The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) ACCConnect was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCConnect_7-29-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Analysis of 2010 Proposed Rules Available
Webinar: Guide to Best Practices in a Comprehensive Prostate Cancer Program
Florida Oncologists Voice Concerns Over Payer Restraints
New Research Opportunity for NSCLC and Multiple Myeloma Trials
Label Change for Erbitux and Vectibix
****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:
Audits of Medicare Physicians to Go Nationwide this Fall
State Budget Cuts $1.5 Billion from Health Care; Denies Care to State's Most Vulnerable Residents
Department of Insurance Regulations Would Halt Illegal Rescissions
CMA Supports Ban on Sale of Tobacco in Pharmacies
Blue Cross Updating Payment Policies
CMA Urges Physicians to Correct Data Used to Grade their Performance
Health Reform Bill Would Require IOM to Study Socioeconomic Factors behind Regional Medicare Cost Variations
Help Make the CMA Foundation Annual Dinner a Success
Don't Forget: Red Flag Rules Take Effect August 1
Wednesday, July 29, 2009
Monday, July 27, 2009
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
The Recovery Audit Contractor Program
This article titled, Recovery Audit Contractor (RAC) Program, has been
added to a new RAC category on the J1 Web site. It provides an overview of
this important program. Please check this page for forthcoming updates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7T6K7W3608?opendocument
J1 Part B LCD Update
View the latest J1 Part B LCD revisions.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U9PEY0310?opendocument
****PALMETTO/J1MAC NEWS****
The Recovery Audit Contractor Program
This article titled, Recovery Audit Contractor (RAC) Program, has been
added to a new RAC category on the J1 Web site. It provides an overview of
this important program. Please check this page for forthcoming updates.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7T6K7W3608?opendocument
J1 Part B LCD Update
View the latest J1 Part B LCD revisions.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U9PEY0310?opendocument
Thursday, July 23, 2009
ASH, CMS, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/07232009.cfm#1. This edition features:
Health Reform Legislation Continues to Develop – Physician Payment Issues Controversial
CMS Proposes 2010 Payment and Policy Changes for Physicians
CMS Proposes Hospital Outpatient Prospective Payment System (HOPPS) 2010 Rule
ASH Meets With CMS About Bone Marrow Transplant
ICD-9-CM Medicare Contractor Annual Update Released
ASH State-of-the-Art Symposium Advance Registration Closing Soon
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) is not providing an updated Codes.ini file with the implementation of the July 2009 release (CR6453). Due to the timing of when the Codes Committee meets, the list of updated Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) will not be available until after the implementation of the July 2009 release. Therefore, CMS will provide an updated list of CARCs and RARCs via the Codes.ini file with the implementation of the October 2009 release.
CMS has launched its website for agency-wide information and education on Versions 5010, D.0 and 3.0. As you may already know, Version 5010 is the new version of the X12 standards for HIPAA transactions; version D.0 is the new version of the National Council for Prescription Drug Program (NCPDP) standards for pharmacy and supplier transactions; and version 3.0 is a new NCPDP standard for Medicaid pharmacy subrogation.
On this website, you can view background information on the new standards, regulatory information, the latest outreach messages from CMS, educational resources, resources specific to D.0 and 3.0, as well as implementation information for the Medicare Fee-For-Service systems. CMS plans to add additional information as it becomes available so bookmark the site today!
http://www.cms.hhs.gov/Versions5010andD0
You can also view the presentation, transcript and listen to the audiofile from the June 9thnational provider conference call on Versions 5010 and D.0 on the Educational Resources page or at http://www.cms.hhs.gov/Versions5010andD0/Downloads/6-9-2009_National_Provider_Call.pdf on the CMS website.
A new video explaining the MLN and its benefits to Fee-For-Service healthcare providers, is now available for download on the CMS website. This video, approximately seven minutes in length, is suitable for self instruction or for use during provider education events. National associations and organizations may want to consider posting this video to their websites to educate their membership on the products and services of the MLN.
To access the video, click on this hyperlink: MLN Video - Quick and Basic Information about the MLN and its Benefits to Providers [ZIP, 44.1MB]. Please note the large file size; download speeds will vary based on your Internet connection.
MM6520 – Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6520.pdf
****PALMETTO/J1MAC NEWS****
Coding and Reporting Principles for the Physician Quality Reporting
Initiative (PQRI) and the Electronic Prescribing (E-Prescribing) Incentive
Programs,
To read CR 6514, Coding and Reporting Principles for the Physician Quality
Reporting Initiative (PQRI) and the Electronic Prescribing (E-Prescribing)
Incentive Programs, open the PDF document below.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TZMYK4572?opendocument
Billing Requirements for Provider Information
Providers are reminded that billing and rendering provider NPI information
submitted on the claim must correspond appropriately.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U5QEG0772?opendocument
Interest Payment on Clean Claims Not Paid Timely
The interest payment on clean claims not paid timely as determined by the
Treasury Department has been updated.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U5R8G5086?opendocument
Medicare Contractor Annual Update of the International Classification of
Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
CR 6520 announces the Medicare Contractor Annual Update of the
International Classification of Diseases, Ninth Revision, Clinical
Modification (ICD-9-CM).
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U5PGN4647?opendocument
Part B LCD Update
Please review the following Part B local coverage determinations, which
have been revised.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U6QLC5666?opendocument
J1 Provider Contact Center to be Closed for Training Friday, July 24
The J1 Provider Contact Center will be closed for training from 11 a.m. to
3 p.m. Friday, July 24, 2009 PST.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U7JPU1353?opendocument
Modifiers - General Information
Not sure which modifier to use to file your claim? Here's a primer on the
most used - and misued - modifiers. Modifiers assure that the carrier will
give consideration to the special circumstances that might affect payment.
Omitting modifiers might result in payment denials or rejections. Using the
correct modifier with the initial filing will eliminate the need for
appeals and processing delays.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U6QVQ8370?opendocument
Redeterminations: What information should I send with the request?
Need to know what information to send with your redetermination request?
Read this article to find out how to send redetermination requests in a
timely manner.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U7K7E7756?opendocument
****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/07232009.cfm#1. This edition features:
Health Reform Legislation Continues to Develop – Physician Payment Issues Controversial
CMS Proposes 2010 Payment and Policy Changes for Physicians
CMS Proposes Hospital Outpatient Prospective Payment System (HOPPS) 2010 Rule
ASH Meets With CMS About Bone Marrow Transplant
ICD-9-CM Medicare Contractor Annual Update Released
ASH State-of-the-Art Symposium Advance Registration Closing Soon
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) is not providing an updated Codes.ini file with the implementation of the July 2009 release (CR6453). Due to the timing of when the Codes Committee meets, the list of updated Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) will not be available until after the implementation of the July 2009 release. Therefore, CMS will provide an updated list of CARCs and RARCs via the Codes.ini file with the implementation of the October 2009 release.
CMS has launched its website for agency-wide information and education on Versions 5010, D.0 and 3.0. As you may already know, Version 5010 is the new version of the X12 standards for HIPAA transactions; version D.0 is the new version of the National Council for Prescription Drug Program (NCPDP) standards for pharmacy and supplier transactions; and version 3.0 is a new NCPDP standard for Medicaid pharmacy subrogation.
