status of Prompt Pay Discount Legislation
Congressmen Introduce Bills that Allow for FDA Approval of Generic Biologics
Update on Tobacco Control Legislation
****ASH NEWS***
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/03262009.cfm#1. This edition features:
Register Now: Webinar to Ensure Hematologists Receive PQRI and E-Prescribing Bonuses for Participation
Average Sales Price Legislation Introduced in the House of Representatives
Senators Kennedy and Hutchison to Introduce Comprehensive Cancer Legislation
Health-Care Reform Debate Continues to Take Shape in Washington
Obama Administration Names Federal Coordinating Council for Comparative Effectiveness Research
ASH Signs On to Letter Urging Medicare Physician Payment Fix
ASH Signs On to Letter Expressing Concerns about RAC Program
Medicare Releases Quarterly CCI Update
New BCBS Predetermination Procedure for Red and White Cell Growth Factors
****CMA NEWS****
The California Medical Association and the American Medical Association have joined individual physicians and other state medical groups to file a class action lawsuit against health insurance company WellPoint, Inc. The lawsuit, filed today in Los Angeles federal court, alleges that WellPoint colluded with Ingenix, a unit of United Health Group, on a price-fixing scheme that relied on an obscure database to set artificially low reimbursement rates for out-of-network care.
“Health insurers are data manipulating to set rates artificially low, forcing patients to pay more than they bargained for when they go to a doctor of their choice,” said Dr. Dev GnanaDev, CMA president. “This undermines the patient choice that insurers promise when they tout their PPO products and under-compensates doctors for the care they provide.”
WellPoint – which operates as Blue Cross in California – is legally bound to pay the usual and customary amount for care provided to their enrollees by an out of network physician. Patients pay any additional amounts over and above what WellPoint decides to pay for those services. To determine these rates, WellPoint uses a database run by Ingenix, a company owned and operated by United Health Group, another health insurance company.
A recent investigation by New York Attorney General Andrew Cuomo concluded that the Ingenix data is intentionally manipulated to allow health plans to scam physicians by shortchanging reimbursements on medical bills. A WellPoint executive acknowledged “conflicts of interest in the Ingenix database,” and the company agreed to pay $10 million to help fund a new database run by an independent non-profit organization to replace Ingenix. The company also agreed to quit feeding data into Ingenix and use the new system once it is up and running. The settlement with Cuomo did not seek redress for patients and doctors.
“As health care costs continue to rise, insurers appear to be scheming to find ways to shift resources to their bottom line rather than towards the health care of their enrollees. The CMA will continue fighting to obtain relief for patients and physicians who were harmed by the systemic flaws of the conflict ridden Ingenix database,” Dr. GnanaDev said.
The CMA and AMA have filed this litigation in partnership with the Medical Association of Connecticut, Georgia, North Carolina and the individual plaintiffs Dr. Stephen D. Henry and Dr. James G. Schwendig.
****CMS NEWS****
MM6394 – Program Overview: 2009 Physician Quality Reporting Initiative (PQRI) And The 2009 Electronic Prescribing (E-Prescribing) Incentive Program
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6394.pdf
MM6310 – Incorporation of Physician Fee Schedule Regulatory Changes into Chapter 10 of the Program Integrity Manual (PIM)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6310.pdf
CMS Provider Communications Group will host the fourth in a series national provider conference calls on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 2:30 p.m. – 4:30 p.m., EDT, on Wednesday, April 22, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
The topics covered on this national provider call will include:
An update on the prostate cancer measures-2008: Measure #101; 2008-2009: Measure #102, #104, and #105;
Tips for satisfactorily participating in the 2009 PQRI; and
Planning for the 2010 PQRI reporting options.
Following this presentation, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website, in the Educational Resources section. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: April 22, 2009
Conference Title: 2009 Physician Quality Reporting Initiative - National Provider Call
Time: 2:30 p.m. EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 2:30 p.m. EDT on April 21, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to: http://www2.eventsvc.com/palmettogba/042209
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 3:30 p.m. EDT 4/22/2009 until 11:59 p.m. EDT 4/29/2009. The call in data for the replay is (800) 642-1687 and the passcode is 90578004.
If you require services for the hearing impaired please send an email to:Medicare.TTT@PalmettoGBA.com.
PQRI Frequently Asked Question of the Week
Q: As required by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), the Centers for Medicare & Medicaid Services (CMS) established the criteria for satisfactorily reporting through the alternative reporting method using measures groups for the Physician Quality Reporting Initiative (PQRI). When referring to these measures groups, how is “consecutive” defined?
A: For Physician Quality Reporting Initiative (PQRI) measures groups, consecutive means in order by date of service. Patients are considered consecutive without regard to gender.
****INSTITUTIONAL MEMBER NEWS****
The University of California, San Francisco is organizing The 3rd International Symposium on Cancer Metastasis and the Lymphovascular System: Basis for Rational Therapy on May 6-9, 2009 at the Intercontinental San Francisco Hotel.
Visit www.ucsfcme.com/blast2009/MSU09002.htm for more information and to register.
Monday, March 23, 2009
ACCC & CMA News plus Employment Opportunity
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-23-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Consensus and Contention on Healthcare Reform at ACCC's Annual Meeting
ACCC Seeks Five Sites for its Community-based Prostate Cancer Project
Annual National Meeting Presentations Available Online
Meeting Attendees Voice Concerns About Private Payers
Arizona Nurse and Cancer Survivorship Advocate Susan Leigh Honored
ACCC Honors Community Oncologist and Researcher James E. Radford, Jr.
Sign Up for ACCC's Regional Oncology Symposia
ACCC Supports Bill to Protect Children with Chronic Medical Conditions
Q&A on ACCC's Listserv: RVUs and Staffing Calculations
ACCC's CE Blackboard: New Course on Hematologic Malignancies
Join Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****CMA NEWS****
The California Medical Association (CMA) Alert was published today and is available online at http://www.calphys.org/html/news.asp. This edition features:
CMA Advises MDs to Begin the EHR Needs Assessment Process Now
FTC Says Physicians Must Comply with “Red Flag” Identity Theft Rules
Blue Shield Will Reprocess Denied Claims for New CPT Codes
Court Bars Hospital from Enforcing Economic Credentialing Policy
Federal Health Reform Update
Friday Is Early-Bird Deadline for CMA’s 12th Annual Health Care Leadership Academy
Webinar: Legislative Update
Deadline to RSVP for CMA’s 35th Annual Legislative Leadership Day Is March 27
Save the Date: Ethnic Physician Summit
IMQ Recruiting Physicians to Serve on Correctional Health Judicial Review Committees
Benefit of the Week: Rental Car Discounts
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-23-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Consensus and Contention on Healthcare Reform at ACCC's Annual Meeting
ACCC Seeks Five Sites for its Community-based Prostate Cancer Project
Annual National Meeting Presentations Available Online
Meeting Attendees Voice Concerns About Private Payers
Arizona Nurse and Cancer Survivorship Advocate Susan Leigh Honored
ACCC Honors Community Oncologist and Researcher James E. Radford, Jr.
Sign Up for ACCC's Regional Oncology Symposia
ACCC Supports Bill to Protect Children with Chronic Medical Conditions
Q&A on ACCC's Listserv: RVUs and Staffing Calculations
ACCC's CE Blackboard: New Course on Hematologic Malignancies
Join Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****CMA NEWS****
The California Medical Association (CMA) Alert was published today and is available online at http://www.calphys.org/html/news.asp. This edition features:
CMA Advises MDs to Begin the EHR Needs Assessment Process Now
FTC Says Physicians Must Comply with “Red Flag” Identity Theft Rules
Blue Shield Will Reprocess Denied Claims for New CPT Codes
Court Bars Hospital from Enforcing Economic Credentialing Policy
Federal Health Reform Update
Friday Is Early-Bird Deadline for CMA’s 12th Annual Health Care Leadership Academy
Webinar: Legislative Update
Deadline to RSVP for CMA’s 35th Annual Legislative Leadership Day Is March 27
Save the Date: Ethnic Physician Summit
IMQ Recruiting Physicians to Serve on Correctional Health Judicial Review Committees
Benefit of the Week: Rental Car Discounts
Sunday, March 22, 2009
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
Medicare Remit EasyPrint (MREP) Software for J1 Part B
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~Software%20Manuals~Medicare%20Remit%20EasyPrint%20(MREP)%20Software%20for%20J1%20Part%20B?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852574B800674EB2?opendocument
Palmetto GBA Announces New Dates and Times for Spring Workshop Series
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Learning%20Education~Workshops~Palmetto%20GBA%20Announces%20New%20Dates%20and%20Times%20for%20Spring%20Workshop%20Series?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525757F0071CCC3?opendocument
Palmetto GBA has added new dates and times for our 2009 Understanding the
Rules and Using the Tools workshop series.
****PALMETTO/J1MAC NEWS****
Medicare Remit EasyPrint (MREP) Software for J1 Part B
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~Software%20Manuals~Medicare%20Remit%20EasyPrint%20(MREP)%20Software%20for%20J1%20Part%20B?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852574B800674EB2?opendocument
Palmetto GBA Announces New Dates and Times for Spring Workshop Series
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Learning%20Education~Workshops~Palmetto%20GBA%20Announces%20New%20Dates%20and%20Times%20for%20Spring%20Workshop%20Series?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525757F0071CCC3?opendocument
Palmetto GBA has added new dates and times for our 2009 Understanding the
Rules and Using the Tools workshop series.
Thursday, March 19, 2009
Palmetto/J1MAC & Corporate Member News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.1,
Effective April 1, 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Quarterly%20Update%20to%20Correct%20Coding%20Initiative%20(CCI)%20Edits%20Version%2015.1%20Effective%20April%201%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525757C005E80D3?opendocument
CR6388, Quarterly Update to Correct Coding Initiative (CCI) Edits, Version
15.1, Effective April 1, 2009, provides a reminder for physicians to take
note of the quarterly updates to Correct Coding Initiative (CCI) edits.
****CORPORATE MEMBER NEWS****
Novartis Oncology cordially invites you to attend a speaker program entitled Gleevec GIST Perspectives with Shreyaskumar Patel, M.D., Medical Director, Sarcoma Center, & Deputy Chair, Department of Sarcoma Medical Oncology, MD Anderson Cancer Center. The program takes place on Wednesday, April 1st, at 6:30PM at Chantilly, 3001 El Camino Real, (at Selby Lane), Redwood City, (650) 321-4080. Please RSVP by March 29th to Linda Karrer, Novartis Oncology, at (408) 482-7680.
****PALMETTO/J1MAC NEWS****
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.1,
Effective April 1, 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Quarterly%20Update%20to%20Correct%20Coding%20Initiative%20(CCI)%20Edits%20Version%2015.1%20Effective%20April%201%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525757C005E80D3?opendocument
CR6388, Quarterly Update to Correct Coding Initiative (CCI) Edits, Version
15.1, Effective April 1, 2009, provides a reminder for physicians to take
note of the quarterly updates to Correct Coding Initiative (CCI) edits.
****CORPORATE MEMBER NEWS****
Novartis Oncology cordially invites you to attend a speaker program entitled Gleevec GIST Perspectives with Shreyaskumar Patel, M.D., Medical Director, Sarcoma Center, & Deputy Chair, Department of Sarcoma Medical Oncology, MD Anderson Cancer Center. The program takes place on Wednesday, April 1st, at 6:30PM at Chantilly, 3001 El Camino Real, (at Selby Lane), Redwood City, (650) 321-4080. Please RSVP by March 29th to Linda Karrer, Novartis Oncology, at (408) 482-7680.
