Thursday, January 29, 2009

Palmetto/J1MAC News

The following information has been received by ANCO.


****PALMETTO/J1MAC NEWS***
Revised Location - 2009 Spring Workshop Series Begins February 18-20, 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~Revised%20Location%20-%202009%20Spring%20Workshop%20Series%20Begins%20February%2018-20,%202009?opendocument

Palmetto GBA is pleased to announce the 2009 Understanding the Rules and
Using the Tools workshop series. This series, which begins February 18-20,
is designed for practice managers, billers, administrative staff and other
users to equip them with the tools they need to be successful with Medicare
billing and documentation guidelines.

Wednesday, January 28, 2009

ASCO, NCCN, & Palmetto/J1MAC News

The following information has been received by ANCO.

All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available at http://anco-online.blogspot.com/.


****ASCO NEWS***
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe5215787d6c01797012&m=ff311d707460&ls=fdec12777c65017975127971&l=fe601575776601757d14&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe3716727565047f731176. ANCO is a state/regional affiliate of ASCO. This edition features:

Update on Economic Stimulus Package

ASCO Urges Lawmakers to Exclude Prompt Pay Discount from ASP

ASCO Runs Ad in The Hill To Welcome the 111th Congress and the Obama Administration

Chemotherapy Administration Safety Standards Are Available for Public Comment

Oncology Added to Draft CCHIT Roadmap

FDA Issues Final Guidance on Adverse Events Reporting

HHS Issues Final ICD-10 Code Sets

Niederhuber Will Continue as NCI Director

Update on Leucovorin Shortage

FDA Cautions About Risk of Skin Numbing Products

Join ASCO's Advocacy Network

ASCO Extends Resources to Practice Administrators


****NCCN NEWS****
Coming in the next issue of JNCCN — The Journal of the National Comprehensive Cancer Network: February 2009 (Volume 7, Number 2)

NCCN Clinical Practice Guidelines in Oncology™:
Breast Cancer

Special Feature:
Predictors and Temporal Trends of Adjuvant Aromatase Inhibitor Use in Breast Cancer

Featured Articles:
Indications for Breast MRI in the Patient with Newly Diagnosed Breast Cancer

Pharmacogenetics of Tamoxifen: Who Should Undergo CYP2D6 Genetic Testing?

Accelerated Partial Breast Irradiation: Where Do We Stand?

Geriatric Assessment in Older Patients with Breast Cancer

Visit http://www.nccn.org/JNCCN/toc/2009feb.asp for more information.


****PALMETTO/J1MAC NEWS***
2009 J1 Part B Clinical Lab Fee Schedules
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Publications~Fee%20Schedules~2009%20J1%20Part%20B%20Clinical%20Lab%20Fee%20Schedules?opendocument

These are the 2009 J1 Part B Clinical Lab Fee Schedules for California,
Nevada and Hawaii.


2009 Spring Workshop Series Begins February 18-20, 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Articles~General~2009%20Spring%20Workshop%20Series%20Begins%20February%2018-20,%202009?opendocument

Palmetto GBA is pleased to announce the 2009 Understanding the Rules and
Using the Tools workshop series. This series, which begins February 18-20,
is designed for practice managers, billers, administrative staff and other
users to equip them with the tools they need to be successful with Medicare
billing and documentation guidelines.


Batch Detail Control Listing (BCL) Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~General~Batch%20Detail%20Control%20Listing%20(BCL)%20Update%20?opendocument

Palmetto GBA has been forwarding the MCS Batch Control Listing (BCL) report
to J1 Part B Submitters. GPNet, our EDI front-end, generates a similar
response report that includes the acceptance or rejection status of claim
files. Since the information on the BCL report is duplicated in the GPNet
Response Report, Palmetto GBA will no longer forward BCL reports after
February 6, 2009.

Tuesday, January 27, 2009

CMS & Palmetto/J1MAC News

The following information has been received by ANCO.

****CMS NEWS****
Now there’s a better way for physicians and non-physician practitioners to enroll or make a change in their Medicare enrollment information. The Internet-based Provider Enrollment, Chain and Ownership System (PECOS) will allow physicians and non-physician practitioners to enroll, make a change in their Medicare enrollment, view their Medicare enrollment information on file with Medicare, or check on the status of a Medicare enrollment application via the Internet.

The Centers for Medicare & Medicaid Services (CMS) will make Internet-based PECOS to all organizational providers and suppliers (except durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers) later this year.