On this website, you can view background information on the new standards, regulatory information, the latest outreach messages from CMS, educational resources, resources specific to D.0 and 3.0, as well as implementation information for the Medicare Fee-For-Service systems. CMS plans to add additional information as it becomes available so bookmark the site today!
http://www.cms.hhs.gov/Versions5010andD0
You can also view the presentation, transcript and listen to the audiofile from the June 9thnational provider conference call on Versions 5010 and D.0 on the Educational Resources page or at http://www.cms.hhs.gov/Versions5010andD0/Downloads/6-9-2009_National_Provider_Call.pdf on the CMS website.
A new video explaining the MLN and its benefits to Fee-For-Service healthcare providers, is now available for download on the CMS website. This video, approximately seven minutes in length, is suitable for self instruction or for use during provider education events. National associations and organizations may want to consider posting this video to their websites to educate their membership on the products and services of the MLN.
To access the video, click on this hyperlink: MLN Video - Quick and Basic Information about the MLN and its Benefits to Providers [ZIP, 44.1MB]. Please note the large file size; download speeds will vary based on your Internet connection.
MM6520 – Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6520.pdf
****PALMETTO/J1MAC NEWS****
Coding and Reporting Principles for the Physician Quality Reporting
Initiative (PQRI) and the Electronic Prescribing (E-Prescribing) Incentive
Programs,
To read CR 6514, Coding and Reporting Principles for the Physician Quality
Reporting Initiative (PQRI) and the Electronic Prescribing (E-Prescribing)
Incentive Programs, open the PDF document below.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TZMYK4572?opendocument
Billing Requirements for Provider Information
Providers are reminded that billing and rendering provider NPI information
submitted on the claim must correspond appropriately.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U5QEG0772?opendocument
Interest Payment on Clean Claims Not Paid Timely
The interest payment on clean claims not paid timely as determined by the
Treasury Department has been updated.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U5R8G5086?opendocument
Medicare Contractor Annual Update of the International Classification of
Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
CR 6520 announces the Medicare Contractor Annual Update of the
International Classification of Diseases, Ninth Revision, Clinical
Modification (ICD-9-CM).
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U5PGN4647?opendocument
Part B LCD Update
Please review the following Part B local coverage determinations, which
have been revised.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U6QLC5666?opendocument
J1 Provider Contact Center to be Closed for Training Friday, July 24
The J1 Provider Contact Center will be closed for training from 11 a.m. to
3 p.m. Friday, July 24, 2009 PST.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U7JPU1353?opendocument
Modifiers - General Information
Not sure which modifier to use to file your claim? Here's a primer on the
most used - and misued - modifiers. Modifiers assure that the carrier will
give consideration to the special circumstances that might affect payment.
Omitting modifiers might result in payment denials or rejections. Using the
correct modifier with the initial filing will eliminate the need for
appeals and processing delays.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U6QVQ8370?opendocument
Redeterminations: What information should I send with the request?
Need to know what information to send with your redetermination request?
Read this article to find out how to send redetermination requests in a
timely manner.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7U7K7E7756?opendocument
Wednesday, July 22, 2009
ACCC Conference Call on New Proposed Rules from CMS (July 23) & Innovent Oncology Webcast for ANCO Member Practices
All:
Here is information on two very important forthcoming meetings.
Medicare Alert:
ACCC Conference Call on Proposed HOPPS Rule and Physician Fee Schedule
Exclusively for ACCC Members
Call in Thursday, July 23, 2009
1:30 pm – 3:00 pm EDT
Join Oncology Policy and Legal Experts for a 90-Minute Discussion of the 2010 Proposed Hospital Outpatient Department Rule and Physician Fee Schedule.
How will the proposed 2010 Hospital Outpatient Prospective Payment System (HOPPS) Rule and Physician Fee Schedule affect your program or practice? Learn about:
The impact of hospital reimbursement of separately paid drugs without pass-through status at average sales price (ASP) +4 percent
Payment changes for imaging services
"Physician Supervision" clarification within the proposed HOPPS Rule
Quality reporting requirements
The proposal in the Physician Fee Schedule to substitute evaluation and management service codes for consultation codes
And more.
Thursday, July 23, at 1:30 pm EDT
To participate in the call, dial 888.283.6452. You will then be asked for the conference ID #: 19180097. Next, you will be prompted to give your name and location, and will then join in the conference call.
1:30 to 1:40 EDT
Introduction
Matt Farber, MA, Manager, Provider Economics and Public Policy, Association of Community Cancer Centers
1:40 to 2:00 EDT
Overview of HOPPS Proposed Rule and Physician Fee Schedule
Beth Roberts, Partner, Hogan & Hartson LLP
2:00 to 2:30 EDT
Potential Policy Implications
Tom Ault, Principal, Health Policy Alternatives, (former Deputy Director, CMS)
2:30 to 3:00 EDT
Q&A
Conference Call Participants
Read more about the proposed HOPPS rule at http://www.accc-cancer.org/mediaroom/media_newsfeed.asp
Read more about the proposed Physician Fee Schedule at http://www.accc-cancer.org/mediaroom/media_newsfeed.asp
REGISTER NOW for the Association of Community Cancer Centers (ACCC) 26th National Oncology Economics Conference, Sept. 22-25, 2009, at the Hyatt Regency Minneapolis in Minneapolis, Minnesota. You need more than on-line resources, listserves, and in-office discussions to meet today's challenges. Attend and learn! Legislative updates, strategies, and innovative ideas. Join your colleagues for Roundtable Discussions, Networking, and the Opportunity to hear from the innovators as they introduce new concepts and programs that SUCCEED for patients, staff, and the bottom line!
Also, Innovent Oncology is hosting a webcast for ANCO member practices.
The webcast, entitled Realizing Pay for Performance: New Incentives in Physician-Directed Cancer Care Management, takes place on Wednesday, August 5th, at 12:30PM.
Visit http://www.P4PWebinar.com for more information and to register.
Here is information on two very important forthcoming meetings.
Medicare Alert:
ACCC Conference Call on Proposed HOPPS Rule and Physician Fee Schedule
Exclusively for ACCC Members
Call in Thursday, July 23, 2009
1:30 pm – 3:00 pm EDT
Join Oncology Policy and Legal Experts for a 90-Minute Discussion of the 2010 Proposed Hospital Outpatient Department Rule and Physician Fee Schedule.
How will the proposed 2010 Hospital Outpatient Prospective Payment System (HOPPS) Rule and Physician Fee Schedule affect your program or practice? Learn about:
The impact of hospital reimbursement of separately paid drugs without pass-through status at average sales price (ASP) +4 percent
Payment changes for imaging services
"Physician Supervision" clarification within the proposed HOPPS Rule
Quality reporting requirements
The proposal in the Physician Fee Schedule to substitute evaluation and management service codes for consultation codes
And more.
Thursday, July 23, at 1:30 pm EDT
To participate in the call, dial 888.283.6452. You will then be asked for the conference ID #: 19180097. Next, you will be prompted to give your name and location, and will then join in the conference call.
1:30 to 1:40 EDT
Introduction
Matt Farber, MA, Manager, Provider Economics and Public Policy, Association of Community Cancer Centers
1:40 to 2:00 EDT
Overview of HOPPS Proposed Rule and Physician Fee Schedule
Beth Roberts, Partner, Hogan & Hartson LLP
2:00 to 2:30 EDT
Potential Policy Implications
Tom Ault, Principal, Health Policy Alternatives, (former Deputy Director, CMS)
2:30 to 3:00 EDT
Q&A
Conference Call Participants
Read more about the proposed HOPPS rule at http://www.accc-cancer.org/mediaroom/media_newsfeed.asp
Read more about the proposed Physician Fee Schedule at http://www.accc-cancer.org/mediaroom/media_newsfeed.asp
REGISTER NOW for the Association of Community Cancer Centers (ACCC) 26th National Oncology Economics Conference, Sept. 22-25, 2009, at the Hyatt Regency Minneapolis in Minneapolis, Minnesota. You need more than on-line resources, listserves, and in-office discussions to meet today's challenges. Attend and learn! Legislative updates, strategies, and innovative ideas. Join your colleagues for Roundtable Discussions, Networking, and the Opportunity to hear from the innovators as they introduce new concepts and programs that SUCCEED for patients, staff, and the bottom line!