Wednesday, March 18, 2009
ASCO & CMS News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider was published today and is available online at http://view.exacttarget.com/?j=fe6515797666007d7016&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2f1672716d027f771475. ANCO is a state/regional affiliate of ASCO. This edition features:
1. Support Legislation to Remove Prompt-Pay Discounts from ASP
2. Leucovorin Shortage Update
3. Coalition Expresses Concern over Medical Imaging Policy Proposals
4. ASCO Comments on CMS' RAC Program
5. ASCO Opposes Red Flags Rule
6. Medicare's Carrier/Contractor Advisory Committee (CAC) Process
7. Patient Satisfaction Surveys
8. CMS Announces New Web Page on the E-Prescribing Incentive Program
9. Upcoming CMS Open Door Forum Calls
10. 2009 PQRI National Provider Conference Call
11. Billing and Coding Q&A
12. From the practice manager's desk
13. What do you think...?
14. Did you know...?
****CMS NEWS****
MM6388 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.1, Effective April 1, 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6388.pdf
On January 15, the U.S. Department of Health and Human Services released two final rules that will facilitate theUnited States’ ongoing transition to an electronic health care environment through adoption of an updated set of diagnosis and procedure codes and updated standards for electronic health care and pharmacy transactions.
In accordance with the White House Chief of Staff’s memorandum of January 20, 2009 entitled “Regulatory Review,” a determination has been made that the effective date will not be extended and the comment period will not be reopened for either of these rules.
The first rule finalizes new code sets to be used for reporting diagnoses and procedures on health care transactions. This final rule replaces the ICD-9-CM code sets, developed nearly 30 years ago, with greatly expanded ICD-10 code sets. The second final rule adopts updated versions of the standards governing electronic transactions under the authority of the Health Insurance Portability and Accountability Act of 1996. The updated versions replace the current standards and will promote greater use of electronic transactions. In response to public comments suggesting that more time would be needed for effective industry implementation, the final rules include later compliance dates. More specifically, the final rules provide compliance dates of Jan. 1, 2012, for the transaction standards and Oct. 1, 2013, for the ICD-10 code set.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider was published today and is available online at http://view.exacttarget.com/?j=fe6515797666007d7016&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2f1672716d027f771475. ANCO is a state/regional affiliate of ASCO. This edition features:
1. Support Legislation to Remove Prompt-Pay Discounts from ASP
2. Leucovorin Shortage Update
3. Coalition Expresses Concern over Medical Imaging Policy Proposals
4. ASCO Comments on CMS' RAC Program
5. ASCO Opposes Red Flags Rule
6. Medicare's Carrier/Contractor Advisory Committee (CAC) Process
7. Patient Satisfaction Surveys
8. CMS Announces New Web Page on the E-Prescribing Incentive Program
9. Upcoming CMS Open Door Forum Calls
10. 2009 PQRI National Provider Conference Call
11. Billing and Coding Q&A
12. From the practice manager's desk
13. What do you think...?
14. Did you know...?
****CMS NEWS****
MM6388 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.1, Effective April 1, 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6388.pdf
On January 15, the U.S. Department of Health and Human Services released two final rules that will facilitate theUnited States’ ongoing transition to an electronic health care environment through adoption of an updated set of diagnosis and procedure codes and updated standards for electronic health care and pharmacy transactions.
In accordance with the White House Chief of Staff’s memorandum of January 20, 2009 entitled “Regulatory Review,” a determination has been made that the effective date will not be extended and the comment period will not be reopened for either of these rules.
The first rule finalizes new code sets to be used for reporting diagnoses and procedures on health care transactions. This final rule replaces the ICD-9-CM code sets, developed nearly 30 years ago, with greatly expanded ICD-10 code sets. The second final rule adopts updated versions of the standards governing electronic transactions under the authority of the Health Insurance Portability and Accountability Act of 1996. The updated versions replace the current standards and will promote greater use of electronic transactions. In response to public comments suggesting that more time would be needed for effective industry implementation, the final rules include later compliance dates. More specifically, the final rules provide compliance dates of Jan. 1, 2012, for the transaction standards and Oct. 1, 2013, for the ICD-10 code set.
Monday, March 16, 2009
ACCC, ASCO, & Corporate Member News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-16-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Send a Message to Congress: Support HR 1392, Fair Drug Reimbursement
This is the Week: ACCC's Annual National Meeting Gets Underway
Secret Exhibitor Contest
ACCC to Release Revised Cancer Program Guidelines
ACCC to Host Three Regional Oncology Symposia
Virtual Colonoscopies: Promising for Whom?
Potential New Target for Melanoma Treatment Identified
Q&A on ACCC's Listserv: Breast Center Efficiencies
ACCC's CE Blackboard: A Full Range of Courses
Join Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) e-News was published and is available online at http://view.exacttarget.com/?j=fe5c157976640d7b7117&m=ff2d16787160&ls=fdf313737662037b751c7277&l=fe5b157573660c747115&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe291672716c0479721d72. ANCO is a state/regional affiliate of ASCO. This edition features:
Application Deadline Extended to March 23 for the ASCO-AACR Workshop
Apply for the Accelerating Anticancer Agent Development and Validation Workshop
Registration and Housing Now Open for the Best of ASCO® Meetings
Read ASCO's First Provisional Clinical Opinion in JOP
Read the JCO Original Report, "Supervised Risk Predictor of Breast Cancer Based on Intrinsic Subtypes"
ASCO Seeks Candidates for Upcoming JCO Editor-in-Chief Term
Cancer Policy Alert: Prompt-Pay Legislation Introduced in House of Representatives; President Obama Overturns Stem Cell Policy
New Resources Available to Help Discuss Cancer Chemoprevention with Patients
Virtual Meeting, Podcast Access Available from the 2009 GU Cancers Symposium
For Your Patients
Special Cancer.Net Podcast: What's New in Lung Cancer with Mark Kris, MD
Cancer.Net Feature: HPV and Cancer
Cancer.Net Feature: Understanding Targeted Treatments
Cancer.Net Feature: Colonoscopy: What to Expect
Register and Reserve Housing for the 2009 ASCO Annual Meeting in Orlando, Florida
Comment on the ASCO-ONS Standards for Safe Chemotherapy Administration
Visit ASCO's EHR Social Network Site
****CORPORATE MEMBER NEWS****
Novartis Oncology, an ANCO Corporate Member, and P4Healthcare invite ANCO members to participate in webinars on Exjade and MDS (visit http://registration.p4healthcare.com/go/invite/live/webconference21 for details). There are several webinar dates to choose from in the remainder of March and in April. This webinar series is open to all healthcare professionals (HCP’s). If practices want to participate, then please e-mail Louis Chinn at LChinn@P4Healthcare.com with the following information:
· Practice contact (contact’s name, title, practice name, phone, email)
· Name and title of each participating staff member
· Desired session date/time per staff member
This webinar also qualifies for the P4Healthcare Administrators Support Program (with an honorarium available to participants). Please contact Louis Chinn for details.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-16-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Send a Message to Congress: Support HR 1392, Fair Drug Reimbursement
This is the Week: ACCC's Annual National Meeting Gets Underway
Secret Exhibitor Contest
ACCC to Release Revised Cancer Program Guidelines
ACCC to Host Three Regional Oncology Symposia
Virtual Colonoscopies: Promising for Whom?
Potential New Target for Melanoma Treatment Identified
Q&A on ACCC's Listserv: Breast Center Efficiencies
ACCC's CE Blackboard: A Full Range of Courses
Join Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) e-News was published and is available online at http://view.exacttarget.com/?j=fe5c157976640d7b7117&m=ff2d16787160&ls=fdf313737662037b751c7277&l=fe5b157573660c747115&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe291672716c0479721d72. ANCO is a state/regional affiliate of ASCO. This edition features:
Application Deadline Extended to March 23 for the ASCO-AACR Workshop
Apply for the Accelerating Anticancer Agent Development and Validation Workshop
Registration and Housing Now Open for the Best of ASCO® Meetings
Read ASCO's First Provisional Clinical Opinion in JOP
Read the JCO Original Report, "Supervised Risk Predictor of Breast Cancer Based on Intrinsic Subtypes"
ASCO Seeks Candidates for Upcoming JCO Editor-in-Chief Term
Cancer Policy Alert: Prompt-Pay Legislation Introduced in House of Representatives; President Obama Overturns Stem Cell Policy
New Resources Available to Help Discuss Cancer Chemoprevention with Patients
Virtual Meeting, Podcast Access Available from the 2009 GU Cancers Symposium
For Your Patients
Special Cancer.Net Podcast: What's New in Lung Cancer with Mark Kris, MD
Cancer.Net Feature: HPV and Cancer
Cancer.Net Feature: Understanding Targeted Treatments
Cancer.Net Feature: Colonoscopy: What to Expect
Register and Reserve Housing for the 2009 ASCO Annual Meeting in Orlando, Florida
Comment on the ASCO-ONS Standards for Safe Chemotherapy Administration
Visit ASCO's EHR Social Network Site
****CORPORATE MEMBER NEWS****
Novartis Oncology, an ANCO Corporate Member, and P4Healthcare invite ANCO members to participate in webinars on Exjade and MDS (visit http://registration.p4healthcare.com/go/invite/live/webconference21 for details). There are several webinar dates to choose from in the remainder of March and in April. This webinar series is open to all healthcare professionals (HCP’s). If practices want to participate, then please e-mail Louis Chinn at LChinn@P4Healthcare.com with the following information:
· Practice contact (contact’s name, title, practice name, phone, email)
· Name and title of each participating staff member
· Desired session date/time per staff member
This webinar also qualifies for the P4Healthcare Administrators Support Program (with an honorarium available to participants). Please contact Louis Chinn for details.
Sunday, March 15, 2009
ASH, CMS, DHCS/MediCal, & Palmetto/J1MAC News & Employment Opportunity
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/policy/practice/03122009.cfm. It features:
Bone Marrow Failure Disease Research and Treatment Act Introduced in House
President Obama Lifts Limits on Federally Funded Stem Cell Research
President Obama Signs Omnibus Budget Legislation
Health-Care Reform Debate Begins to Take Shape in Washington
President Obama to Nominate Former New York City Health Commissioner as FDA Commissioner
FTC Commissioner Thinks Obama Administration Will Help Stop Agreements to Delay Generics
RAC Protests Resolved
March is DVT Awareness Month
ASH PQRI and E-Prescribing Webinar: Rescheduling in Process
IOM Cancer Care Workshop Presentation Slides Available
****CMS NEWS
MM6347 – Updates to the Medicare Claims Processing Manual (Publication 100-04), Chapter 15, Ambulance Services
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6347.pdf
*****DHCS/MediCal NEWS*****
IMPORTANT National Drug Code (NDC) Reporting Requirements - Reminder
The implementation date is fast approaching! Providers are reminded that, claims with dates of service on or after April 1, 2009 that do not meet the NDC reporting requirements to include a valid NDC with a HCPCS code, will be denied. For more information on NDC reporting, including FAQs, please visit the NDC page on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/ndc/ndc.asp
In order to comply with the DRA, providers must bill for physician-adminstered drugs using the appropriate CPT-4, HCPCS Level II, or local HCPCS Level III codes and, in addition, must include the NDC on the claim form. Providers have been encouraged, for dates of service on or after September 1, 2008, to include the NDC code on the claim, but claims without an NDC code have still been paid. Unfortunately, we are seeing minimal voluntary submissions of NDC and now is the time for providers to practice how they are going to comply.