Fast

By submitting the initial Medicare enrollment application through Internet-based PECOS, a physician or non-physician practitioner’s enrollment application can be processed as much as 50 percent faster than by paper. This means that it will take less time to enroll or make a change in an existing enrollment record. For additional information about the types of changes that must be reported, go to the download section of www.cms.hhs.gov/MedicareProviderSupEnroll.

Secure

Internet-based PECOS meets all required Government security standards in terms of data entry, data transmission, and the electronic storage of Medicare enrollment information. Only authorized individuals can enter enrollment information into PECOS or view PECOS data from the Internet. Authorized individuals include physicians and non-physician practitioners. Their User IDs and passwords protect the access to their enrollment information. After physicians or non-physician practitioners create User IDs and passwords or change their passwords, they should keep this information secure and not share it with anyone. By safeguarding their User IDs and passwords, they are taking an important step in protecting their enrollment information. CMS does not disclose Medicare enrollment information to anyone except when we are authorized or required to do so by law.

Easy

Internet-based PECOS is a scenario-driven application process with front-end editing capabilities and built-in help screens. The scenario-driven application process will ensure that physicians and non-physician practitioners complete and submit only the information necessary to enroll or make a change in their Medicare enrollment record.

There are three basic steps to completing an enrollment action using Internet-based PECOS. Physicians and non-physician practitioners must:

1. Have an NPPES User ID and password to use Internet-based PECOS.

For security reasons, physicians and non-physician practitioners should change passwords periodically, at least once a year. For information on how to change a password, go to the NPPES Application Help page available at https://nppes.cms.hhs.gov/NPPES/Welcome.do and select the “Reset Password Page” under the NPPES Application help page.

2. Go to Internet-based PECOS at https://pecos.cms.hhs.gov and complete, review, and submit the electronic enrollment application via Internet-based PECOS.

3. Print, sign and date the Certification Statement (blue ink recommended) and mail the Certification Statement and all supporting paper documentation to the Medicare contractor.

Note: A Medicare contractor will not process an Internet enrollment application without the signed and dated Certification Statement and the required supporting documentation. In addition, the effective date of filing an enrollment application is the date the Medicare contractor receives the signed Certification Statement that is associated with the Internet submission.

Additional Information

For information about Internet-based PECOS, including important information that physicians and non-physician practitioners should know before submitting a Medicare enrollment application via Internet-based PECOS, go to www.cms.hhs.gov/MedicareProviderSupEnroll.


****PALMETTO/J1MAC NEWS****
Holding of Claims Containing a Current Procedural Terminology (CPT) Code
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~Holding%20of%20Claims%20Containing%20a%20Current%20Procedural%20Terminology%20(CPT)%20Code?opendocument

Change Request 6254, which is the annual therapy code update, omitted the
bundled status indicator for a CPT Code. As a result, claims that contain
this code will be suspended because there is no separate fee amount
assigned to this code.


J1 Electronic Claims and Fax Attachment Information
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Publications~Physician-Supplier%20Guide~Claims%20Filing:%20Medicare~J1%20Electronic%20Claims%20and%20Fax%20Attachment%20Information?opendocument

Monday, January 26, 2009

ACCC, CMA, & NCCN News

The following information has been received by ANCO.

All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available at http://anco-online.blogspot.com/.

****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/2009/media_ACCCNEWSLETTER_1-26-2009.html. ANCO is an Institutional Member of ACCC. This edition features:

Evaluate Your Capital and Strategic Planning at ACCC's Annual National Meeting

CMS Proposes Improvements to Cervical Cancer Proficiency Testing Program

Hot Off the Press: Highlights of the Newest Oncology Issues

New Report Offers Look at Trends in Oncology for 2009

Welcome Aboard to ACCC's Newest Members

Q&A on ACCC's Listserv: The Value of Oncology Social Workers

ACCC's CE Blackboard: Lung Cancer, Year in Review

Take Our Survey: Oncology Issues and ACCC's Website

State Medical Oncology Societies Host Membership Meetings


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

United Healthcare Eliminates “Progressive Fee Schedule”

Medi-Cal Claims with Patient SSNs Will Be Denied Beginning 2/1

HHS Extends ICD-10 Deadline to 2013; CMA, AMA Continue to Advocate for an Eight Year Transition Plan

Palmetto Agrees to Eliminate Monitored Anesthesia Policy

Despite Escalating Budget Crisis State Will Not Delay Medi-Cal Payments

House Passes Children’s Health Insurance Bill; Senate Expected to Follow

CMA Launches Webinar Series

Federal Economic Stimulus Plan Contains $150 Billion for Health Care

Call for Data: Out-of-Network Underpayment and Rescission of Treatment Authorization