Also, Innovent Oncology is hosting a webcast for ANCO member practices.
The webcast, entitled Realizing Pay for Performance: New Incentives in Physician-Directed Cancer Care Management, takes place on Wednesday, August 5th, at 12:30PM.
Visit http://www.P4PWebinar.com for more information and to register.
Thursday, July 16, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
MM6514 – Coding and Reporting Principles for the Physician Quality Reporting Initiative (PQRI) and the Electronic Prescribing (E-Prescribing) Incentive Programs
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6514.pdf
****PALMETTO/J1MAC NEWS****
J1 Alert – LCD Policy L28300 Skin Lesions Update
Palmetto GBA will identify claims with dates of service on or after October
1, 2008, which have been denied incorrectly for CPT Codes 11300-11313 when
covered diagnosis 078.12 was indicated on the claim. Mass adjustment was
completed on June 30, 2009.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TCPKF4408?opendocument
J1 Open Draft LCD Meeting: California, July 21
A new Part B Draft LCD, Category III CPT Codes, has been added for the J1
Open Draft Local Coverage Determination (LCD) meeting for both Part A and
Part B in California, July 21, 2009. The general public is invited to
submit information related to the proposed LCDs for Palmetto GBA's
consideration.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TKQ3P7107?opendocument
J1 Provider Contact Center to be closed for training in August
The J1 Provider Contact Center will be closed for training Friday, August
14, 2009, and Friday, August 28, 2009, from 11 a.m. to 3 p.m. PST.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TYN476025?opendocument
Notice of New Interest Rate for Medicare Overpayments & Underpayments: 4th
Notification for FY 2009
Medicare Regulation 42 CFR §405.378 provides for the assessment of interest
at the higher of the current value of funds rate (3 percent for calendar
year 2009) or the private consumer rate as fixed by the Department of the
Treasury. The Department of the Treasury has notified the Department of
Health and Human Services that the private consumer rate has been changed
to 11.25 percent effective July 17, 2009.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7R3PUL0000?opendocument
****CMS NEWS****
MM6514 – Coding and Reporting Principles for the Physician Quality Reporting Initiative (PQRI) and the Electronic Prescribing (E-Prescribing) Incentive Programs
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6514.pdf
****PALMETTO/J1MAC NEWS****
J1 Alert – LCD Policy L28300 Skin Lesions Update
Palmetto GBA will identify claims with dates of service on or after October
1, 2008, which have been denied incorrectly for CPT Codes 11300-11313 when
covered diagnosis 078.12 was indicated on the claim. Mass adjustment was
completed on June 30, 2009.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TCPKF4408?opendocument
J1 Open Draft LCD Meeting: California, July 21
A new Part B Draft LCD, Category III CPT Codes, has been added for the J1
Open Draft Local Coverage Determination (LCD) meeting for both Part A and
Part B in California, July 21, 2009. The general public is invited to
submit information related to the proposed LCDs for Palmetto GBA's
consideration.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TKQ3P7107?opendocument
J1 Provider Contact Center to be closed for training in August
The J1 Provider Contact Center will be closed for training Friday, August
14, 2009, and Friday, August 28, 2009, from 11 a.m. to 3 p.m. PST.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TYN476025?opendocument
Notice of New Interest Rate for Medicare Overpayments & Underpayments: 4th
Notification for FY 2009
Medicare Regulation 42 CFR §405.378 provides for the assessment of interest
at the higher of the current value of funds rate (3 percent for calendar
year 2009) or the private consumer rate as fixed by the Department of the
Treasury. The Department of the Treasury has notified the Department of
Health and Human Services that the private consumer rate has been changed
to 11.25 percent effective July 17, 2009.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7R3PUL0000?opendocument
Wednesday, July 15, 2009
ACCC & Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
ACCC Conference Call: New Proposed Rules from CMS and How They Will Affect You
Thursday, July 23, 2009, at 1:30 pm to 3:00 pm EDT: Join oncology policy and legal experts for a 90-minute discussion of the 2010 proposed Hospital Outpatient Department Rule and Physician Fee Schedule. Learn how the proposed 2010 Hospital Outpatient Prospective Payment System (HOPPS) Rule and Physician Fee Schedule will affect your program or practice.
Visit http://www.accc-cancer.org/mediaroom/alerts/2009/media_alerts_HOPPS_7-20-2009.html to learn more.
Pemedtrexed Receives FDA Approval for Maintenance Therapy for Nonsquamous Non-Small Cell Lung Cancer
Eli Lilly and Company announced July 5, 2009, it received a new approval from the U.S. Food and Drug Administration (FDA) for pemetrexed for injection (Alimta®). The latest approval is for Alimta as a maintenance therapy for locally advanced or metastatic non-small cell lung cancer (NSCLC), specifically for patients with a nonsquamous histology whose disease has not progressed after four cycles of platinum-based first-line chemotherapy.
Visit http://www.accc-cancer.org/mediaroom/media_newsfeed.asp to learn more.
OIG: Medicare Data Insufficient to Determine Consistently Whether Chemotherapy Administration Payments Are Appropriate
The Office of Inspector General (OIG) released a report on Medicare Part B payment for chemotherapy administration and examined whether chemotherapy administration codes were billed correctly. Among the findings: About $60 million of physician claims for chemotherapy administration were paid when no drug or no chemotherapy drug was billed on the same day. The OIG also found that contractors have not adopted consistent policies identifying whether a drug should be billed with a chemotherapy code or non-chemo drug administration code.
Visit http://www.oig.hhs.gov/oei/reports/oei-09-08-00190.pdf to learn more.
****PALMETTO/J1MAC NEWS****
Draft Revision of Category III CPT Codes LCD J1B-08-0020-L
The Draft Category III CPT Codes Local Coverage Determination is open for
comments beginning July 16, 2009.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TXNU86355?opendocument
J1 Provider Outreach and Education Events Calendar
More educational events are added to our Learning and Education July events
calendar! Click on the events hightlighted in blue for more details.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
****ACCC NEWS****
ACCC Conference Call: New Proposed Rules from CMS and How They Will Affect You
Thursday, July 23, 2009, at 1:30 pm to 3:00 pm EDT: Join oncology policy and legal experts for a 90-minute discussion of the 2010 proposed Hospital Outpatient Department Rule and Physician Fee Schedule. Learn how the proposed 2010 Hospital Outpatient Prospective Payment System (HOPPS) Rule and Physician Fee Schedule will affect your program or practice.
Visit http://www.accc-cancer.org/mediaroom/alerts/2009/media_alerts_HOPPS_7-20-2009.html to learn more.
Pemedtrexed Receives FDA Approval for Maintenance Therapy for Nonsquamous Non-Small Cell Lung Cancer
Eli Lilly and Company announced July 5, 2009, it received a new approval from the U.S. Food and Drug Administration (FDA) for pemetrexed for injection (Alimta®). The latest approval is for Alimta as a maintenance therapy for locally advanced or metastatic non-small cell lung cancer (NSCLC), specifically for patients with a nonsquamous histology whose disease has not progressed after four cycles of platinum-based first-line chemotherapy.