Resources
The ASC X12N Version 4010A1 Companion Guides have been updated and are available on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/hipaa/hipaaspecs_home.asp . These guides will enable technical staff or software vendors to update your software to include the NDC requirements on the 837 electronic transactions. Additionally, the Part 2 provider bulletins (General Medicine, Obstetrics and Outpatient) include NDC information, physician-administered drug definitions, billing descriptions and examples for CMS 1500 and UB-04 paper claim forms, as well as both 837 Institutional and Professional electronic formats, and Section 340B information. These bulletins can be viewed on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/Bulletins_menu.asp . Finally, the CMS 1500 and UB-04 claim form tutorials on the Medi-Cal Web site have been updated to include instructions on how to bill HCPCS and NDCs and can be viewed at http://files.medi-cal.ca.gov/pubsdoco/eo/elearning.asp .
Provider Workshops
There will be additional overviews presented at the Medi-Cal seminar, to address the NDC reporting requirements, in Long Beach on 3/24 and 3/25. The locations of the sessions and how to pre-register can be found on the Medi-Cal Web site http://files.medi-cal.ca.gov/pubsdoco/eo/training.asp
Should you have any questions or need additional information, please call the Telephone Service Center (TSC) at 1-800-541-5555 and choose the appropriate prompt or visit the Medi-Cal Web site at the address listed above.
Fiscal Year 2008–09 March Payment Hold Updated March 13, 2009
Pursuant to Chapter 4, Statutes of 2009 (SBx 3 8), reimbursement to Medi-Cal institutional providers except for small and rural hospitals, designated public hospitals, and local education agencies, will be held for a period of four weeks effective March 26 (the fourth warrant release date of March) and released four weeks later beginning April 23, 2009. The hold is necessary to address the State’s cash flow issues. A total of one check write in March will be held as a result of the March Payment Hold. Payments to Medi-Cal non-institutional providers will not be held. Please note, the list below is limited to providers whose claims are processed by the Medi-Cal fiscal intermediary.
Beginning the week of March 23, 2009 providers whose held amount is $5,000 or more will receive a Value of Claims (VOC) Letter from the Department of Health Care Services. The letter will specify the amount of their claims payments $5,000 and above being suppressed as a result of the March hold. The purpose of these letters is to assist providers in working with their fiduciary institutions during this payment hold.
Please note that if the State’s cash flow does not improve, there is a possibility that claim payments in the first three weeks of April could be held, under an April hold, for up to four weeks and paid in the following month one week at a time. If the April hold is implemented, the same criteria (types of providers held) applied to the March hold will be applied to the April hold. If an April hold is implemented, the Department will continue to provide weekly VOC letters to providers meeting the $5,000 dollars held threshold.
To ensure implementation of this proposal, the Department of Health Care Services will hold reimbursement on the following Medi-Cal institutional providers.
Medi-Cal Institutional Providers
Adult Day Health Care Centers (ADHC)
Assistive Device and Sick Room Supply Dealers
Blood Banks
Clinical Laboratories
Fabricating Optical Laboratory/Prison Industry Authority (PIA)
Home Health Agencies (HHA)
Community Hospital Outpatient Departments
Community Hospital Inpatient (with the exception of Designated Public Hospitals)
Long Term Care (LTC) facilities
Ground Medical Transportation
Genetic Disease Testing
Public Law 95 – 210 RHC/Federally Qualified Health Center (RHC/FQHC)
Air Ambulance Transportation Services
Certified Hospice Service per Assembly Bill 4249
Free Clinics
Community Clinics
Chronic Dialysis Clinics
Multispecialty Clinics
Surgical Clinics
Exempt from Licensure Clinics
Rehabilitation Clinics
County Clinics not associated with a hospital
Birthing Center Services: Primary Care Clinics
Clinics otherwise undesignated
Alternative Birth Centers: Specialty Clinics
Home and Community Based Services (HCBS) Nursing Facilities
County Hospital Inpatient (with the exception of Designated Public Hospitals)
County Hospital Outpatient
Pediatric Subacute Care: LTC (distinct and freestanding) LTC accommodation codes 83 – 90 and 91 – 98
Institutions for Mental Disease: Mental Health Inpatient
Multipurpose Senior Services Program (MSSP)
Indian Health Services
Residential Care Facilities for the Elderly
The following providers are exempt from the March payment hold.
Local Educational Agencies
Small and Rural Hospitals
Designated Public Hospitals – Inpatient Payments
****PALMETTO/J1MAC NEWS****
New Dates and Revised Times to the 2009 Understanding the Rules and Using
the Tools workshop series
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~New%20Dates%20and%20Revised%20Times%20to%20the%202009%20Understanding%20the%20Rules%20and%20Using%20the%20Tools%20workshop%20series?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257577006137E3?opendocument
Palmetto GBA has added new dates and times for our 2009 Understanding the
Rules and Using the Tools workshop series.
April Update to the 2009 Medicare Physician Fee Schedule Database
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~April%20Update%20to%20the%202009%20Medicare%20Physician%20Fee%20Schedule%20Database?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257578006953D6?opendocument
CR6397, April Update to the 2009 Medicare Physician Fee Schedule Database,
amends payment files that were issued to contractors based upon the 2009
Medicare Physician Fee Schedule (MPFS) Final Rule.
Healthcare Provider Taxonomy Codes (HPTC) Update April 2009
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Healthcare%20Provider%20Taxonomy%20Codes%20(HPTC)%20Update%20April%202009?opendocument
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temporary alternate link provided below.
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CR 6382, Healthcare Provider Taxonomy Codes (HPTC) Update April 2009,
includes information on changes to HPTC codes and information on the
requirements of The Health Insurance Portability and Accountability Act.
Updates to the Medicare Claims Processing Manual (Publication 100-04),
Chapter 15, Ambulance Services
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Updates%20to%20the%20Medicare%20Claims%20Processing%20Manual%20(Publication%20100-04)%20Chapter%2015%20Ambulance%20Services?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257578006A5BD7?opendocument
CR6347, Updates to the Medicare Claims Processing Manual (Publication
100-04), Chapter 15, Ambulance Services, implements significant changes to
the Internet-Only Manual Publication 100-04, Chapter 15.
****Empllyment Opportunity****
Oncologists Needed for Medical Director Positions with West Coast Biotech. No Industry Experience Required.
Several Oncologists are needed to fill Medical Director level positions with a West Coast biotech company. Candidates will fill medical director positions overseeing clinical trials ranging from phase one to phase four.
Previous Industry experience is not required.
This is a full time position and offers a full relocation package.
Candidates will be accepted even if they are fresh out of school. Candidates must be board eligible Oncologists or Hematologists. I am also accepting candidates out of industry, academia, or private practice. Similar positions are also available for Orthopedic Surgeons, Endocrinologists, and Rheumatologists.
Please contact me at 760-525-9739 or jaketanner82@gmail.com .
****ASH NEWS****
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/03122009.cfm. It features:
Bone Marrow Failure Disease Research and Treatment Act Introduced in House
President Obama Lifts Limits on Federally Funded Stem Cell Research
President Obama Signs Omnibus Budget Legislation
Health-Care Reform Debate Begins to Take Shape in Washington
President Obama to Nominate Former New York City Health Commissioner as FDA Commissioner
FTC Commissioner Thinks Obama Administration Will Help Stop Agreements to Delay Generics
RAC Protests Resolved
March is DVT Awareness Month
ASH PQRI and E-Prescribing Webinar: Rescheduling in Process
IOM Cancer Care Workshop Presentation Slides Available
****CMS NEWS
MM6347 – Updates to the Medicare Claims Processing Manual (Publication 100-04), Chapter 15, Ambulance Services
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6347.pdf
*****DHCS/MediCal NEWS*****
IMPORTANT National Drug Code (NDC) Reporting Requirements - Reminder
The implementation date is fast approaching! Providers are reminded that, claims with dates of service on or after April 1, 2009 that do not meet the NDC reporting requirements to include a valid NDC with a HCPCS code, will be denied. For more information on NDC reporting, including FAQs, please visit the NDC page on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/ndc/ndc.asp
In order to comply with the DRA, providers must bill for physician-adminstered drugs using the appropriate CPT-4, HCPCS Level II, or local HCPCS Level III codes and, in addition, must include the NDC on the claim form. Providers have been encouraged, for dates of service on or after September 1, 2008, to include the NDC code on the claim, but claims without an NDC code have still been paid. Unfortunately, we are seeing minimal voluntary submissions of NDC and now is the time for providers to practice how they are going to comply.
Resources
The ASC X12N Version 4010A1 Companion Guides have been updated and are available on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/hipaa/hipaaspecs_home.asp . These guides will enable technical staff or software vendors to update your software to include the NDC requirements on the 837 electronic transactions. Additionally, the Part 2 provider bulletins (General Medicine, Obstetrics and Outpatient) include NDC information, physician-administered drug definitions, billing descriptions and examples for CMS 1500 and UB-04 paper claim forms, as well as both 837 Institutional and Professional electronic formats, and Section 340B information. These bulletins can be viewed on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/Bulletins_menu.asp . Finally, the CMS 1500 and UB-04 claim form tutorials on the Medi-Cal Web site have been updated to include instructions on how to bill HCPCS and NDCs and can be viewed at http://files.medi-cal.ca.gov/pubsdoco/eo/elearning.asp .
Provider Workshops
There will be additional overviews presented at the Medi-Cal seminar, to address the NDC reporting requirements, in Long Beach on 3/24 and 3/25. The locations of the sessions and how to pre-register can be found on the Medi-Cal Web site http://files.medi-cal.ca.gov/pubsdoco/eo/training.asp
Should you have any questions or need additional information, please call the Telephone Service Center (TSC) at 1-800-541-5555 and choose the appropriate prompt or visit the Medi-Cal Web site at the address listed above.
Fiscal Year 2008–09 March Payment Hold Updated March 13, 2009
Pursuant to Chapter 4, Statutes of 2009 (SBx 3 8), reimbursement to Medi-Cal institutional providers except for small and rural hospitals, designated public hospitals, and local education agencies, will be held for a period of four weeks effective March 26 (the fourth warrant release date of March) and released four weeks later beginning April 23, 2009. The hold is necessary to address the State’s cash flow issues. A total of one check write in March will be held as a result of the March Payment Hold. Payments to Medi-Cal non-institutional providers will not be held. Please note, the list below is limited to providers whose claims are processed by the Medi-Cal fiscal intermediary.
Beginning the week of March 23, 2009 providers whose held amount is $5,000 or more will receive a Value of Claims (VOC) Letter from the Department of Health Care Services. The letter will specify the amount of their claims payments $5,000 and above being suppressed as a result of the March hold. The purpose of these letters is to assist providers in working with their fiduciary institutions during this payment hold.