Benefit of the Week: Employment Practices Liability Insurance


****NCCN NEWS****
Adjuvant Therapy in Breast Cancer: From Testing to Treatment
Join members of the National Comprehensive Cancer Network (NCCN) Breast Cancer Guidelines Panel to discuss the use of adjuvant therapy in the management of breast cancer. The program will focus on issues such as indications for systemic adjuvant therapy, predictive and prognostic factors in adjuvant treatment, endocrine therapy for women, targeted therapy for HER2-positive tumors, and the appropriate use of cytotoxic chemotherapy.

Adjuvant Therapy in Breast Cancer: From Testing to Treatment
(http://discoveryhealthcme.discovery.com/breast-cancer/breast-cancer.html)

Discovery Health offers the most flexible way to earn free CME credit. Watch online anytime via high-speed internet connection, download the podcast, or order the DVD. Complete the post-test and evaluation on-line and print your certificate right from your computer.

Faculty
Robert W. Carlson, MD
Stanford Comprehensive Cancer Center

Lori J. Goldstein, MD
Fox Chase Cancer Center

Clifford A. Hudis, MD
Memorial Sloan-Kettering Cancer Center

Program Overview
In response to the burgeoning data regarding patient risk assessment and the selection of adjuvant hormonal, biologic, and cytotoxic therapies, the NCCN, in conjunction with Discovery Health, has brought together members of the NCCN Breast Cancer Guidelines Panel to discuss the use of adjuvant therapy in the management of breast cancer. The program will focus on issues such as indications for systemic adjuvant therapy, predictive and prognostic factors in adjuvant treatment, endocrine therapy for women, targeted therapy for HER2-positive tumors, and the appropriate use of cytotoxic chemotherapy.

Educational Objectives
Following this activity, participants should be able to:

Describe various testing options for hormonal and HER2 status
Explain the limitations and strengths of existing risk assessment tools
Identify the role of tamoxifen therapy in hormone receptor-positive younger women
Describe the role of aromatase inhibitors and the data supporting their use in hormone receptor-positive postmenopausal women
Discuss the use of cytotoxic chemotherapy based on risk assessment
Summarize the role of trastuzumab in treatment of HER2-positive tumors in the adjuvant setting

Intended Audience

This educational activity is designed to meet the needs of physicians, nurses, and other clinical professionals who manage patients with cancer.


NCCN 14th Annual Conference - Register Now
Register now (at http://www.nccn.org/professionals/meetings/14thannual/default.asp) for a continuing education event hosted by the National Comprehensive Cancer Network – NCCN 14th Annual Conference: Clinical Practice Guidelines & Quality Cancer Care™. This NCCN Conference will include a special roundtable discussion that will offer a multiple-perspective examination of issues addressing the definition of value across the myriad of diseases in cancer; how quality of care and value should be measured and quantified; and the distribution methods and availability of reimbursement for reporting, performing, and enhancing value in the delivery of cancer care.

Date: March 11 – 15, 2009
Place: The Westin Diplomat
3555 South Ocean Drive
Hollywood, Florida
Fee: Nurses $395
Physicians, Pharmacists, and Other Health Care Professionals (not including Industry) $495
Industry $1,495

If you register and then cannot attend, a substitute attendee may be sent in your place. A $50 administration fee will be charged for each substitution. The registration fee is not refundable.

NCCN 14th Annual Conference:
Clinical Practice Guidelines & Quality Cancer Care™
(http://www.nccn.org/professionals/meetings/14thannual/default.asp)

Roundtable Discussion:
Finding and Achieving Value in Cancer Care
Friday, March 13, 2009

Moderator:
Clifford Goodman, PhD
The Lewin Group

Panel:
Joseph S. Bailes, MD
American Society of Clinical Oncology

Stephen B. Edge, MD
Roswell Park Cancer Institute

Mark Fendrick, MD
University of Michigan Comprehensive Cancer Center

Scott Gotlieb, MD
American Enterprise Institute

Robert Mass, MD
Genentech, Inc.

Lee N. Newcomer, MD, MHA
United Healthcare

Lynn Zonakis
Delta Airlines

Panel members subject to change

Click here to register for the NCCN 14th Annual Conference: Clinical Practice Guidelines & Quality Cancer Care™ March 11 – 15, 2009 or to view additional agenda topics.