Visit http://www.accc-cancer.org/mediaroom/media_newsfeed.asp to learn more.
OIG: Medicare Data Insufficient to Determine Consistently Whether Chemotherapy Administration Payments Are Appropriate
The Office of Inspector General (OIG) released a report on Medicare Part B payment for chemotherapy administration and examined whether chemotherapy administration codes were billed correctly. Among the findings: About $60 million of physician claims for chemotherapy administration were paid when no drug or no chemotherapy drug was billed on the same day. The OIG also found that contractors have not adopted consistent policies identifying whether a drug should be billed with a chemotherapy code or non-chemo drug administration code.
Visit http://www.oig.hhs.gov/oei/reports/oei-09-08-00190.pdf to learn more.
****PALMETTO/J1MAC NEWS****
Draft Revision of Category III CPT Codes LCD J1B-08-0020-L
The Draft Category III CPT Codes Local Coverage Determination is open for
comments beginning July 16, 2009.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TXNU86355?opendocument
J1 Provider Outreach and Education Events Calendar
More educational events are added to our Learning and Education July events
calendar! Click on the events hightlighted in blue for more details.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument
Tuesday, July 14, 2009
CMA & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMA NEWS****
The California Medical Association (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. Among the featured items of interest to oncologists are:
Don't Forget: Red Flag Rules Take Effect August 1
The Federal Trade Commission (FTC) has implemented a new regulation known as the Red Flag Rule, which requires “creditors” – including many physicians – to develop and implement identity theft detection and prevention programs by August 1, 2009. CMA has published a toolkit to help physicians and their staff understand the scope and requirements of the Red Flag Rule.
The toolkit provides guidance on designing and implementing an identity theft detection and prevention program for the physician practice. It also explains how the Red Flag Rule interacts or overlaps with other legal requirements governing the safeguarding of patient information, particularly the federal Health Information Portability and Accountability Act (HIPAA).
CMA’s Red Flag Rules Toolkit is free to members at the members-only website.
Members can also view CMA's Red Flag Rules webinar on-demand in the webinar archives at the members-only website.
Contact: Samantha Pellon, 916/551-2872 or spellon@cmanet.org.
****PALMETTO/J1MAC NEWS****
Opt Out of Medicare Provider Enrollment: Instructions
Are you thinking about opting out of Medicare? View this J1 Part B article
to know how providers opt out and who is eligible.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TTJV55850?opendocument
Updated: ACT Call on Provider Enrollment - June 23, 2009
The meeting minutes for the Part B Provider Enrollment ACT call on Tuesday,
June 23 is now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7SXR7T7302?opendocument
****CMA NEWS****
The California Medical Association (CMA) Alert was published and is available online at http://www.calphys.org/html/news.asp. Among the featured items of interest to oncologists are:
Don't Forget: Red Flag Rules Take Effect August 1
The Federal Trade Commission (FTC) has implemented a new regulation known as the Red Flag Rule, which requires “creditors” – including many physicians – to develop and implement identity theft detection and prevention programs by August 1, 2009. CMA has published a toolkit to help physicians and their staff understand the scope and requirements of the Red Flag Rule.
The toolkit provides guidance on designing and implementing an identity theft detection and prevention program for the physician practice. It also explains how the Red Flag Rule interacts or overlaps with other legal requirements governing the safeguarding of patient information, particularly the federal Health Information Portability and Accountability Act (HIPAA).
CMA’s Red Flag Rules Toolkit is free to members at the members-only website.
Members can also view CMA's Red Flag Rules webinar on-demand in the webinar archives at the members-only website.
Contact: Samantha Pellon, 916/551-2872 or spellon@cmanet.org.
****PALMETTO/J1MAC NEWS****
Opt Out of Medicare Provider Enrollment: Instructions
Are you thinking about opting out of Medicare? View this J1 Part B article
to know how providers opt out and who is eligible.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TTJV55850?opendocument
Updated: ACT Call on Provider Enrollment - June 23, 2009
The meeting minutes for the Part B Provider Enrollment ACT call on Tuesday,
June 23 is now available on our Web site.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7SXR7T7302?opendocument
Sunday, July 12, 2009
ACCC, ASCO, ASH, CMS, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Centers (ACCC) is conducting a brief survey to assess Medicare denials for erythropoiesis-stimulating agents (ESAs) and iron supplementation on the same monthly bill.
ACCC will use the data in an upcoming article in Oncology Issues. This is a blinded survey, and we do not track individuals.
Visit http://www.surveymonkey.com/s.aspx?sm=nlN3XFVF_2fTIF7JvfjFuUNg_3d_3d to take the 11-question survey.
****ASCO NEWS****
Over the past 10 days, ASCO has been hearing from oncology practices across the country about how the proposed 6 percent cut to Medicare payments for medical oncology services will have a devastating impact on their ability to provide care to their patients. We share your concerns about the adverse impact these cuts will have on the delivery of cancer care in this country.
ASCO is calling on Congress and CMS to fix this untenable situation. We fully recognize that our community and members cannot sustain further payment reductions at a time when the number of people with cancer is increasing, practice expenses continue to rise, and the oncology workforce is dwindling.
As you consider the effects that these payments cuts will have on your practice and your patients, please share your specific feedback with us. It will be very helpful to provide specific examples and real-life stories to Congress and CMS about the impact that the fee schedule cuts will have on practices and patients. Please send any comments you would like to share to publicpolicy@asco.org.
In addition, ASCO is conducting an in-depth analysis of all of the components of the fee schedule to be sure all of its ramifications are considered. Over the coming days and weeks, we will be reaching out to you with specific guidance on communicating with your Representative and Senators to let them know how your patients and your practice will be directly affected if proposed payment cuts are enacted.
We are committed to working with Congress and the Administration to ensure that national policy supports the ability of oncology practices to provide quality, innovative, and evidence-based cancer care to the millions of Americans who need it.
Contact ASCO's Cancer Policy & Clinical Affairs Department at 571-483-1670 or publicpolicy@asco.org with any immediate questions that you have.
****ASH NEWS****
The ASH Practice Update for July was published and is available online at http://www.hematology.org/policy/practice/07092009.cfm#1. This edition features:
Medicare Releases Proposed Payment and Policy Changes for Physicians for CY 2010
OIG Releases Report on Chemotherapy Administration
ASH Weighs In on "Meaningful Use" of Electronic Health Records
ASH Commends House, Senate on Comparative Effectiveness
ICD-10 Clinical Modification/Procedure Coding System Educational Product Available From the Medicare Learning Network
****CMS NEWS****
The publication titled ICD-10-CM/PCS Myths & Facts (June 2009), which presents correct information in response to some myths regarding the ICD-10-Clinical Modification/Procedure Coding System, is now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10Mappingfctsht.pdf .
· The Second in Series: General Equivalence Mappings – ICD-9-CM to and from ICD-10-CM and ICD-10-PCS Fact Sheet (May 2009), which provides basic information about the General Equivalence Mappings (GEM) including possible users of the GEMs, why the GEMs are needed, and how the GEMs files are formatted as well as Reimbursement Mappings information, is now available in print format from the Centers for Medicare & Medicaid ServicesMedicare Learning Network. To place your order, visit http://www.cms.hhs.gov/MLNGenInfo/ , scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”
MM6330 – Clarification on Use of National Drug Codes (NDCs) in 837 I Billing
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6330.pdf
The Clinical Laboratory Improvement Amendment established quality standards for laboratories to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test is performed. The CLIA brochure contains information and links to a variety of CLIA resources including: CLIA regulations, CLIA enrollment, CLIA certificates, CLIA fee schedules, CLIA-approved accrediting organizations and CLIA State and Regional offices. To view the brochure, go to http://www.cms.hhs.gov/MLNProducts/downloads/CLIABrochure.pdf .
