CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
Physicians and Other Health Professionals Value-Based Purchasing Issues Paper Posted
The Centers for Medicare & Medicaid Services (CMS) has posted the Issues Paper that is part of the development of a Plan to transition to a Medicare Value-Based Purchasing Program for physician and other professional services, as required by Section 131(d) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). The Issues Paper is posted on the CMS Website Physician Center Spotlights at: http://www.cms.hhs.gov/center/physician.asp.

This Issues Paper will be the basis of a Listening Session to be held at the CMS Central Facility on December 9, 2008, from 10 AM EST to 4 PM EST. The notice for this meeting was published in the Federal Register on October 24, 2008. Physicians and other professionals, their associations, health care purchasers, consumers, and all other interested parties are invited to participate, in person or by calling in to the teleconference. The issues identified and discussed during this meeting will assist CMS in developing options for the Plan. The meeting is open to the public, but attendance is limited to space and teleconference lines available.

Interested parties are reminded that to participate, either in person or by teleconference, on‑line registration is required via the CMS website at: http://registration.intercall.com/go/cms2. Registration will close at 5 PM EST on Tuesday, December 2, 2008.

Written comments or statements on the Issues Paper are welcome and may be sent via email toPhysicianVBP@cms.hhs.gov; faxed to 410-786-8005; or sent via regular mail to: Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244-1850, Mail Stop C5-15-02, Attn: Physician VBP Comments. All persons planning to make a statement in person at the Listening Session are urged to submit statements in writing during the Listening Session and should subsequently submit the information electronically. The deadline for receipt of comments is 5 PM EST on Tuesday, December 16, 2008.

For further information regarding the December 9, 2008 Listening Session, contact Robin Phillips, at 410-786-3010 in the Provider Communications Group. Inquiries may also be sent via e‑mail to mpf@cms.hhs.gov

Listening Session Format
The Listening Session will consider the key design issues raised in the Issues Paper. The session will begin at 10 AM EST with an overview of the objectives for the session and a brief summary of the approach to developing the Plan. Beginning at approximately 10:30 AM EST, the remainder of the meeting will be devoted to presenting and receiving comments on key design and policy issues for each of the major components for the Plan: (1) measures, (2) incentive structure, (3) data strategy and infrastructure, and (4) public reporting. The agenda will provide opportunities for brief 2-minute comments on each of the key issues from on-site session attendees. As time allows, telephone participants will also have the opportunity to provide brief 2-minute comments. A lunch break will occur from approximately 12:15 to 1 PM EST. The meeting will conclude by 4 PM EST with brief comments on next steps.

The final Agenda and copies of the PowerPoint slides to be used in the Listening Session will be posted by 5 PM EST Friday, December 5, 2008, on the CMS Website Physician Center Spotlights at: http://www.cms.hhs.gov/center/physician.asp.


MM6229 – Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6229.pdf

SE0831 – Steps for IACS Defined “Organizations” to Access Their Physician Quality Reporting Initiative (PQRI) Feedback Reports
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf

SE0830 – Steps for Eligible Professionals to Access Their Physician Quality Reporting Initiative (PQRI) Feedback Reports
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf


Medicare Part B Drug Competitive Acquisition Program (CAP): Feedback about the CAP – A Special Open Door Forum (ODF) Teleconference on the 2009 CAP Postponement and How to Submit E-mail Comments
The Centers for Medicare & Medicaid Services (CMS) is soliciting public feedback about the CAP. CMS is interested in hearing about a range of issues, including, but not limited to:
§ the categories of drugs provided under the CAP
§ the distribution of areas that are served by the CAP
§ procedural changes that may increase the program's flexibility and appeal to potential vendors and physicians.

On December 3, 2008, CMS will host a Special ODF Teleconference to obtain feedback about the program. This teleconference will be a listening session and is intended for current and former participating CAP physicians, potential Approved CAP Vendors, and any other interested parties. CMS will assess the information that it receives as it considers implementing changes to the CAP.

Call Details:

Date and Time: December 3, 2008 from 2:00-3:30PM EST
Toll Free Call Number: (800) 837-1935
Conference ID: 66307647

Interested parties can also submit comments to the CAP e-mailbox at MMA303DDrugBid@cms.hhs.gov


****PALMETTO/J1MAC NEWS****
December 2008 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~December%202008%20J1%20AB%20MAC%20Medicare%20Advisory?opendocument

The December 2008 J1 A/B MAC Medicare Advisory is now available to be
viewed on the Palmetto GBA Web site.