Sunday, January 25, 2009

Clinical Trial Opportunity

We are pleased to let you know that the Stanford Dermatology Department and Comprehensive Cancer Center are taking part in an industry-sponsored national study evaluating the efficacy and safety of an oral, small molecule antagonist of the Hedgehog pathway (Hh) in patients with locally advanced and unresectable basal cell carcinoma.

Approximately 50 subjects will be enrolled at sites in the United States.

We would like to request your assistance in identifying patients who may be eligible for participation in the study. The inclusion/ exclusion criteria are listed at the end of this letter.
If you have any patients meeting the criteria and who may be interested in participating in the research study, please contact Tony Oro, MD at (650) 723-7843, oro@cmgm.stanford.edu or Anne Chang, MD, the Co-Principal Investigator at (650) 721-2699, alschang@stanford.edu.

We appreciate your assistance and look forward to collaborating with you to offer this research study to your patients.

Anthony Oro, MD, PhD Anne Chang, MD
Associate Professor of Dermatology Instructor, Director of Dermatological
Department of Dermatology Clinical Trials, Dept. of Dermatology
Stanford School of Medicine Stanford School of Medicine


Primary Outcome Measures:
The primary objective of this study is to estimate the clinical benefit of an oral, small molecule antagonist of the Hedgehog pathway (Hh) given as therapy for patients with locally advanced or metastatic BCC, as measured by overall response rate (ORR).

Selected Inclusion Criteria:
• Men and women age ≥ 18 years
• For patients with locally advanced BCC, histologically confirmed disease that is considered to be inoperable or medical contraindication to surgery (see below), in the opinion of a Mohs dermatologic surgeon, head and neck surgeon, or plastic surgeon
• For patients with locally advanced BCC, radiotherapy must have been previously administered for their locally advanced BCC, unless radiotherapy is contraindicated or inappropriate (e.g., hypersensitivity to radiation due to genetic syndrome such as Gorlin syndrome, limitations because of location of tumor, or cumulative prior radiotherapy dose). For patients whose locally advanced BCC has been irradiated, disease must have progressed after radiation.
• Patients with nevoid BCC syndrome (Gorlin syndrome) may enroll in this study but must meet the criteria for locally advanced or metastatic disease listed above.

Selected Exclusion Criteria:
• Pregnancy or lactation
• Life expectancy of < 12 weeks
• Concurrent non–protocol-specified anti-tumor therapy (e.g., chemotherapy, other targeted therapy, radiation therapy, or photodynamic therapy)
• History of other malignancies within 3 years of Day 1, except for tumors with a negligible risk for metastasis or death, such as adequately treated squamous cell carcinoma of the skin, ductal carcinoma in situ of the breast, or carcinoma in situ of the cervix
• Uncontrolled medical illnesses such as infection requiring treatment with intravenous antibiotics

Palmetto/J1MAC News

The following information has been received by ANCO.

****PALMETTO/J1MAC NEWS****
Claim Status Category Code and Claim Status Code Update
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~MLNs~General~Claim%20Status%20Category%20Code%20and%20Claim%20Status%20Code%20Update?opendocument

Change Request (CR) 6325, Claim Status Category Code and Claim Status Code
Update, reminds providers of the periodic updates to the Claim Status Codes
and Claim Status Category Codes that Medicare contractors use with the
Health Care Claim Status Request (ASC X12N 276), and the Health Care Claim
Response (ASC X12N 277).


Notice of New Interest Rate for Medicare Overpayments and Underpayments:
2nd Update for FY 2009
http://www.palmettogba.com/palmetto/Providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Articles~General~Notice%20of%20New%20Interest%20Rate%20for%20Medicare%20Overpayments%20and%20Underpayments:%202nd%20Update%20for%20FY%202009%20?opendocument

The Department of the Treasury has notified the Department of Health and
Human Services that the private consumer rate will remain at 11.375
percent.

Friday, January 23, 2009

ASH & Palmetto/J1MAC News

The following information has been received by ANCO.

All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available at http://anco-online.blogspot.com/.

****ASH NEWS****
The American Society of Hematology (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/. This edition features:

Congress Considers Health Provisions in Economic Recovery Legislation

ICD-10 Adoption Final Regulations - Summary Document

CMS Announces Last Five Medicare Administrative Contractors

MedPAC Votes on Final Recommendations for Congress

Senate Holds Confirmation Hearing for HHS Secretary Nominee Daschle


****PALMETTO/J1MAC NEWS****
MM6325 - Claim Status Category Code and Claim Status Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6325.pdf