****PALMETTO/J1MAC NEWS****
J1 Part B LCD Update
Two J1 Part B LCDs have been revised.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7TRQL75331?opendocument
PC-ACE Pro32 version 2.12 update file
The PC-ACE Pro32 software has been updated with several CMS Medicare
mandates and enhancements. All PC-ACE Pro32 users must download and install
the attached software update file immediately.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7KVL2S3512?opendocument
Updated: ACT Call: Palmetto GBA J1 Web site - June 16, 2009
The meeting minutes for the Part B weekly ACT call: J1 A/B MAC Web site on
Tuesday, June 16 is now available on our Web site.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7S3T650154?opendocument
****ACCC NEWS****
The Association of Community Cancer Centers (ACCC) is conducting a brief survey to assess Medicare denials for erythropoiesis-stimulating agents (ESAs) and iron supplementation on the same monthly bill.
ACCC will use the data in an upcoming article in Oncology Issues. This is a blinded survey, and we do not track individuals.
Visit http://www.surveymonkey.com/s.aspx?sm=nlN3XFVF_2fTIF7JvfjFuUNg_3d_3d to take the 11-question survey.
****ASCO NEWS****
Over the past 10 days, ASCO has been hearing from oncology practices across the country about how the proposed 6 percent cut to Medicare payments for medical oncology services will have a devastating impact on their ability to provide care to their patients. We share your concerns about the adverse impact these cuts will have on the delivery of cancer care in this country.
ASCO is calling on Congress and CMS to fix this untenable situation. We fully recognize that our community and members cannot sustain further payment reductions at a time when the number of people with cancer is increasing, practice expenses continue to rise, and the oncology workforce is dwindling.
As you consider the effects that these payments cuts will have on your practice and your patients, please share your specific feedback with us. It will be very helpful to provide specific examples and real-life stories to Congress and CMS about the impact that the fee schedule cuts will have on practices and patients. Please send any comments you would like to share to publicpolicy@asco.org.
In addition, ASCO is conducting an in-depth analysis of all of the components of the fee schedule to be sure all of its ramifications are considered. Over the coming days and weeks, we will be reaching out to you with specific guidance on communicating with your Representative and Senators to let them know how your patients and your practice will be directly affected if proposed payment cuts are enacted.
We are committed to working with Congress and the Administration to ensure that national policy supports the ability of oncology practices to provide quality, innovative, and evidence-based cancer care to the millions of Americans who need it.
Contact ASCO's Cancer Policy & Clinical Affairs Department at 571-483-1670 or publicpolicy@asco.org with any immediate questions that you have.
****ASH NEWS****
The ASH Practice Update for July was published and is available online at http://www.hematology.org/policy/practice/07092009.cfm#1. This edition features:
Medicare Releases Proposed Payment and Policy Changes for Physicians for CY 2010
OIG Releases Report on Chemotherapy Administration
ASH Weighs In on "Meaningful Use" of Electronic Health Records
ASH Commends House, Senate on Comparative Effectiveness
ICD-10 Clinical Modification/Procedure Coding System Educational Product Available From the Medicare Learning Network
****CMS NEWS****
The publication titled ICD-10-CM/PCS Myths & Facts (June 2009), which presents correct information in response to some myths regarding the ICD-10-Clinical Modification/Procedure Coding System, is now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10Mappingfctsht.pdf .
· The Second in Series: General Equivalence Mappings – ICD-9-CM to and from ICD-10-CM and ICD-10-PCS Fact Sheet (May 2009), which provides basic information about the General Equivalence Mappings (GEM) including possible users of the GEMs, why the GEMs are needed, and how the GEMs files are formatted as well as Reimbursement Mappings information, is now available in print format from the Centers for Medicare & Medicaid ServicesMedicare Learning Network. To place your order, visit http://www.cms.hhs.gov/MLNGenInfo/ , scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”
MM6330 – Clarification on Use of National Drug Codes (NDCs) in 837 I Billing
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6330.pdf
The Clinical Laboratory Improvement Amendment established quality standards for laboratories to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test is performed. The CLIA brochure contains information and links to a variety of CLIA resources including: CLIA regulations, CLIA enrollment, CLIA certificates, CLIA fee schedules, CLIA-approved accrediting organizations and CLIA State and Regional offices. To view the brochure, go to http://www.cms.hhs.gov/MLNProducts/downloads/CLIABrochure.pdf .
****PALMETTO/J1MAC NEWS****
J1 Part B LCD Update
Two J1 Part B LCDs have been revised.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7TRQL75331?opendocument
PC-ACE Pro32 version 2.12 update file
The PC-ACE Pro32 software has been updated with several CMS Medicare
mandates and enhancements. All PC-ACE Pro32 users must download and install
the attached software update file immediately.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7KVL2S3512?opendocument
Updated: ACT Call: Palmetto GBA J1 Web site - June 16, 2009
The meeting minutes for the Part B weekly ACT call: J1 A/B MAC Web site on
Tuesday, June 16 is now available on our Web site.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7S3T650154?opendocument
Wednesday, July 8, 2009
ACCC, ASCO, ASH, & Palmetto/J1MAC News
The following information has been received by ANCO.
****ACCC NEWS****
Looming Crises in Cancer Care:
26th National Oncology Economics Conference
Association of Community Cancer Centers
September 22-25; Minneapolis, MN
How Will the Proposed Rules from CMS Affect Your Bottom Line & Your Service Line?
Just last week the Centers for Medicare & Medicaid Services (CMS) released its proposed 2010 Hospital Outpatient Department Rule and Physician Fee Schedule. Will reduction in payments be steep and excessive? Will changes affect the way you deliver care? What's new in "physician supervision" and quality reporting requirements?
The 26th National Oncology Economics Conference in Minneapolis, Minnesota, September 22-25, 2009, is designed to answer these questions. . . and offers a roadmap to surmount the coming challenges that 2010 holds for both cancer programs and practices.
View the meeting announcement/registration form at http://www.accc-cancer.org/meetings/pdf/meetings_noec2009_brochure.pdf
****ASCO NEWS****
The American Society of Clinical Oncology (ASCO) invites you to participate in the ASCO Study of Collaborative Practice Arrangements, funded by Susan G. Komen for the Cure®. Oncology Metrics, llc, has been commissioned by ASCO and is conducting a survey to inform the study. This study builds on the ASCO report published in the March 2007 Journal of Oncology Practice that projected a significant shortage of medical oncologists in the United States by 2020.
The study aims to address the workforce shortage by exploring collaborative practice models between oncologists and non-physician practitioners (NPPs). It will examine the impact of these models on practice efficiency and quality of care, and explore the satisfaction of physicians, NPPs and their patients with collaborative practice models. With the anticipated shortage of oncologists in coming years, identifying and sharing best practice models for greater efficiency in oncology practices is crucial for our profession, and both providers and patients will benefit.
During the first phase of this project, a brief survey will be administered to collect data about your practice and the services provided by NPPs in your office, as well as the oncologist/NPP collaboration style. If your practice does not employ NPPs, please answer the survey with that information. This survey should take your practice administrator or lead physician 20-30 minutes to complete.