Medicare's Practical Guide to the E-Prescribing Incentive Program is now
available online!
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~Medicares%20Practical%20Guide%20to%20the%20E-Prescribing%20Incentive%20Program%20is%20now%20available%20online!?opendocument

The guide explains the e-prescribing incentive program, how eligible
professionals can participate, and how to choose a qualified e-prescribing
system. By adopting e-prescribing through Medicare's program, eligible
professionals can save time, enhance office and pharmacy productivity, and
improve patient safety and quality of care while earning incentives from
Medicare.


Medicare Part B Drug Competitive Acquisition Program (CAP): Feedback about
the CAP - A Special Open Door Forum (ODF) Teleconference on the 2009 CAP
Postponement and How to Submit E-mail Comments
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~Medicare%20Part%20B%20Drug%20Competitive%20Acquisition%20Program%20(CAP):%20Feedback%20about%20the%20CAP%20-%20A%20Special%20Open%20Door%20Forum%20(ODF)%20Teleconference%20on%20the%202009%20CAP%20Postponement%20and%20How%20to%20Submit%20E-mail%20Comments?opendocument

On December 3, 2008, CMS will host a Special ODF Teleconference to obtain
feedback about the program. This teleconference will be a listening session
and is intended for current and former participating CAP physicians,
potential Approved CAP Vendors, and any other interested parties. CMS will
assess the information that it receives as it considers implementing
changes to the CAP.


Part B LCD Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Part%20B%20LCD%20Update?opendocument

There are four J1 Part B LCD updates.


Physicians and Other Health Professionals Value-Based Purchasing Issues
Paper Posted
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~Physicians%20and%20Other%20Health%20Professionals%20Value-Based%20Purchasing%20Issues%20Paper%20Posted%20?opendocument

The Centers for Medicare & Medicaid Services (CMS) has posted the Issues
Paper that is part of the development of a Plan to transition to a Medicare
Value-Based Purchasing Program for physician and other professional
services, as required by Section 131(d) of the Medicare Improvements for
Patients and Providers Act of 2008 (MIPPA). This Issues Paper will be the
basis of a Listening Session to be held at the CMS Central Facility on
December 9, 2008, from 10 AM EST to 4 PM EST.

ASCO & CMA 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 at http://view.exacttarget.com/?j=fe571578766d037f7112&m=ff311d707460&ls=fdec12777c65017975127971&l=fe601575776601757d14&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2d16717065017b701174. ANCO is a state/regional affiliate of ACSO. This edition features:

Congress Likely to Take Up Additional NIH Funding After Recess

Prepare for Coding Changes in the New Year

ASCO Encourages President-elect Obama to Name Next NIH Director

ASCO Issues Recommendations to Address Looming Oncology Workforce Shortage

ASCO/AMA Survey Update


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

Healthy Families Facing Minimum 6 Month Enrollment Freeze

Survey Finds Widespread Dissatisfaction Among Primary Care Physicians; Predicts Massive Shortfall by 2025

Medi-Cal Update

Family PACT Waiver Deadline Extended to November 30

Court Weighs CMA Lawsuit Against Balance Billing Regulation

Deadline to Request CPPI Quality Data is December 5

Highlights from AMA's Interim Meeting

Member Benefit of the Week: Magazine Discount Program

ACCC, ASCO, & Palmetto/J1MAC 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 today and is available online at http://www.accc-cancer.org/mediaroom/newsletters/media_ACCCNEWSLETTER_11-24-2008.html. ANCO is an Institutional Member of ACCC. This edition features:

ACCC's Hospital Summit: At Only $169. Don't Miss It!

CMS Clarifies Requirements for Physician Supervision of HOPD Services

Time is Running Out: Apply for ACCC Cancer Care Navigation Project Pilot Site

Regional Symposium Coming to Philadelphia Next Week

Q&A on ACCC's Listserv: Coding for Multiple Encounters

ACCC's CE Blackboard: Breast Cancer Concepts

Take Our Survey: Oncology Issues and ACCC's Website

NCI Advisors Approve Major Cancer Research Initiatives

NCI Technology Research Facility Gets Off the Ground

State Medical Oncology Societies Host Membership Meetings


****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) e-News was published today and is available at http://view.exacttarget.com/?j=fe5c1578766c027d7111&m=ff2d16787160&ls=fded127873670c7c73147770&l=fe5f157577630c7d7713&s=fdf2157972640d79751d7073&jb=ffcf14&ju=fe3416717064007c741178. ANCO is a state/regional affiliate of ASCO. This edition features:

Last Chance to Vote in the 2009 ASCO Election

Check Out What's New in JCO

Newest Issue of JOP Available Online

Virtual Meeting for the ASCO-NCI-EORTC Annual Meeting on Molecular Markers in Cancer Now Available for Free

EHR Field Guide Now Available on ASCO's Bookstore

New Online CME Activities Available for Members

ASCO Launches Its First Maintenance of Certification Module

Letters of Intent for 2009 ACRAs in Breast Cancer and Glioma Due Dec. 4

Application Deadline Approaching for 2009 ASCO State Affiliate Grants

Apply for the 2009 Susan G. Komen for the Cure®/ASCO Loan Repayment Program

Register and Reserve Housing for the 2009 GU Cancers Symposium

Apply for the 2009 IDEA Grant

Review ASCO State/Regional Affiliates Calendar of Events

Cancer Policy Alert: President's Cancer Panel Releases Report on Combating Cancer; CMS Issues Final Medicare Physician Payment Rule for 2009; New Report Issues Recommendations on Improving Cancer Clinical Trials

Cancer.Net Features: Answers to Holiday Questions


****PALMETTO/J1MAC NEWS****
CMS Issues Improper Payment Rates for Medicare, Medicaid, and SCHIP
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~CMS%20Issues%20Improper%20Payment%20Rates%20for%20Medicare,%20Medicaid,%20and%20SCHIP?opendocument

CMS today reported it protected roughly $400 million of taxpayer dollars as
improper payments for Medicare fee-for-service (FFS) decreased from 3.9
percent in Fiscal Year (FY) 2007 to 3.6 percent, or $10.4 billion, in FY
2008. The Medicare, Medicaid and SCHIP improper payment rates are issued
annually as part of the HHS Agency Financial Report.


Inappropriate Access to or Use of Electronic Data Interchange (EDI)
Transaction Data by Third Party Entities
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Railroad%20Medicare~EDI~General~Inappropriate%20Access%20to%20or%20Use%20of%20Electronic%20Data%20Interchange%20(EDI)%20Transaction%20Data%20by%20Third%20Party%20Entities?opendocument

This MLM article was originally published in 2004. Palmetto GBA wants to
make sure all submtiters understand the existing Medicare requirements and
prohibitions concerning use of EDI numbers and passwords.

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.

****CMS NEWS****
MM6187 – 2008 Physician Quality Reporting Initiative Claims-Based Reporting of Measures Groups
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6187.pdf

Revised:
MM6258 – Update to Medicare Deductible, Coinsurance and Premium Rates for 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6258.pdf


****PALMETTO/J1MAC NEWS****
2008 Physician Quality Reporting Initiative Claims-Based Reporting of
Measures Groups
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~Physician%20Quality%20Reporting%20Initiative~2008%20Physician%20Quality%20Reporting%20Initiative%20Claims-Based%20Reporting%20of%20Measures%20Groups?opendocument

This article announces that the 2008 PQRI Claims-Based Measures Groups
reporting alternative is available for the six-month reporting period from
July 1 through December 31, 2008.


Medicare Billing Information for Rural Providers, Suppliers, and Physicians
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~Medicare%20Billing%20Information%20for%20Rural%20Providers,%20Suppliers,%20and%20Physicians?opendocument

"Medicare Billing Information for Rural Providers, Suppliers, and
Physicians" (October 2008), which consists of charts that provide Medicare
billing information for Rural Health Clinics, Federally Qualified Health
Centers, Skilled Nursing Facilities, Home Health Agencies, Critical Access
Hospitals, and Swing Beds, is now available.


Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code
(CARC) Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Remittance%20Advice%20Remark%20Code%20(RARC)%20and%20Claim%20Adjustment%20Reason%20Code%20(CARC)%20Update?opendocument

This article is based on Change Request (CR) 6229 which updates Remittance
Advice Remark Codes (RARCs) and Claim Adjustment Reason Codes (CARCs). If
you use the Medicare Remit Easy Print software, note that Medicare will
update that software as a result of implementing CR 6229. Be sure billing
staff are aware of these updates.

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
“Medicare’s Practical Guide to the E-Prescribing Incentive Program” is now available online!

The guide explains the e-prescribing incentive program, how eligible professionals can participate, and how to choose a qualified e-prescribing system. To read or print the guide, visit: http://www.cms.hhs.gov/partnerships/downloads/11399.pdf.