Please note that if the State’s cash flow does not improve, there is a possibility that claim payments in the first three weeks of April could be held, under an April hold, for up to four weeks and paid in the following month one week at a time. If the April hold is implemented, the same criteria (types of providers held) applied to the March hold will be applied to the April hold. If an April hold is implemented, the Department will continue to provide weekly VOC letters to providers meeting the $5,000 dollars held threshold.
To ensure implementation of this proposal, the Department of Health Care Services will hold reimbursement on the following Medi-Cal institutional providers.
Medi-Cal Institutional Providers
Adult Day Health Care Centers (ADHC)
Assistive Device and Sick Room Supply Dealers
Blood Banks
Clinical Laboratories
Fabricating Optical Laboratory/Prison Industry Authority (PIA)
Home Health Agencies (HHA)
Community Hospital Outpatient Departments
Community Hospital Inpatient (with the exception of Designated Public Hospitals)
Long Term Care (LTC) facilities
Ground Medical Transportation
Genetic Disease Testing
Public Law 95 – 210 RHC/Federally Qualified Health Center (RHC/FQHC)
Air Ambulance Transportation Services
Certified Hospice Service per Assembly Bill 4249
Free Clinics
Community Clinics
Chronic Dialysis Clinics
Multispecialty Clinics
Surgical Clinics
Exempt from Licensure Clinics
Rehabilitation Clinics
County Clinics not associated with a hospital
Birthing Center Services: Primary Care Clinics
Clinics otherwise undesignated
Alternative Birth Centers: Specialty Clinics
Home and Community Based Services (HCBS) Nursing Facilities
County Hospital Inpatient (with the exception of Designated Public Hospitals)
County Hospital Outpatient
Pediatric Subacute Care: LTC (distinct and freestanding) LTC accommodation codes 83 – 90 and 91 – 98
Institutions for Mental Disease: Mental Health Inpatient
Multipurpose Senior Services Program (MSSP)
Indian Health Services
Residential Care Facilities for the Elderly
The following providers are exempt from the March payment hold.
Local Educational Agencies
Small and Rural Hospitals
Designated Public Hospitals – Inpatient Payments
****PALMETTO/J1MAC NEWS****
New Dates and Revised Times to the 2009 Understanding the Rules and Using
the Tools workshop series
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~New%20Dates%20and%20Revised%20Times%20to%20the%202009%20Understanding%20the%20Rules%20and%20Using%20the%20Tools%20workshop%20series?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257577006137E3?opendocument
Palmetto GBA has added new dates and times for our 2009 Understanding the
Rules and Using the Tools workshop series.
April Update to the 2009 Medicare Physician Fee Schedule Database
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~April%20Update%20to%20the%202009%20Medicare%20Physician%20Fee%20Schedule%20Database?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257578006953D6?opendocument
CR6397, April Update to the 2009 Medicare Physician Fee Schedule Database,
amends payment files that were issued to contractors based upon the 2009
Medicare Physician Fee Schedule (MPFS) Final Rule.
Healthcare Provider Taxonomy Codes (HPTC) Update April 2009
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Healthcare%20Provider%20Taxonomy%20Codes%20(HPTC)%20Update%20April%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852575780071AB6F?opendocument
CR 6382, Healthcare Provider Taxonomy Codes (HPTC) Update April 2009,
includes information on changes to HPTC codes and information on the
requirements of The Health Insurance Portability and Accountability Act.
Updates to the Medicare Claims Processing Manual (Publication 100-04),
Chapter 15, Ambulance Services
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Updates%20to%20the%20Medicare%20Claims%20Processing%20Manual%20(Publication%20100-04)%20Chapter%2015%20Ambulance%20Services?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA385257578006A5BD7?opendocument
CR6347, Updates to the Medicare Claims Processing Manual (Publication
100-04), Chapter 15, Ambulance Services, implements significant changes to
the Internet-Only Manual Publication 100-04, Chapter 15.
****Empllyment Opportunity****
Oncologists Needed for Medical Director Positions with West Coast Biotech. No Industry Experience Required.
Several Oncologists are needed to fill Medical Director level positions with a West Coast biotech company. Candidates will fill medical director positions overseeing clinical trials ranging from phase one to phase four.
Previous Industry experience is not required.
This is a full time position and offers a full relocation package.
Candidates will be accepted even if they are fresh out of school. Candidates must be board eligible Oncologists or Hematologists. I am also accepting candidates out of industry, academia, or private practice. Similar positions are also available for Orthopedic Surgeons, Endocrinologists, and Rheumatologists.
Please contact me at 760-525-9739 or jaketanner82@gmail.com .
Wednesday, March 11, 2009
ASCO & Palmetto/J1MAC News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe57157977610c747512&m=ff311d707460&ls=fdf8137271640478771d727d&l=fe62157570620c7d7615&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe27167271660c7b731175. ANCO is a state/regional affiliate of ASCO. This edition features:
Prompt-Pay Legislation Introduced in House of Representatives
President Obama Convenes Health Care Summit
Update on Federal and State Clinical Trials Coverage Bills
President Obama Overturns Stem Cell Policy
Family Smoking Prevention and Tobacco Control Act Introduced in the House
ASCO Comments to FDA on Enrolling Special Populations in Clinical Trials
ASCO Comments to CMS on Recovery Audit Contractor Program
Coalition Expresses Concern over Medical Imaging Policy Proposals
NIH Announces Challenge Grants
Comment on ASCO and ONS Chemotherapy Administration Safety Standards
Update on Leucovorin Shortage
Join ASCO's Advocacy Network
ASCO Extends Resources to Practice Administrators
****PALMETTO/J1MAC NEWS****
California Medicaid Denying Claims If Providers’ NPI is Not Registered with
Medi-Cal
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~California%20Medicaid%20Denying%20Claims%20If%20Providers’%20NPI%20is%20Not%20Registered%20with%20Medi-Cal?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852575750040B020?opendocument
Palmetto GBA has learned that California Medicaid (Medi-Cal) is not
accepting claims in cases where the provider’s Medicare National Provider
Identifier (NPI) is not registered with Medi-Cal. This document contains
information on resolving the issue and a copy of the provider memorandum.
Instructions for the Implementation of the Internet-Based Provider
Enrollment, Chain and Ownership System (PECOS)
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Instructions%20for%20the%20Implementation%20of%20the%20Internet-Based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852575750049C438?opendocument
This article is based on Change Request (CR) 6231 and alerts providers to
the fact that the information about Internet-based PECOS applications is
now incorporated into Centers for Medicare & Medicaid Services (CMS)
Medicare Program Integrity Manual Chapter 10. CR6231 describes the PECOS
CMS-855 applications.
J1 MAC Provider Outreach & Education ACT Request Form
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Forms~J1%20MAC%20Provider%20Outreach%20Education%20ACT%20Request%20Form?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525757500416E87?opendocument
This is J1 MAC Provider Outreach & Education Ask-the-Contractor
Teleconference (ACT) Request Form. The Ask-the-Contractor Teleconference is
intended to open the communication channels between providers and Palmetto
GBA.
Palmetto GBA Announces More IVR Enhancements
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Palmetto%20GBA%20Announces%20More%20IVR%20Enhancements?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525757500417BF6?opendocument
Palmetto GBA is pleased to announce new updates to our IVR system. The
updates will become effective for providers on Tuesday, March 10, 2009.
Understanding the Rules and Using the Tools 2009 Spring Workshops - Hawaii
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Understanding%20the%20Rules%20and%20Using%20the%20Tools%202009%20Spring%20Workshops%20-%20Hawaii?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852575750040E494?opendocument
Palmetto GBA is adding new dates and locations to the 2009 Understanding
the Rules and Using the Tools workshop series for Hawaii. This series is
designed for practice managers, billers, administrative staff and other
users to equip them with the tools they need to be successful with Medicare
billing and documentation guidelines. Instructions on how to register for
the workshops are listed at the end of the article.
Implementation of New Provider Authentication Requirements for Medicare
Contractor Provider Telephone and Written Inquiries
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Implementation%20of%20New%20Provider%20Authentication%20Requirements%20for%20Medicare%20Contractor%20Provider%20Telephone%20and%20Written%20Inquiries?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525756700713924?opendocument
This article was revised on March 5, 2009, to reflect the revised CR 6139,
which CMS re-issued on March 4, 2009. (The effective and implementation
dates for providers were previously changed to April 6, 2009 by Transmittal
R23COM on February 10.) In this revision of the article, the CR release
date, transmittal number, and the Web address of the CR have been changed.
All other information remains the same.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe57157977610c747512&m=ff311d707460&ls=fdf8137271640478771d727d&l=fe62157570620c7d7615&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe27167271660c7b731175. ANCO is a state/regional affiliate of ASCO. This edition features:
Prompt-Pay Legislation Introduced in House of Representatives
President Obama Convenes Health Care Summit
Update on Federal and State Clinical Trials Coverage Bills
President Obama Overturns Stem Cell Policy
Family Smoking Prevention and Tobacco Control Act Introduced in the House
ASCO Comments to FDA on Enrolling Special Populations in Clinical Trials
ASCO Comments to CMS on Recovery Audit Contractor Program
Coalition Expresses Concern over Medical Imaging Policy Proposals
NIH Announces Challenge Grants
Comment on ASCO and ONS Chemotherapy Administration Safety Standards
Update on Leucovorin Shortage
Join ASCO's Advocacy Network
ASCO Extends Resources to Practice Administrators
****PALMETTO/J1MAC NEWS****
California Medicaid Denying Claims If Providers’ NPI is Not Registered with
Medi-Cal
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~California%20Medicaid%20Denying%20Claims%20If%20Providers’%20NPI%20is%20Not%20Registered%20with%20Medi-Cal?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852575750040B020?opendocument
Palmetto GBA has learned that California Medicaid (Medi-Cal) is not
accepting claims in cases where the provider’s Medicare National Provider
Identifier (NPI) is not registered with Medi-Cal. This document contains
information on resolving the issue and a copy of the provider memorandum.
Instructions for the Implementation of the Internet-Based Provider
Enrollment, Chain and Ownership System (PECOS)
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Instructions%20for%20the%20Implementation%20of%20the%20Internet-Based%20Provider%20Enrollment%20Chain%20and%20Ownership%20System%20(PECOS)?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852575750049C438?opendocument
This article is based on Change Request (CR) 6231 and alerts providers to
the fact that the information about Internet-based PECOS applications is
now incorporated into Centers for Medicare & Medicaid Services (CMS)
Medicare Program Integrity Manual Chapter 10. CR6231 describes the PECOS
CMS-855 applications.
J1 MAC Provider Outreach & Education ACT Request Form
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Resources~Forms~J1%20MAC%20Provider%20Outreach%20Education%20ACT%20Request%20Form?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525757500416E87?opendocument
This is J1 MAC Provider Outreach & Education Ask-the-Contractor
Teleconference (ACT) Request Form. The Ask-the-Contractor Teleconference is
intended to open the communication channels between providers and Palmetto
GBA.
Palmetto GBA Announces More IVR Enhancements
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Palmetto%20GBA%20Announces%20More%20IVR%20Enhancements?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525757500417BF6?opendocument
Palmetto GBA is pleased to announce new updates to our IVR system. The
updates will become effective for providers on Tuesday, March 10, 2009.