All practices completing the full survey will receive an electronic summary of the survey results. In addition, in appreciation of your time, the first 25 participants completing the full survey will receive a $25 American Express gift card; the next 100 participants will receive a $10 gift card. Please be sure to include your email address as requested at the end of the survey.
Forty practices (representing a diversity of practice models) will then be invited to participate in a detailed analysis of the collaborative practice models being used today. Oncology practices that are selected to participate will receive a modest honorarium.
The individually-identified data collected from this survey will be kept strictly confidential. All reports resulting from this survey will use de-identified information to guard the confidentiality of all participants. Oncology Metrics will create analytical reports including aggregated data from this survey, but will only publish in a manner that obscures data sources, ensuring that readers will be unable to make any supported inference of data to any individual practice.
All survey responses must be submitted electronically. To complete the survey, go to
https://www.surveymonkey.com/s.aspx?sm=mUFMdcthVymqtS9m8JUc1Q_3d_3d
Individuals and practices may receive more than one invitation to participate in this survey; please submit only one survey per practice.
Through your participation, you will be making a lasting contribution to assure high quality care remains available to future oncology patients. If you have questions, please contact Elaine Towle at etowle@oncomet.com or (603) 887-8433.
****ASH NEWS****
Register Now for the 51st ASH Annual Meeting
The American Society of Hematology (ASH) welcomes you to the vibrant, charming city of New Orleans for our 51st annual meeting. Since Hurricane Katrina, major improvements and renovations have been made throughout the city, and there has never been a better time to experience this national treasure. As the largest hematology meeting in the world, this event offers many invaluable benefits, including the opportunity to:
• Grow professionally: This year’s Education Program will offer nearly 30 sessions covering the breadth of hematology, including a number of other intriguing, less traditional topics such as nanotechnology, complementary medicine, and emergency preparedness. The Scientific Program will include 17 sessions on a wide range of topics presented by each of ASH’s scientific committees. The meeting is also a valuable source of continuing medical education (CME) for physicians.
• Learn from the best: At the Meet-the-Expert Sessions, more than 40 speakers from all over the world will facilitate small-group discussions on advances in hematologic malignancies, bleeding disorders, sickle cell disease, transplantation, and many other topics, which will allow participants to present their questions directly to foremost experts in these areas and gain new insights and perspectives.
• Keep abreast of the hottest research: Abstracts selected for oral and poster presentations feature the latest research in the field and are chosen through blind scoring and a peer-review selection process as the most outstanding among the thousands submitted for the annual meeting. Simultaneous Sessions will take place Sunday through Tuesday, including a newly added Monday evening session. Late-breaking abstracts will be presented on Tuesday.
• Further your career: The annual meeting provides a variety of high-quality educational, career-development, and networking opportunities to meet the unique needs and interests of undergraduates, medical and graduate students, residents, and fellows. Trainees are invited to participate in these activities to make the most of the experience.
Review the 2009 schedule and program at http://www.hematology.org/meetings/2009/program/index.cfm
****PALMETTO/J1MAC NEWS****
J1 Provider Contact Center to be Closed for Training Friday, July 10, 2009
The J1 Provider Contact Center will be closed for training on Friday, July
10, from 11 a.m. PST to 3 p.m. PST. The call center will reopen at 3 p.m.
PST.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7TQN6H3171?opendocument
News and Fact Sheet:CMS Proposed Payment, Policy Changes For Physicians'
Services To Medicare Beneficiaries in 2010
The Centers for Medicare & Medicaid Services (CMS) announced today proposed
changes to policies and payment rates for services to be furnished during
calendar year 2010 by over one million physicians and nonphysician
practitioners who are paid under the Medicare Physician Fee Schedule
(MPFS).
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7TQL237108?opendocument
Part B LCD Updates
There have been updates to several Part B LCDs.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7TQMQM1435?opendocument
J1 Open Draft LCD Meeting: California, July 21
Palmetto GBA J1 A/B MAC will host an Open Draft Local Coverage
Determination (LCD) meeting for both Part A and Part B in California, July
21, 2009. The general public is invited to submit information related to
the proposed LCDs for Palmetto GBA's consideration.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7TKQ3P7107?opendocument
****ACCC NEWS****
Looming Crises in Cancer Care:
26th National Oncology Economics Conference
Association of Community Cancer Centers
September 22-25; Minneapolis, MN
How Will the Proposed Rules from CMS Affect Your Bottom Line & Your Service Line?
Just last week the Centers for Medicare & Medicaid Services (CMS) released its proposed 2010 Hospital Outpatient Department Rule and Physician Fee Schedule. Will reduction in payments be steep and excessive? Will changes affect the way you deliver care? What's new in "physician supervision" and quality reporting requirements?
The 26th National Oncology Economics Conference in Minneapolis, Minnesota, September 22-25, 2009, is designed to answer these questions. . . and offers a roadmap to surmount the coming challenges that 2010 holds for both cancer programs and practices.
View the meeting announcement/registration form at http://www.accc-cancer.org/meetings/pdf/meetings_noec2009_brochure.pdf
****ASCO NEWS****
The American Society of Clinical Oncology (ASCO) invites you to participate in the ASCO Study of Collaborative Practice Arrangements, funded by Susan G. Komen for the Cure®. Oncology Metrics, llc, has been commissioned by ASCO and is conducting a survey to inform the study. This study builds on the ASCO report published in the March 2007 Journal of Oncology Practice that projected a significant shortage of medical oncologists in the United States by 2020.
The study aims to address the workforce shortage by exploring collaborative practice models between oncologists and non-physician practitioners (NPPs). It will examine the impact of these models on practice efficiency and quality of care, and explore the satisfaction of physicians, NPPs and their patients with collaborative practice models. With the anticipated shortage of oncologists in coming years, identifying and sharing best practice models for greater efficiency in oncology practices is crucial for our profession, and both providers and patients will benefit.
During the first phase of this project, a brief survey will be administered to collect data about your practice and the services provided by NPPs in your office, as well as the oncologist/NPP collaboration style. If your practice does not employ NPPs, please answer the survey with that information. This survey should take your practice administrator or lead physician 20-30 minutes to complete.
All practices completing the full survey will receive an electronic summary of the survey results. In addition, in appreciation of your time, the first 25 participants completing the full survey will receive a $25 American Express gift card; the next 100 participants will receive a $10 gift card. Please be sure to include your email address as requested at the end of the survey.
Forty practices (representing a diversity of practice models) will then be invited to participate in a detailed analysis of the collaborative practice models being used today. Oncology practices that are selected to participate will receive a modest honorarium.
The individually-identified data collected from this survey will be kept strictly confidential. All reports resulting from this survey will use de-identified information to guard the confidentiality of all participants. Oncology Metrics will create analytical reports including aggregated data from this survey, but will only publish in a manner that obscures data sources, ensuring that readers will be unable to make any supported inference of data to any individual practice.
All survey responses must be submitted electronically. To complete the survey, go to
https://www.surveymonkey.com/s.aspx?sm=mUFMdcthVymqtS9m8JUc1Q_3d_3d
Individuals and practices may receive more than one invitation to participate in this survey; please submit only one survey per practice.
Through your participation, you will be making a lasting contribution to assure high quality care remains available to future oncology patients. If you have questions, please contact Elaine Towle at etowle@oncomet.com or (603) 887-8433.