By adopting e-prescribing through Medicare’s program, eligible professionals can save time, enhance office and pharmacy productivity, and improve patient safety and quality of care while earning incentives from Medicare.

For additional information about e-prescribing, you can also visit:
www.cms.hhs.gov/PQRI. Select “E-prescribing Incentive Program”;
www.cms.hhs.gov/eprescribing. (for information on Part D e-prescribing standards that will be effective April 1, 2009); and
www.ehealthinitiative.org to download “A Clinician’s Guide to Electronic Prescribing.”

Continuing Education Credits Available
On October 6–7, 2008, CMS and 34 partner organizations hosted the National E-Prescribing Conference to promote and explain the potential of e-prescribing to improve health care in the United States. Sessions included the e-prescribing incentive payment program; strategies and tools for integrating e-prescribing with current health care delivery practices; and privacy, security, and risk management implications.

The Massachusetts Medical Society and the American Pharmacists Association will provide continuing education for selected presentations from the conference through an online education portal. Available credits are a maximum of 22.5 AMA PRA Category 1 Credits™, and Continuing Education for pharmacists (up to 13.25 hours of continuing education credit (1.325 CEUs)). To view or listen to the presentations, and complete an online test on each segment, go to www.massmed.org/cme/CMS_eprescribing.

Additional information is available on the National E-Prescribing Conference site at http://www.epsilonregistration.com/er/EventHomePage/CustomPage.jsp?ActivityID=378&ItemID=1117.

The Centers for Medicare & Medicaid Services looks forward to working with you on the adoption of e-prescribing and implementation of the incentive program.


****PALMETTO/J1MAC NEWS****
J1 Interactive Voice Response (IVR) System Enhancements
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~J1%20Interactive%20Voice%20Response%20(IVR)%20System%20Enhancements?opendocument

Palmetto GBA is pleased to announce updates to our IVR system serving the
J1 Part B provider community. The IVR enhancements will be available for
Part B providers beginning Monday, November 24, 2008. An overview of the
Part B enhancements includes: Payment Floor information: Part B Providers
will be able to obtain the number of claims approved to pay and the pending
payment amount for those claims; Providers will continue to have access to
information regarding the last three checks paid; Blood Deductible
information: Part B Providers will be able to verify the total number of
pints remaining for a patient to meet the Blood Deductible; Psychiatric
information: Part B Providers will now be able to obtain the number of
Psychiatric days remaining in the benefit; Physical Therapy: Part B
Providers will have access to the amount of the Physical Therapy Cap
satisfied by a patient; and Occupational Therapy: Part B Providers will be
able to obtain the amount of the Occupational Therapy Cap satisfied by a
patient.

Cephalon/ION Program

The following information has been received by ANCO.


****CEPHALON/ION PROGRAM****
Cephalon Oncology and ION cordially invite you to a unique live event:
NEW TREATMENT ADVANCES IN CHRONIC LYMPHOCYTIC LEUKEMIA
A Webcast presented on behalf of Cephalon Oncology
Speaker: Wolfgang Knauf, M.D.,
Friday, December 12, 2008 11AM PDT
During this Web event, topics of discussion will focus on Treanda and:
• clinical understanding of Treanda's use in CLL
• clinical rational for using Treanda in CLL
• proper dosing and administration of Treanda
• Treanda's overall response in CLL
• safety profile of Treanda

Contact Julie Goldberg at (888) 536-7697 x6826 or julie.goldberg@iononline.com for further assistance.

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
MM6258 – Update to Medicare Deductible, Coinsurance and Premium Rates for 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6258.pdf

MM6191 – Compendia as Authoritative Sources for Use in the Determination of a "Medically Accepted Indication" of Drugs and Biologicals Used Off-Label in an Anti-Cancer Chemotherapeutic Regimen
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6191.pdf


****PALMETTO/J1MAC NEWS****
2008 Physician Quality Reporting Initiative National Provider Question &
Answer Session
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Current%20News~2008%20Physician%20Quality%20Reporting%20Initiative%20National%20Provider%20Question%20Answer%20Session?opendocument

The Centers for Medicare & Medicaid Services' (CMS) Provider Communications
Group will host the eighth in a series of national provider conference
calls that began in November of 2007 on the 2008 Physician Quality
Reporting Initiative (PQRI). This toll-free call will take place from 1:30
pm - 3:30 pm, EST, on Thursday, November 20, 2008. Registration will close
at 1:30 p.m. EST, November 19, 2008, or when available space has been
filled. No exceptions will be made, so please be sure to register prior to
this time.