Understanding the Rules and Using the Tools 2009 Spring Workshops - Hawaii
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Understanding%20the%20Rules%20and%20Using%20the%20Tools%202009%20Spring%20Workshops%20-%20Hawaii?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852575750040E494?opendocument
Palmetto GBA is adding new dates and locations to the 2009 Understanding
the Rules and Using the Tools workshop series for Hawaii. This series is
designed for practice managers, billers, administrative staff and other
users to equip them with the tools they need to be successful with Medicare
billing and documentation guidelines. Instructions on how to register for
the workshops are listed at the end of the article.
Implementation of New Provider Authentication Requirements for Medicare
Contractor Provider Telephone and Written Inquiries
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Implementation%20of%20New%20Provider%20Authentication%20Requirements%20for%20Medicare%20Contractor%20Provider%20Telephone%20and%20Written%20Inquiries?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525756700713924?opendocument
This article was revised on March 5, 2009, to reflect the revised CR 6139,
which CMS re-issued on March 4, 2009. (The effective and implementation
dates for providers were previously changed to April 6, 2009 by Transmittal
R23COM on February 10.) In this revision of the article, the CR release
date, transmittal number, and the Web address of the CR have been changed.
All other information remains the same.
Tuesday, March 10, 2009
ASCO, CMS, DHCS/MediCal, & Corporate Member News
****ASCO NEWS****
Prompt-Pay Legislation Introduced in House of Representatives
Please Urge Your Representative to Co-sponsor H.R. 1392
Reps. Gene Green (D-TX), Ed Whitfield (R-KY), Diana DeGette (D-CO), Mike Ross (D-AR), Edolphus Towns (D-NY), Mike Rogers (R-MI), Betty Sutton (D-OH), Bart Gordon (D-TN), Lee Terry (R-NE), and Ralph Hall (R-TX) have introduced legislation to address an issue with the calculation of the Average Sales Price (ASP) for Medicare Part B drugs. We thank and applaud them for their leadership on this important issue.
The bill, H.R. 1392, would remove prompt-pay discounts extended to wholesalers from the ASP calculation.
ASCO, along with members of the cancer community, supports this legislation and has long been working on Capitol Hill to make members of Congress aware that including prompt pay discounts in the ASP calculation threatens community oncology practices by artificially lowering the reimbursement rate for chemotherapy treatments. In the 110th Congress, ASCO worked with members of Congress to introduce similar legislation.
Significant support of this legislation is critical to its consideration and passage. Please contact your Representative in the House today and urge him or her to co-sponsor H.R. 1392. It is important to let them know the impact that underwater drugs are having on your practice and your patients. You can find contact information for your Representative on ASCO's Grassroots Action Center.
For more information, contact ASCO's Cancer Policy & Clinical Affairs Department at 571-483-1670 or publicpolicy@asco.org.
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the new Electronic Prescribing Incentive Program (E-Prescribing) web page at http://www.cms.hhs.gov/ERXIncentive on the CMS website. All information about the E-Prescribing Incentive Program has been moved from the CMS PQRI web page at http://www.cms.hhs.gov/PQRI to http://www.cms.hhs.gov/ERXIncentive.
This new web page provides information about the new E-Prescribing incentive program that was authorized by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
Please note that many new resources have also been added to the E-Prescribing Incentive web page as part of the migration to the new URL.
Included on this page in the Downloads section is:
• A 2009 Electronic Prescribing (E-Prescribing) Incentive Program Made Simple Fact Sheet;
• A Spanish version of the Introduction to E-Prescribing Incentive Fact Sheet;
• A Sample Electronic Prescribing Claim; and
• Information on how to access the audiotapes and slides from the National E-Prescribing Conference that was held in October 2008 for continuing education credit.
New and updated information will continually be added, so please visit the Electronic Incentive Program web page at http://www.cms.hhs.gov/ERXIncentive on the CMS website on a frequent basis.
****DHCS/MEDICAL NEWS****
The implementation date is fast approaching! Providers are reminded that, claims with dates of service on or after April 1, 2009 that do not meet the NDC reporting requirements to include a valid NDC with a HCPCS code, will be denied. For more information on NDC reporting, including FAQs, please visit the NDC page on the Medi-Cal Web site at: http://files.medi-cal.ca.gov/pubsdoco/ndc/ndc.asp
In order to comply with the DRA, providers must bill for physician-adminstered drugs using the appropriate CPT-4, HCPCS Level II, or local HCPCS Level III codes and, in addition, must include the NDC on the claim form. Providers have been encouraged, for dates of service on or after September 1, 2008, to include the NDC code on the claim, but claims without an NDC code have still been paid. Unfortunately, we are seeing minimal voluntary submissions of NDC and now is the time for providers to practice how they are going to comply.
Resources
The ASC X12N Version 4010A1 Companion Guides have been updated and are available on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/hipaa/hipaaspecs_home.asp . These guides will enable technical staff or software vendors to update your software to include the NDC requirements on the 837 electronic transactions. Additionally, the Part 2 provider bulletins (General Medicine, Obstetrics and Outpatient) include NDC information, physician-administered drug definitions, billing descriptions and examples for CMS 1500 and UB-04 paper claim forms, as well as both 837 Institutional and Professional electronic formats, and Section 340B information. These bulletins can be viewed on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/Bulletins_menu.asp . Finally, the CMS 1500 and UB-04 claim form tutorials on the Medi-Cal Web site have been updated to include instructions on how to bill HCPCS and NDCs and can be viewed at: http://files.medi-cal.ca.gov/pubsdoco/eo/elearning.asp .
Provider Workshops
There will be additional overviews presented at the Medi-Cal seminar, to address the NDC reporting requirements, in Long Beach on 3/24 and 3/25. The locations of the sessions and how to pre-register can be found on the Medi-Cal Web site: http://files.medi-cal.ca.gov/pubsdoco/eo/training.asp
Please share this information with your membership, including a notice in your newsletters. Should you have any questions or need additional information, please call the Telephone Service Center (TSC) at 1-800-541-5555 and choose the appropriate prompt or visit the Medi-Cal Web site at the address listed above.
****CORPORATE MEMBER NEWS****
Oncology Reimbursement Solutions, a service of US Oncology, is hosting a webinar entitled "E/M Documentation: Woud Yours Survive an Audit?" taking place on Tuesday, March 17th and Wednesday, March 18th.
For more information, please visit www.ors-insight.com/orsoncology.

Prompt-Pay Legislation Introduced in House of Representatives
Please Urge Your Representative to Co-sponsor H.R. 1392
Reps. Gene Green (D-TX), Ed Whitfield (R-KY), Diana DeGette (D-CO), Mike Ross (D-AR), Edolphus Towns (D-NY), Mike Rogers (R-MI), Betty Sutton (D-OH), Bart Gordon (D-TN), Lee Terry (R-NE), and Ralph Hall (R-TX) have introduced legislation to address an issue with the calculation of the Average Sales Price (ASP) for Medicare Part B drugs. We thank and applaud them for their leadership on this important issue.
The bill, H.R. 1392, would remove prompt-pay discounts extended to wholesalers from the ASP calculation.
ASCO, along with members of the cancer community, supports this legislation and has long been working on Capitol Hill to make members of Congress aware that including prompt pay discounts in the ASP calculation threatens community oncology practices by artificially lowering the reimbursement rate for chemotherapy treatments. In the 110th Congress, ASCO worked with members of Congress to introduce similar legislation.
Significant support of this legislation is critical to its consideration and passage. Please contact your Representative in the House today and urge him or her to co-sponsor H.R. 1392. It is important to let them know the impact that underwater drugs are having on your practice and your patients. You can find contact information for your Representative on ASCO's Grassroots Action Center.
For more information, contact ASCO's Cancer Policy & Clinical Affairs Department at 571-483-1670 or publicpolicy@asco.org.
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the new Electronic Prescribing Incentive Program (E-Prescribing) web page at http://www.cms.hhs.gov/ERXIncentive on the CMS website. All information about the E-Prescribing Incentive Program has been moved from the CMS PQRI web page at http://www.cms.hhs.gov/PQRI to http://www.cms.hhs.gov/ERXIncentive.
This new web page provides information about the new E-Prescribing incentive program that was authorized by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
Please note that many new resources have also been added to the E-Prescribing Incentive web page as part of the migration to the new URL.
Included on this page in the Downloads section is:
• A 2009 Electronic Prescribing (E-Prescribing) Incentive Program Made Simple Fact Sheet;
• A Spanish version of the Introduction to E-Prescribing Incentive Fact Sheet;
• A Sample Electronic Prescribing Claim; and
• Information on how to access the audiotapes and slides from the National E-Prescribing Conference that was held in October 2008 for continuing education credit.
New and updated information will continually be added, so please visit the Electronic Incentive Program web page at http://www.cms.hhs.gov/ERXIncentive on the CMS website on a frequent basis.
****DHCS/MEDICAL NEWS****
The implementation date is fast approaching! Providers are reminded that, claims with dates of service on or after April 1, 2009 that do not meet the NDC reporting requirements to include a valid NDC with a HCPCS code, will be denied. For more information on NDC reporting, including FAQs, please visit the NDC page on the Medi-Cal Web site at: http://files.medi-cal.ca.gov/pubsdoco/ndc/ndc.asp
In order to comply with the DRA, providers must bill for physician-adminstered drugs using the appropriate CPT-4, HCPCS Level II, or local HCPCS Level III codes and, in addition, must include the NDC on the claim form. Providers have been encouraged, for dates of service on or after September 1, 2008, to include the NDC code on the claim, but claims without an NDC code have still been paid. Unfortunately, we are seeing minimal voluntary submissions of NDC and now is the time for providers to practice how they are going to comply.
Resources
The ASC X12N Version 4010A1 Companion Guides have been updated and are available on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/hipaa/hipaaspecs_home.asp . These guides will enable technical staff or software vendors to update your software to include the NDC requirements on the 837 electronic transactions. Additionally, the Part 2 provider bulletins (General Medicine, Obstetrics and Outpatient) include NDC information, physician-administered drug definitions, billing descriptions and examples for CMS 1500 and UB-04 paper claim forms, as well as both 837 Institutional and Professional electronic formats, and Section 340B information. These bulletins can be viewed on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/Bulletins_menu.asp . Finally, the CMS 1500 and UB-04 claim form tutorials on the Medi-Cal Web site have been updated to include instructions on how to bill HCPCS and NDCs and can be viewed at: http://files.medi-cal.ca.gov/pubsdoco/eo/elearning.asp .
Provider Workshops
There will be additional overviews presented at the Medi-Cal seminar, to address the NDC reporting requirements, in Long Beach on 3/24 and 3/25. The locations of the sessions and how to pre-register can be found on the Medi-Cal Web site: http://files.medi-cal.ca.gov/pubsdoco/eo/training.asp
Please share this information with your membership, including a notice in your newsletters. Should you have any questions or need additional information, please call the Telephone Service Center (TSC) at 1-800-541-5555 and choose the appropriate prompt or visit the Medi-Cal Web site at the address listed above.
****CORPORATE MEMBER NEWS****
Oncology Reimbursement Solutions, a service of US Oncology, is hosting a webinar entitled "E/M Documentation: Woud Yours Survive an Audit?" taking place on Tuesday, March 17th and Wednesday, March 18th.
For more information, please visit www.ors-insight.com/orsoncology.