****ASH NEWS****
Register Now for the 51st ASH Annual Meeting
The American Society of Hematology (ASH) welcomes you to the vibrant, charming city of New Orleans for our 51st annual meeting. Since Hurricane Katrina, major improvements and renovations have been made throughout the city, and there has never been a better time to experience this national treasure. As the largest hematology meeting in the world, this event offers many invaluable benefits, including the opportunity to:
• Grow professionally: This year’s Education Program will offer nearly 30 sessions covering the breadth of hematology, including a number of other intriguing, less traditional topics such as nanotechnology, complementary medicine, and emergency preparedness. The Scientific Program will include 17 sessions on a wide range of topics presented by each of ASH’s scientific committees. The meeting is also a valuable source of continuing medical education (CME) for physicians.
• Learn from the best: At the Meet-the-Expert Sessions, more than 40 speakers from all over the world will facilitate small-group discussions on advances in hematologic malignancies, bleeding disorders, sickle cell disease, transplantation, and many other topics, which will allow participants to present their questions directly to foremost experts in these areas and gain new insights and perspectives.
• Keep abreast of the hottest research: Abstracts selected for oral and poster presentations feature the latest research in the field and are chosen through blind scoring and a peer-review selection process as the most outstanding among the thousands submitted for the annual meeting. Simultaneous Sessions will take place Sunday through Tuesday, including a newly added Monday evening session. Late-breaking abstracts will be presented on Tuesday.
• Further your career: The annual meeting provides a variety of high-quality educational, career-development, and networking opportunities to meet the unique needs and interests of undergraduates, medical and graduate students, residents, and fellows. Trainees are invited to participate in these activities to make the most of the experience.
Review the 2009 schedule and program at http://www.hematology.org/meetings/2009/program/index.cfm
****PALMETTO/J1MAC NEWS****
J1 Provider Contact Center to be Closed for Training Friday, July 10, 2009
The J1 Provider Contact Center will be closed for training on Friday, July
10, from 11 a.m. PST to 3 p.m. PST. The call center will reopen at 3 p.m.
PST.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7TQN6H3171?opendocument
News and Fact Sheet:CMS Proposed Payment, Policy Changes For Physicians'
Services To Medicare Beneficiaries in 2010
The Centers for Medicare & Medicaid Services (CMS) announced today proposed
changes to policies and payment rates for services to be furnished during
calendar year 2010 by over one million physicians and nonphysician
practitioners who are paid under the Medicare Physician Fee Schedule
(MPFS).
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7TQL237108?opendocument
Part B LCD Updates
There have been updates to several Part B LCDs.
http://www.palmettogba.com/Palmetto/Providers.nsf/vMasterDID/7TQMQM1435?opendocument
J1 Open Draft LCD Meeting: California, July 21
Palmetto GBA J1 A/B MAC will host an Open Draft Local Coverage
Determination (LCD) meeting for both Part A and Part B in California, July
21, 2009. The general public is invited to submit information related to
the proposed LCDs for Palmetto GBA's consideration.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7TKQ3P7107?opendocument
Monday, July 6, 2009
ANCO's ASCO/ONS Highlights 2009
ANCO's ASCO/ONS Highlights 2009 will take place on Saturday, August 29th, at The Claremont Resort in Oakland.
Please download the meeting announcement and registration form at http://www.anco-online.org/ASCOHL2009.html.
The registration deadline for ANCO's ASCO/ONS Highlights 2009 is Friday, August 21st and space is limited so please send your registration as soon as possible.
Please download the meeting announcement and registration form at http://www.anco-online.org/ASCOHL2009.html.
The registration deadline for ANCO's ASCO/ONS Highlights 2009 is Friday, August 21st and space is limited so please send your registration as soon as possible.
Friday, July 3, 2009
CMS & Palmetto/J1MAC News
The following information has been received by ANCO.
****CMS NEWS****
New:
MM6525 – Claim Status Category Code and Claim Status Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6525.pdf
If you downloaded the National Correct Coding Initiative (NCCI) Edits for Physicians (version number 15.2, effective 7/1/09 – 9/30/09) yesterday or today, please download the files again. Incorrect files were posted for the NCCI Edits for Physicians. The files have been corrected, and can be found at http://www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp on the CMS website.
MM6431 – Billing Routine Costs of Clinical Trials
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6431.pdf
****PALMETTO/J1MAC NEWS***
J1 Open Draft LCD Meeting: Nevada July 16
Palmetto GBA J1 A/B MAC will host an Open Draft Local Coverage
Determination (LCD) meeting for both Part A and Part B in Nevada, July 16,
2009. The general public is invited to submit information related to the
proposed LCDs for Palmetto GBA's consideration.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7TKHPT7557?opendocument
****CMS NEWS****
New:
MM6525 – Claim Status Category Code and Claim Status Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6525.pdf
If you downloaded the National Correct Coding Initiative (NCCI) Edits for Physicians (version number 15.2, effective 7/1/09 – 9/30/09) yesterday or today, please download the files again. Incorrect files were posted for the NCCI Edits for Physicians. The files have been corrected, and can be found at http://www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp on the CMS website.
MM6431 – Billing Routine Costs of Clinical Trials
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6431.pdf
****PALMETTO/J1MAC NEWS***
J1 Open Draft LCD Meeting: Nevada July 16
Palmetto GBA J1 A/B MAC will host an Open Draft Local Coverage
Determination (LCD) meeting for both Part A and Part B in Nevada, July 16,
2009. The general public is invited to submit information related to the
proposed LCDs for Palmetto GBA's consideration.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7TKHPT7557?opendocument
Wednesday, July 1, 2009
ASCO & CMS News
The following information has been received by ANCO.
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) announced today proposed changes to policies and payment rates for services to be furnished during calendar year (CY 2010) by over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). The MPFS sets payment rates for more than 7,000 types of services in physician offices, hospitals, and other settings.
CMS is making several proposals to refine Medicare payments to physicians, which are expected to increase payment rates for primary care services. The proposals include an update to the practice expense component of physician fees. For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association.
CMS will accept comments on the proposed rule until August 31, and will respond to all comments in a final rule to be issued by November 1, 2009. Unless otherwise specified, the new payment rates and policies will apply to services furnished to Medicare beneficiaries on or after January 1, 2010.
To read the entire CMS Press Release issued today (6/30), please click here:
http://www.cms.hhs.gov/apps/media/press_releases.asp
To read the CMS Fact Sheet on the Physician Fee Proposed rule also issued today (6/30), click here:
http://www.cms.hhs.gov/apps/media/fact_sheets.asp
For more information on the proposed rule, which went on display at 11:15 a.m. (approx.) today (7/1) and be published on Monday, July 13. The 60-day comment period will close on Monday, August 31. Click here:
http://www.federalregister.gov/OFRUpload/OFRData/2009-15835_PI.pdf . More information will be posted shortly at: http://www.cms.hhs.gov/PhysicianFeeSched/PFSFRN/list.asp .
****ASCO NEWS****
CMS just released its proposed physician fee schedule for 2010, and our preliminary review is deeply concerning. An initial analysis of the fee schedule indicates that there could be reductions in overall payments to medical oncologists in the range of 6 percent, with steeper cuts in payments to radiation oncologists upwards of 10 percent.
As you know, AMA conducted a Physician Practice Information (PPI) survey in conjunction with more than 30 medical specialties in order to collect updated data on physician practice expenses per hour. AMA provided this data to CMS earlier this year as the agency developed its physician fee schedule for the coming year.