Monday, March 9, 2009
ACCC, CMA, COA-CAN, & CMS News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Centers's (ACCC) This Week At ACCC was published and is available at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-9-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Policy Experts Explore Healthcare Reform at ACCC's Annual Meetingg
Sneak Peek: ACCC Meeting to Showcase More Than 60 Exhibitors
CMS Advises MedPAC About Drastic Cuts to Physician Payments
Younger Breast Cancer Patients Have Greater Chance of Recurrence
NCI Teleconference to Explore Proteomic Technologies
NIH Announces Funding Opportunities Related to Health Research
IOM Seeks Information About Comparative Effectiveness
NY State Cuts Off Medicaid Reimbursement to Low-Volume Facilities
Q&A on ACCC's Listserv: Wait Times for Mammography
ACCC's CE Blackboard: A Full Range of Courses
Joins Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****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:
CMA Opposes Expansion of Chiropractic Scope of Practice
Supreme Court Rules Against Drug Maker in Liability Case
CMA Sponsors Bill to Protect Kids' Access to Vaccinations
Obama Gets the Health Reform Ball Rolling; Promises SGR Fix
HealthNet Clarifies Prepayment Review Policy
New Law Limits Markup for Radiologic Services
Webinar: HIT and the Economic Stimulus Package
Deadline for 2009 Medical School Loan Repayment Program Is March 24
Concerns with Health Insurers? Tell CMA.
Don't Miss Early Bird Deadline for CMA's 12th
Annual Health Care Leadership Academy
First Statewide POLST Conference Is March 30
Essentials for Medical Staff Leaders – a How-To Program
Benefit of the Week: Reduced Loan Administration Fees
****COA-CAN NEWS****
Everyone in Oncology is so very busy right now that even if something new and wonderful comes along there is some likelihood you might miss it. So, that’s why I want to tell you about the COA Community Oncology Administrators’ Network (“CAN”) website. Because we are all hassled and short on time, the COA Administrative Task Force has tried to put everything that you need to improve your practice in one spot so that you do not need to be browsing and Google-ing your life away.
Below I will describe some of the great features on the CAN web site with their web links in parentheses. Put these in your bookmarks so you can get to our information fast when you need it:
1. Log-in and read the latest news (http://www.communityoncology.org): Go to the main COA site; read the latest news about cancer; and, then, click on the big yellow tube to go to the CAN site.
2. Check out the latest Oncology discussion boards on the front page (http://www.communityoncology.info/): Here we have blogs on “hot topics”; coding issues; clinical practice; PQRI; MAC issues; RAC requests (when they get back in the swing of things); pharmacy issues; and many more. This is our version of an electronic community---we want to make you feel like you are not alone out there.
3. Searching for a fee schedule or regulation? We’ve got ‘em (http://communityoncology.info/regulatory/): The CMS website is not the friendliest place on earth. Therefore, we have all of the regulations on the site for you! You no longer need to be a Medicare expert to find them!
4. Visit our most popular feature---downloadable practice forms (http://communityoncology.info/forms-tools/): Why reinvent the wheel? We have been collecting these for years and now they are here for you on the web!
5. Educate your staff or yourself about reimbursement with downloadable PowerPoint® presentations and back issues of E-Reimbursement Updates (http://communityoncology.info/category/library/): We have assembled the latest coding, E/M, and practice management information so that you can get it in a heartbeat.
There are so many other features I could tell you about—like our recruiting site, polls, fee schedule calculator, and more. But, let’s face it---no one reads long-winded e-mails anymore. If you have any questions or suggestions, e-mail me (bobbibuell1@covad.net). Or, just log on at http://www.communityoncology.organd check it out for yourself! By clicking on the orange action bar (upper right corner) you can access a 15 minute web demo on the site.
Bobbi Buell
COA Web Mistress
****CMS NEWS****
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the first in a series of national provider conference calls on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 1:30 p.m. – 3:30 p.m., EDT, on Thursday, March 19, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
Following a short presentation on what’s new for the 2009 PQRI, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website, in the Educational Resources section. Feel free to download the resources prior to the call so that you may ask questions of the presenters, Dr. Michael Rapp and Dr. Daniel Green.
Conference call details:
Date: March 19, 2009
Conference Title: 2009 PQRI- National Provider Call
Time: 1:30 p.m. EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 1:30 p.m. EDT on March 18, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to http://www2.eventsvc.com/palmettogba/031909
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 4:30 p.m. EDT 3/19/2009 until 11:59 p.m. EDT 3/26/2009. The call in data for the replay is (800) 642-1687 and the passcode is 84546375.
****ACCC NEWS****
The Association of Community Cancer Centers's (ACCC) This Week At ACCC was published and is available at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-9-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Policy Experts Explore Healthcare Reform at ACCC's Annual Meetingg
Sneak Peek: ACCC Meeting to Showcase More Than 60 Exhibitors
CMS Advises MedPAC About Drastic Cuts to Physician Payments
Younger Breast Cancer Patients Have Greater Chance of Recurrence
NCI Teleconference to Explore Proteomic Technologies
NIH Announces Funding Opportunities Related to Health Research
IOM Seeks Information About Comparative Effectiveness
NY State Cuts Off Medicaid Reimbursement to Low-Volume Facilities
Q&A on ACCC's Listserv: Wait Times for Mammography
ACCC's CE Blackboard: A Full Range of Courses
Joins Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****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:
CMA Opposes Expansion of Chiropractic Scope of Practice
Supreme Court Rules Against Drug Maker in Liability Case
CMA Sponsors Bill to Protect Kids' Access to Vaccinations
Obama Gets the Health Reform Ball Rolling; Promises SGR Fix
HealthNet Clarifies Prepayment Review Policy
New Law Limits Markup for Radiologic Services
Webinar: HIT and the Economic Stimulus Package
Deadline for 2009 Medical School Loan Repayment Program Is March 24
Concerns with Health Insurers? Tell CMA.
Don't Miss Early Bird Deadline for CMA's 12th
Annual Health Care Leadership Academy
First Statewide POLST Conference Is March 30
Essentials for Medical Staff Leaders – a How-To Program
Benefit of the Week: Reduced Loan Administration Fees
****COA-CAN NEWS****
Everyone in Oncology is so very busy right now that even if something new and wonderful comes along there is some likelihood you might miss it. So, that’s why I want to tell you about the COA Community Oncology Administrators’ Network (“CAN”) website. Because we are all hassled and short on time, the COA Administrative Task Force has tried to put everything that you need to improve your practice in one spot so that you do not need to be browsing and Google-ing your life away.
Below I will describe some of the great features on the CAN web site with their web links in parentheses. Put these in your bookmarks so you can get to our information fast when you need it:
1. Log-in and read the latest news (http://www.communityoncology.org): Go to the main COA site; read the latest news about cancer; and, then, click on the big yellow tube to go to the CAN site.
2. Check out the latest Oncology discussion boards on the front page (http://www.communityoncology.info/): Here we have blogs on “hot topics”; coding issues; clinical practice; PQRI; MAC issues; RAC requests (when they get back in the swing of things); pharmacy issues; and many more. This is our version of an electronic community---we want to make you feel like you are not alone out there.
3. Searching for a fee schedule or regulation? We’ve got ‘em (http://communityoncology.info/regulatory/): The CMS website is not the friendliest place on earth. Therefore, we have all of the regulations on the site for you! You no longer need to be a Medicare expert to find them!
4. Visit our most popular feature---downloadable practice forms (http://communityoncology.info/forms-tools/): Why reinvent the wheel? We have been collecting these for years and now they are here for you on the web!
5. Educate your staff or yourself about reimbursement with downloadable PowerPoint® presentations and back issues of E-Reimbursement Updates (http://communityoncology.info/category/library/): We have assembled the latest coding, E/M, and practice management information so that you can get it in a heartbeat.
There are so many other features I could tell you about—like our recruiting site, polls, fee schedule calculator, and more. But, let’s face it---no one reads long-winded e-mails anymore. If you have any questions or suggestions, e-mail me (bobbibuell1@covad.net). Or, just log on at http://www.communityoncology.organd check it out for yourself! By clicking on the orange action bar (upper right corner) you can access a 15 minute web demo on the site.
Bobbi Buell
COA Web Mistress
****CMS NEWS****
The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the first in a series of national provider conference calls on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 1:30 p.m. – 3:30 p.m., EDT, on Thursday, March 19, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
Following a short presentation on what’s new for the 2009 PQRI, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website, in the Educational Resources section. Feel free to download the resources prior to the call so that you may ask questions of the presenters, Dr. Michael Rapp and Dr. Daniel Green.
Conference call details:
Date: March 19, 2009
Conference Title: 2009 PQRI- National Provider Call
Time: 1:30 p.m. EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 1:30 p.m. EDT on March 18, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to http://www2.eventsvc.com/palmettogba/031909
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 4:30 p.m. EDT 3/19/2009 until 11:59 p.m. EDT 3/26/2009. The call in data for the replay is (800) 642-1687 and the passcode is 84546375.
Sunday, March 8, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
MM6371 – Claims Processing Instructions for Diagnostic Tests Subject to the Anti-Markup Pricing Limitation
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6371.pdf
MM6362 – Reporting the National Provider Identifier (NPI) on Claims for Reference Laboratory and Purchased Diagnostic Services Performed Outside the Billing Jurisdiction
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6362.pdf
MM6370 – New Waived Tests
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6370.pdf
MM6139 – Implementation of New Provider Authentication Requirements for Medicare Contractor Provider Telephone and Written Inquiries
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6139.pdf
SE0902 – Important Information for Providers Serving Medicare Beneficiaries Enrolled in Private Fee-for-Service Plans
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0902.pdf
MM6397 – April Update to the 2009 Medicare Physician Fee Schedule Database (MPFSDB)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6397.pdf
MM6231 – Instructions for the Implementation of the Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6231.pdf
****PALMETTO/J1MAC NEWS****
Claims Processing Instructions for Diagnostic Tests Subject to the
Anti-Markup Pricing Limitation
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Claims%20Processing%20Instructions%20for%20Diagnostic%20Tests%20Subject%20to%20the%20Anti-Markup%20Pricing%20Limitation?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA38525756F0064677F?opendocument
CR6371, Claims Processing Instructions for Diagnostic Tests Subject to the
Anti-Markup Pricing Limitation, clarifies changes finalized in the Calendar
Year (CY) 2009 Medicare Physician Fee Schedule (MPFS) final rule with
comment related to diagnostic tests and the revised anti-markup provisions
in section 414.50 of the Medicare regulations.
J1 Part B LCD Updates
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~J1%20Part%20B%20LCD%20Updates?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA385257570007255CE?opendocument
These are the J1 Part B LCD Updates for March 5, 2009. Included are the
Blepharoplasty, Blepharoptosis and Brow Lift, Psychotherapy Services, Mohs
Micrographic Surgery and Injection of Spinal Canal LCDs.
New Waived Tests
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~New%20Waived%20Tests?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA385257570006CFB16?opendocument
CR6370, New Waived Tests, alerts providers that the Centers for Medicare &
Medicaid Services (CMS) has listed the twelve latest tests approved by the
Food and Drug Administration (FDA) as waived tests under Clinical
Laboratory Improvement Amendments of 1988 (CLIA).