ASCO had concerns about participating in the survey but ultimately encouraged practices to participate, as the AMA survey is the only mechanism recognized by CMS for calculating the expense of services that oncology practices provide to patients.
According to the AMA, only 50 oncology practices provided data on practice expenses. This is substantially lower than the 245 responses yielded by the 2002 ASCO survey that Gallup conducted and that currently forms the basis for our practice expense payments.
We are certain that your practice expenses have not dropped since 2005, given the high level of the care and treatment that oncologists currently provide people with cancer. In fact, we believe that expenses have more likely increased substantially for many practices. ASCO is prepared to protest this proposed reduction in fee schedule payments in the strongest terms possible. We are already in direct communication with CMS and leaders in Congress to express how critical it is to provide the resources that practices require in order to ensure that all cancer patients receive the care they need.
ASCO will complete a thorough analysis of all provisions in the fee schedule affecting oncology and will provide more detailed information as soon as possible. Contact ASCO's Cancer Policy & Clinical Affairs Department at 571-483-1670 or publicpolicy@asco.org with any immediate questions that you have.
****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) announced today proposed changes to policies and payment rates for services to be furnished during calendar year (CY 2010) by over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). The MPFS sets payment rates for more than 7,000 types of services in physician offices, hospitals, and other settings.
CMS is making several proposals to refine Medicare payments to physicians, which are expected to increase payment rates for primary care services. The proposals include an update to the practice expense component of physician fees. For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association.
CMS will accept comments on the proposed rule until August 31, and will respond to all comments in a final rule to be issued by November 1, 2009. Unless otherwise specified, the new payment rates and policies will apply to services furnished to Medicare beneficiaries on or after January 1, 2010.
To read the entire CMS Press Release issued today (6/30), please click here:
http://www.cms.hhs.gov/apps/media/press_releases.asp
To read the CMS Fact Sheet on the Physician Fee Proposed rule also issued today (6/30), click here:
http://www.cms.hhs.gov/apps/media/fact_sheets.asp
For more information on the proposed rule, which went on display at 11:15 a.m. (approx.) today (7/1) and be published on Monday, July 13. The 60-day comment period will close on Monday, August 31. Click here:
http://www.federalregister.gov/OFRUpload/OFRData/2009-15835_PI.pdf . More information will be posted shortly at: http://www.cms.hhs.gov/PhysicianFeeSched/PFSFRN/list.asp .
****ASCO NEWS****
CMS just released its proposed physician fee schedule for 2010, and our preliminary review is deeply concerning. An initial analysis of the fee schedule indicates that there could be reductions in overall payments to medical oncologists in the range of 6 percent, with steeper cuts in payments to radiation oncologists upwards of 10 percent.
As you know, AMA conducted a Physician Practice Information (PPI) survey in conjunction with more than 30 medical specialties in order to collect updated data on physician practice expenses per hour. AMA provided this data to CMS earlier this year as the agency developed its physician fee schedule for the coming year.
ASCO had concerns about participating in the survey but ultimately encouraged practices to participate, as the AMA survey is the only mechanism recognized by CMS for calculating the expense of services that oncology practices provide to patients.
According to the AMA, only 50 oncology practices provided data on practice expenses. This is substantially lower than the 245 responses yielded by the 2002 ASCO survey that Gallup conducted and that currently forms the basis for our practice expense payments.
We are certain that your practice expenses have not dropped since 2005, given the high level of the care and treatment that oncologists currently provide people with cancer. In fact, we believe that expenses have more likely increased substantially for many practices. ASCO is prepared to protest this proposed reduction in fee schedule payments in the strongest terms possible. We are already in direct communication with CMS and leaders in Congress to express how critical it is to provide the resources that practices require in order to ensure that all cancer patients receive the care they need.
ASCO will complete a thorough analysis of all provisions in the fee schedule affecting oncology and will provide more detailed information as soon as possible. Contact ASCO's Cancer Policy & Clinical Affairs Department at 571-483-1670 or publicpolicy@asco.org with any immediate questions that you have.
Palmetto/J1MAC & Corporate Member News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
ACT Call: Recovery Audit Contractor (RAC) - July 14, 2009
Palmetto GBA will offer a J1 Part B ACT call on Tuesday, July 14, at 12:30
p.m. PST. The call will focus on the Recovery Audit Contractor (RAC)
appeals process and recoupment.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7T2KU95544?opendocument
Understanding the Rules and Using the Tools Webinar To Be Held July 15 and
16
Did you miss the Understanding the Rules and Using the Tools Spring
workshop series? Here’s your chance to catch up: Palmetto GBA J1 Part B
Providers and Billers, join us for a free Understanding the Rules and Using
the Tools Webinar on July 15 and 16!
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7THSGR3582?opendocument
CMS recently issued updated instructions for contractors to follow when
contacting providers on EFT who have failed to respond with a completed EFT
application as requested. To comply with these new instructions, we have
taken the listing of those that are on EFT and compared to our database of
ones that completed and returned the EFT applications as requested. Providers
who have not returned a new completed EFT application are being mailed a
letter indicating that they must respond to us by July 24th or their provider
number will be placed on DNF. If they fail to respond 90 days after the DNF
has been placed, their number will be deactivated. The letters were mailed
late last week.
****CORPORATE MEMBER NEWS****
Onmark, along with GlaxoSmithKline, invite oncologists in your practice to earn $100 by completing a brief web-based survey about Radioimmunotherapty (RIT).
Visit http://www.surveymonkey.com/s.aspx?sm=ztITVvz9_2fTn_2bD70_2fiJxCLA_3d_3d%20 to participate now.
In order to process the $100 honoraria, survey respondents must fax a completed W9 form to (650) 745-1278. A limited number of responses will be accepted, so please complete this survey at your earliest convenience.
****PALMETTO/J1MAC NEWS****
ACT Call: Recovery Audit Contractor (RAC) - July 14, 2009
Palmetto GBA will offer a J1 Part B ACT call on Tuesday, July 14, at 12:30
p.m. PST. The call will focus on the Recovery Audit Contractor (RAC)
appeals process and recoupment.
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7T2KU95544?opendocument
Understanding the Rules and Using the Tools Webinar To Be Held July 15 and
16
Did you miss the Understanding the Rules and Using the Tools Spring
workshop series? Here’s your chance to catch up: Palmetto GBA J1 Part B
Providers and Billers, join us for a free Understanding the Rules and Using
the Tools Webinar on July 15 and 16!
http://www.palmettogba.com/palmetto/Providers.nsf/vMasterDID/7THSGR3582?opendocument
CMS recently issued updated instructions for contractors to follow when
contacting providers on EFT who have failed to respond with a completed EFT
application as requested. To comply with these new instructions, we have
taken the listing of those that are on EFT and compared to our database of
ones that completed and returned the EFT applications as requested. Providers
who have not returned a new completed EFT application are being mailed a
letter indicating that they must respond to us by July 24th or their provider
number will be placed on DNF. If they fail to respond 90 days after the DNF
has been placed, their number will be deactivated. The letters were mailed
late last week.
****CORPORATE MEMBER NEWS****
Onmark, along with GlaxoSmithKline, invite oncologists in your practice to earn $100 by completing a brief web-based survey about Radioimmunotherapty (RIT).
Visit http://www.surveymonkey.com/s.aspx?sm=ztITVvz9_2fTn_2bD70_2fiJxCLA_3d_3d%20 to participate now.
In order to process the $100 honoraria, survey respondents must fax a completed W9 form to (650) 745-1278. A limited number of responses will be accepted, so please complete this survey at your earliest convenience.
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