Reporting the National Provider Identifier (NPI) on Claims for Reference
Laboratory and Purchased Diagnostic Services Performed Outside the Billing
Jurisdiction
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Reporting%20the%20National%20Provider%20Identifier%20(NPI)%20on%20Claims%20for%20Reference%20Laboratory%20and%20Purchased%20Diagnostic%20Services%20Performed%20Outside%20the%20Billing%20Jurisdiction?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA3852575700047F26E?opendocument
CR6362 establishes an exception to the standard reporting of the national
provider identifier (NPI) on Medicare fee-for-service claims for reference
laboratory and purchased diagnostic services performed by a provider
outside billing jurisdiction.
Incorrect Provider Option Combinations
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Incorrect%20Provider%20Option%20Combinations?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA385257571005BFF57?opendocument
This article details incorrect provider option combinations that will be
rejected effective immediately.
National Provider Identifier (NPI) Development to Resume
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~National%20Provider%20Identifier%20(NPI)%20Development%20to%20Resume?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA38525756A004F9B70?opendocument
For claims processed on and after April 1, 2009, Palmetto GBA will resume
development of claims when a one-to-one match for you National Provider
Identifier (NPI) and your Provider Transaction Access Number (PTAN) can not
be made.
Outpatient Therapy Caps with Exceptions in Calendar Year (CY) 2009
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Outpatient%20Therapy%20Caps%20with%20Exceptions%20in%20Calendar%20Year%20(CY)%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA38525757100509630?opendocument
CR6321, Outpatient Therapy Caps with Exceptions in Calendar Year (CY) 2009,
describes the policy for outpatient therapy cap exceptions and updates the
dollar amount of the therapy caps for 2009.
Supporting Documentation and Coding Requirements for Postoperative Care:
CPT Modifier 55
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Supporting%20Documentation%20and%20Coding%20Requirements%20for%20Postoperative%20Care%20CPT%20Modifier%2055?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA38525757100506AF4?opendocument
This article details the necessary supporting documentation and coding
requirements for Postoperative Care: CPT Modifier 55
****CMS NEWS****
MM6371 – Claims Processing Instructions for Diagnostic Tests Subject to the Anti-Markup Pricing Limitation
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6371.pdf
MM6362 – Reporting the National Provider Identifier (NPI) on Claims for Reference Laboratory and Purchased Diagnostic Services Performed Outside the Billing Jurisdiction
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6362.pdf
MM6370 – New Waived Tests
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6370.pdf
MM6139 – Implementation of New Provider Authentication Requirements for Medicare Contractor Provider Telephone and Written Inquiries
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6139.pdf
SE0902 – Important Information for Providers Serving Medicare Beneficiaries Enrolled in Private Fee-for-Service Plans
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0902.pdf
MM6397 – April Update to the 2009 Medicare Physician Fee Schedule Database (MPFSDB)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6397.pdf
MM6231 – Instructions for the Implementation of the Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6231.pdf
****PALMETTO/J1MAC NEWS****
Claims Processing Instructions for Diagnostic Tests Subject to the
Anti-Markup Pricing Limitation
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Claims%20Processing%20Instructions%20for%20Diagnostic%20Tests%20Subject%20to%20the%20Anti-Markup%20Pricing%20Limitation?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA38525756F0064677F?opendocument
CR6371, Claims Processing Instructions for Diagnostic Tests Subject to the
Anti-Markup Pricing Limitation, clarifies changes finalized in the Calendar
Year (CY) 2009 Medicare Physician Fee Schedule (MPFS) final rule with
comment related to diagnostic tests and the revised anti-markup provisions
in section 414.50 of the Medicare regulations.
J1 Part B LCD Updates
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~J1%20Part%20B%20LCD%20Updates?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA385257570007255CE?opendocument
These are the J1 Part B LCD Updates for March 5, 2009. Included are the
Blepharoplasty, Blepharoptosis and Brow Lift, Psychotherapy Services, Mohs
Micrographic Surgery and Injection of Spinal Canal LCDs.
New Waived Tests
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~New%20Waived%20Tests?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA385257570006CFB16?opendocument
CR6370, New Waived Tests, alerts providers that the Centers for Medicare &
Medicaid Services (CMS) has listed the twelve latest tests approved by the
Food and Drug Administration (FDA) as waived tests under Clinical
Laboratory Improvement Amendments of 1988 (CLIA).
Reporting the National Provider Identifier (NPI) on Claims for Reference
Laboratory and Purchased Diagnostic Services Performed Outside the Billing
Jurisdiction
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Reporting%20the%20National%20Provider%20Identifier%20(NPI)%20on%20Claims%20for%20Reference%20Laboratory%20and%20Purchased%20Diagnostic%20Services%20Performed%20Outside%20the%20Billing%20Jurisdiction?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA3852575700047F26E?opendocument
CR6362 establishes an exception to the standard reporting of the national
provider identifier (NPI) on Medicare fee-for-service claims for reference
laboratory and purchased diagnostic services performed by a provider
outside billing jurisdiction.
Incorrect Provider Option Combinations
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Incorrect%20Provider%20Option%20Combinations?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA385257571005BFF57?opendocument
This article details incorrect provider option combinations that will be
rejected effective immediately.
National Provider Identifier (NPI) Development to Resume
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~National%20Provider%20Identifier%20(NPI)%20Development%20to%20Resume?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA38525756A004F9B70?opendocument
For claims processed on and after April 1, 2009, Palmetto GBA will resume
development of claims when a one-to-one match for you National Provider
Identifier (NPI) and your Provider Transaction Access Number (PTAN) can not
be made.
Outpatient Therapy Caps with Exceptions in Calendar Year (CY) 2009
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~All%20Part%20A%20MLNs~Outpatient%20Therapy%20Caps%20with%20Exceptions%20in%20Calendar%20Year%20(CY)%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA38525757100509630?opendocument
CR6321, Outpatient Therapy Caps with Exceptions in Calendar Year (CY) 2009,
describes the policy for outpatient therapy cap exceptions and updates the
dollar amount of the therapy caps for 2009.
Supporting Documentation and Coding Requirements for Postoperative Care:
CPT Modifier 55
http://www.palmettogba.com/Palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Supporting%20Documentation%20and%20Coding%20Requirements%20for%20Postoperative%20Care%20CPT%20Modifier%2055?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/Palmetto/Providers.nsf/docsCat/8525746A00550AA38525757100506AF4?opendocument
This article details the necessary supporting documentation and coding
requirements for Postoperative Care: CPT Modifier 55
Wednesday, March 4, 2009
ASCO, NCCN, & Stanford News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider (an e-Digest for Practice Management) was published today and is available at http://view.exacttarget.com/?j=fe5c157974610d797116&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2c16727665027a741376. ANCO is a state/regional affiliate of ASCO. This edition features:
1. ASCO Asks CMS to Rescind Local Policy Due to Impact on Antiemetics
2. ASCO Submits Comments on Viatmin-D Assay Testing
3. EHR Social Networking Site
4. Are You ICD-10 Ready?
5. CMS Resumes Recovery Audit Contractor Program
6. Update on Leucovorin Shortage
7. AMA Announces Physician Class-Actions Against Aetna and CIGNA
8. PQRI Update
9. ASP Quarterly Updates
10. Billing and Coding Q&A
11. What do you think...?
12. Did you know..?
****NCCN NEWS****
The National Comprehensive Cancer Network (NCCN) and Medscape are proud to offer several new continuing education programs on www.medscape.com. These programs feature distinguished faculty from the NCCN Member Institutions presenting information in a 30-minute, roundtable format.
Available Medscape Spotlights
2009 Updates to the NCCN Non-Small Cell Lung Cancer Guidelines (http://www.medscape.com/viewprogram/18689)
Supported by educational grants from Amgen, Eli Lilly and Company, and Genentech BioOncology | OSI Oncology.
Treating and Monitoring Patients With Chronic Myelogenous (http://www.medscape.com/viewprogram/17646)
Supported by educational grants from Bristol-Myers Squibb Company and Novartis Oncology.
Multiple Myeloma: Determining Prognosis and Choosing Therapy (http://www.medscape.com/viewprogram/12524)
Supported by an educational grant from Millennium Pharmaceuticals, Inc.
NCCN/Medscape Spotlight Programs are approved for AMA PRA Category 1 Credit™ and are also approved for nursing contact hours.
****STANFORD NEWS****
Stanford's 3rd Annual GI Cancers Meeting takes place July 31st-August 2nd, 2009 at the Mauna Lani Hotel in Hawaii.
Please find attached a Save the Date announcement and registration form.
For additional details, please visit www.cme.stanfordhospital.com
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider (an e-Digest for Practice Management) was published today and is available at http://view.exacttarget.com/?j=fe5c157974610d797116&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2c16727665027a741376. ANCO is a state/regional affiliate of ASCO. This edition features:
1. ASCO Asks CMS to Rescind Local Policy Due to Impact on Antiemetics
2. ASCO Submits Comments on Viatmin-D Assay Testing
3. EHR Social Networking Site
4. Are You ICD-10 Ready?
5. CMS Resumes Recovery Audit Contractor Program
6. Update on Leucovorin Shortage
7. AMA Announces Physician Class-Actions Against Aetna and CIGNA
8. PQRI Update
9. ASP Quarterly Updates
10. Billing and Coding Q&A
11. What do you think...?
12. Did you know..?
****NCCN NEWS****
The National Comprehensive Cancer Network (NCCN) and Medscape are proud to offer several new continuing education programs on www.medscape.com. These programs feature distinguished faculty from the NCCN Member Institutions presenting information in a 30-minute, roundtable format.
Available Medscape Spotlights
2009 Updates to the NCCN Non-Small Cell Lung Cancer Guidelines (http://www.medscape.com/viewprogram/18689)
Supported by educational grants from Amgen, Eli Lilly and Company, and Genentech BioOncology | OSI Oncology.
Treating and Monitoring Patients With Chronic Myelogenous (http://www.medscape.com/viewprogram/17646)
Supported by educational grants from Bristol-Myers Squibb Company and Novartis Oncology.
Multiple Myeloma: Determining Prognosis and Choosing Therapy (http://www.medscape.com/viewprogram/12524)
Supported by an educational grant from Millennium Pharmaceuticals, Inc.
NCCN/Medscape Spotlight Programs are approved for AMA PRA Category 1 Credit™ and are also approved for nursing contact hours.
****STANFORD NEWS****
Stanford's 3rd Annual GI Cancers Meeting takes place July 31st-August 2nd, 2009 at the Mauna Lani Hotel in Hawaii.
Please find attached a Save the Date announcement and registration form.
For additional details, please visit www.cme.stanfordhospital.com
Monday, March 2, 2009
ACCC, ASCO, & NCCN News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Centers' (ACCC) This Week at ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-2-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Less Than Three Weeks Until ACCC's Annual National Meeting
Sneak Peek: ACCC Meeting to Showcase More Than 60 Exhibitors
President Calls For Boost to NIH Budget
ACCC Welcomes Pfizer to its Industry Advisory Council
ACCC Welcomes Biotech Company TopoTarget
Liver Cancer Incidence Continues Steep Climb
Final Week for Cancer Program Administrators to Take Survey
Q&A on ACCC's Listserv: Radiation Oncology Volumes, Up or Down?
ACCC's CE Blackboard: A Full Range of Courses
Joins Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) e-News was published and is available online at http://view.exacttarget.com/?j=fe60157974600c7b7516&m=ff2d16787160&ls=fdf01372736d047f7617767c&l=fe5f1575706c00787615&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe3b167276640775741570. ANCO is a state/regional affiliate of ASCO. This edition features:
Cancer Policy Alert: House Leaders Introducing Bill to Remove Prompt-Pay Discounts, ASCO Makes Recommendations to NCI on Stimulus Funding
New Resources Available to Help Discuss Cancer Chemoprevention with Patients
Read the JCO Original Report, "Phase II Trial of the Combination of Bevacizumab and Erlotinib in Patients Who Have Advanced Hepatocellular Carcinoma"
Virtual Meeting, Podcast Access Available from the 2009 GU Cancers Symposium
View, Purchase Electronic Resources from the 2009 GI Cancers Symposium
The 2008 Breast Cancer Symposium DVD Available for Purchase
For Your Patients
Special Cancer.Net Podcast: 2009 GU Cancers Symposium Highlights
Cancer.Net Feature: After Treatment for Prostate Cancer: Managing Side Effects
New Guideline on Drugs to Help Prevent Prostate Cancer
Check Out the Latest News on Prostate and Bladder Cancer
Reminders
Apply for the 2009 ASCO/AACR Workshop: Methods in Clinical Cancer Research, By March 16
Comment on the ASCO-ONS Standards for Safe Chemotherapy Administration
Register and Reserve Housing for the 2009 ASCO Annual Meeting in Orlando, Florida
Visit ASCO's EHR Social Network Site
****NCCN NEWS****
Join members of the National Comprehensive Cancer Network Colon Cancer Guidelines Panel to discuss the evolving data in medical and surgical management of metastatic colon cancer and their application in the current NCCN Guidelines, selection of adjuvant and systemic therapy for advanced disease, and sequencing of agents in second- and third-line therapy.
Metastatic Colon Cancer: The Continuum of Care (http://discoveryhealthcme.discovery.com/colon-cancer/colon-cancer.html)
Discovery Health offers the most flexible way to earn free CME credit. Watch online anytime via high-speed internet connection, download the podcast, or order the DVD. Complete the post-test and evaluation on-line and print your certificate right from your computer.
Faculty
Al B. Benson III, MD
Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Paul F. Engstrom, MD
Fox Chase Cancer Center
Leonard Saltz, MD
Memorial Sloan-Kettering Cancer Center
Program Overview
In response to the burgeoning data regarding patient risk assessment and the selection of therapies, the NCCN has brought together members of the NCCN Colon Cancer Guidelines Panel to discuss the process for development of the NCCN Clinical Practice Guidelines in Oncology™. The program will focus on the evolving data in medical and surgical management of metastatic colon cancer and their application in the current NCCN guidelines, selection of adjuvant and systemic therapy for advanced disease, and sequencing of agents in second- and third-line therapy.
Educational Objectives
Following this activity, participants should be able to:
Discuss recent updates made to the NCCN Clinical Practice Guidelines in Oncology™ Colon Cancer
List current options for metastatic disease
Describe the use of adjuvant therapy
Provide the rationale for sequencing of systemic therapy
Differentiate between management strategies for patients with good versus poor performance status
Intended Audience
This educational activity is designed to meet the needs of physicians, nurses, and other clinical professionals who manage patients with cancer.
****ACCC NEWS****
The Association of Community Cancer Centers' (ACCC) This Week at ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-2-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Less Than Three Weeks Until ACCC's Annual National Meeting
Sneak Peek: ACCC Meeting to Showcase More Than 60 Exhibitors
President Calls For Boost to NIH Budget
ACCC Welcomes Pfizer to its Industry Advisory Council
ACCC Welcomes Biotech Company TopoTarget
Liver Cancer Incidence Continues Steep Climb
Final Week for Cancer Program Administrators to Take Survey
Q&A on ACCC's Listserv: Radiation Oncology Volumes, Up or Down?
ACCC's CE Blackboard: A Full Range of Courses
Joins Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) e-News was published and is available online at http://view.exacttarget.com/?j=fe60157974600c7b7516&m=ff2d16787160&ls=fdf01372736d047f7617767c&l=fe5f1575706c00787615&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe3b167276640775741570. ANCO is a state/regional affiliate of ASCO. This edition features:
Cancer Policy Alert: House Leaders Introducing Bill to Remove Prompt-Pay Discounts, ASCO Makes Recommendations to NCI on Stimulus Funding
New Resources Available to Help Discuss Cancer Chemoprevention with Patients
Read the JCO Original Report, "Phase II Trial of the Combination of Bevacizumab and Erlotinib in Patients Who Have Advanced Hepatocellular Carcinoma"
Virtual Meeting, Podcast Access Available from the 2009 GU Cancers Symposium
View, Purchase Electronic Resources from the 2009 GI Cancers Symposium
The 2008 Breast Cancer Symposium DVD Available for Purchase
For Your Patients
Special Cancer.Net Podcast: 2009 GU Cancers Symposium Highlights
Cancer.Net Feature: After Treatment for Prostate Cancer: Managing Side Effects
New Guideline on Drugs to Help Prevent Prostate Cancer
Check Out the Latest News on Prostate and Bladder Cancer
Reminders
Apply for the 2009 ASCO/AACR Workshop: Methods in Clinical Cancer Research, By March 16
Comment on the ASCO-ONS Standards for Safe Chemotherapy Administration
Register and Reserve Housing for the 2009 ASCO Annual Meeting in Orlando, Florida
Visit ASCO's EHR Social Network Site
****NCCN NEWS****
Join members of the National Comprehensive Cancer Network Colon Cancer Guidelines Panel to discuss the evolving data in medical and surgical management of metastatic colon cancer and their application in the current NCCN Guidelines, selection of adjuvant and systemic therapy for advanced disease, and sequencing of agents in second- and third-line therapy.
Metastatic Colon Cancer: The Continuum of Care (http://discoveryhealthcme.discovery.com/colon-cancer/colon-cancer.html)
Discovery Health offers the most flexible way to earn free CME credit. Watch online anytime via high-speed internet connection, download the podcast, or order the DVD. Complete the post-test and evaluation on-line and print your certificate right from your computer.
Faculty
Al B. Benson III, MD
Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Paul F. Engstrom, MD
Fox Chase Cancer Center
Leonard Saltz, MD
Memorial Sloan-Kettering Cancer Center
Program Overview
In response to the burgeoning data regarding patient risk assessment and the selection of therapies, the NCCN has brought together members of the NCCN Colon Cancer Guidelines Panel to discuss the process for development of the NCCN Clinical Practice Guidelines in Oncology™. The program will focus on the evolving data in medical and surgical management of metastatic colon cancer and their application in the current NCCN guidelines, selection of adjuvant and systemic therapy for advanced disease, and sequencing of agents in second- and third-line therapy.
Educational Objectives
Following this activity, participants should be able to:
Discuss recent updates made to the NCCN Clinical Practice Guidelines in Oncology™ Colon Cancer
List current options for metastatic disease
Describe the use of adjuvant therapy
Provide the rationale for sequencing of systemic therapy
Differentiate between management strategies for patients with good versus poor performance status
Intended Audience
This educational activity is designed to meet the needs of physicians, nurses, and other clinical professionals who manage patients with cancer.
Sunday, March 1, 2009
ASCO & Palmetto/J1MAC News
The following information has been received by ANCO.
****ASCO NEWS****
What’s a good way to discuss cancer chemoprevention with interested patients? Decision Aids and Discussion Guides showing and describing risks and benefits can help shared decision-making. Check out ASCO’s new Discussion Guide on chemoprevention for prostate cancer using finasteride, based on a newly published joint guideline with the American Urological Association.
The Discussion Guide graphically demonstrates the benefits and risks in terms of prostate cancer incidence, shows the likelihood of other risks and benefits, and includes ways for men to think over this topic.
This new resource is free and available online at www.asco.org/guidelines/5ari.
****PALMETTO/J1MAC NEWS****
Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and
Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Healthcare%20Common%20Procedure%20Coding%20System%20(HCPCS)%20Codes%20Subject%20to%20and%20Excluded%20from%20Clinical%20Laboratory%20Improvement%20Amendments%20(CLIA)%20Edits?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852575690068C227?opendocument
CR6356, Healthcare Common Procedure Coding System (HCPCS) Codes Subject to
and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits,
includes information on modifiers for 2009 that are both subject to, and
excluded from, CLIA edits.
California J1 Open Draft LCD Meeting - March 17
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~California%20J1%20Open%20Draft%20LCD%20Meeting%20-%20March%2017?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525756A004F7263?opendocument
A J1 Open Draft LCD Meeting is scheduled for California on March 17.
March 2009 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~March%202009%20J1%20AB%20MAC%20Medicare%20Advisory?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525756A00712535?opendocument
The March 2009 J1 A/B MAC Medicare Advisory is now available to be viewed
on the Palmetto GBA Web site. It contains the latest updates and useful
information regarding Medicare. Please share this information with your
staff.
National Provider Identifier (NPI) Development to Resume
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~National%20Provider%20Identifier%20(NPI)%20Development%20to%20Resume?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525756A004F9B70?opendocument
For claims processed on and after April 1, 2009, Palmetto GBA will resume
development of claims when a one-to-one match for you National Provider
Identifier (NPI) and your Provider Transaction Access Number (PTAN) can not
be made.
****ASCO NEWS****
What’s a good way to discuss cancer chemoprevention with interested patients? Decision Aids and Discussion Guides showing and describing risks and benefits can help shared decision-making. Check out ASCO’s new Discussion Guide on chemoprevention for prostate cancer using finasteride, based on a newly published joint guideline with the American Urological Association.
The Discussion Guide graphically demonstrates the benefits and risks in terms of prostate cancer incidence, shows the likelihood of other risks and benefits, and includes ways for men to think over this topic.
This new resource is free and available online at www.asco.org/guidelines/5ari.
****PALMETTO/J1MAC NEWS****
Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and
Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Healthcare%20Common%20Procedure%20Coding%20System%20(HCPCS)%20Codes%20Subject%20to%20and%20Excluded%20from%20Clinical%20Laboratory%20Improvement%20Amendments%20(CLIA)%20Edits?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA3852575690068C227?opendocument
CR6356, Healthcare Common Procedure Coding System (HCPCS) Codes Subject to
and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits,
includes information on modifiers for 2009 that are both subject to, and
excluded from, CLIA edits.
California J1 Open Draft LCD Meeting - March 17
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~California%20J1%20Open%20Draft%20LCD%20Meeting%20-%20March%2017?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525756A004F7263?opendocument
A J1 Open Draft LCD Meeting is scheduled for California on March 17.
March 2009 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~March%202009%20J1%20AB%20MAC%20Medicare%20Advisory?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525756A00712535?opendocument
The March 2009 J1 A/B MAC Medicare Advisory is now available to be viewed
on the Palmetto GBA Web site. It contains the latest updates and useful
information regarding Medicare. Please share this information with your
staff.
National Provider Identifier (NPI) Development to Resume
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~National%20Provider%20Identifier%20(NPI)%20Development%20to%20Resume?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/Providers.nsf/docsCat/8525746A00550AA38525756A004F9B70?opendocument
For claims processed on and after April 1, 2009, Palmetto GBA will resume
development of claims when a one-to-one match for you National Provider
Identifier (NPI) and your Provider Transaction Access Number (PTAN) can not
be made.
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