The following information has been received by ANCO.
****CMS NEWS****
MM6407 – Medicare Claims Processing Manual Clarifications for Skilled Nursing Facility (SNF) and Therapy Billing
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6407.pdf
CMS has made available the Medicare Part B Drug and Biological Average Sales Price (ASP) Payment Amounts for April 1, 2009 to June 30, 2009 on the CMS website at http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a1_2009aspfiles.asp. The files are located in the "Downloads" section of this web page. Revised pricing files for January 2009, October 2008, July 2008 and April 2008 are also available for download. The 2008 revised pricing files are posted at http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a_2008aspfiles.asp.
****PALMETTO/J1MAC NEWS****
Access Unavailable during Significant System Updates This Weekend
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Access%20Unavailable%20during%20Significant%20System%20Updates%20This%20Weekend?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525758900668577?opendocument
This weekend significant system updates are being implemented. The system
will go down at 7 p.m. PST on Friday, April 3, 2009. While updates are
being deployed, you may be unable to access claims information through the
IVR. Claims information will, once again, be obtainable on Monday, April 6,
2009.
April 2009 J1 A/B MAC Medicare Advisory
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20A~Publications~Medicare%20Advisory~April%202009%20J1%20AB%20MAC%20Medicare%20Advisory?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385257589004DD7B4?opendocument
The April 2009 J1 A/B MAC Medicare Advisory is now available to be viewed
on the Palmetto GBA Web site. It contains the latest updates and useful
information regarding Medicare. Please share this information with your
staff.
CMS Quarterly Provider Update
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Ohio%20Part%20B%20Carrier~Articles~General~CMS%20Quarterly%20Provider%20Update?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA385256D3400525573?opendocument
The Quarterly Provider Update is a comprehensive resource published by the
Centers for Medicare & Medicaid Services (CMS) on the first business day of
each quarter. It is a listing of all non-regulatory changes to Medicare
including Program Memoranda, manual changes, and any other instructions
that could affect providers. Regulations and instructions published in the
previous quarter are also included in the Update.
****UHC NEWS****
KRAS gene requirement for cetuximab and panitumumab in colorectal cancer
Effective April 1, 2009, UnitedHealthcare will require the submission of a pathology report documenting a wild type KRAS gene for coverage of Erbitux® (cetuximab J9055) and Vectibix® (panitumumab J9303) in the treatment of metastatic colorectal cancer. As always, final coverage is subject to the member’s benefit plan document.
UnitedHealthcare has contracts with two national laboratories (Genzyme Genetics and LabCorp) that provide KRAS testing. Specimens may be sent directly to these laboratories; claims for members that are paid on a fee for service basis (non capitated) will be paid directly to the laboratories by UnitedHealthcare. Both laboratories request that a copy of the pathology report be sent with the specimen. If your local participating laboratory provides this test it will also be covered.
Requirements:
The submission of a KRAS pathology report is required for members starting therapy using cetuximab or panitumumab after the implementation date. Only one pathology report per member ID is required.
Physicians will not be required to submit pathology reports for individuals that were on cetuximab or panitumumab prior to the effective date for the plan's policy.
The policy applies to those individuals where UnitedHealthcare or one of its affiliated entities is the primary payor.
Pathology reports are NOT required if UnitedHealthcare or one of its affiliated entities is the secondary payor.
For UnitedHealthcare patients: Fax a copy of the pathology report to (915) 231-1970 using the KRAS fax coversheet. The coversheet is available at UnitedHealthcareOnline.com >Cancer - Oncology > KRAS > KRAS Fax Coversheet. You may use this process and submit your claims electronically.
For Oxford patients: Oxford will also require the KRAS pathology report for individuals starting cetuximab and panitumumab therapy 4/1/09. Providers are required to obtain prior authorization for the use of cetuximab and panitumumab for patients with colorectal cancer. Prior authorization requirements include the submission of the laboratory report demonstrating the presence of the KRAS wild type gene. Providers should follow the standard prior authorization process.
Additional information regarding the implementation of this policy for UnitedHealthcare and its entities is available at UnitedHealthcareOnline.com and on the other health plan websites.
Lee Newcomer comments: UnitedHealthcare had a similar process for the HER2 gene and trastuzumab coverage. During the two years the edit was active we noted that the billing offices frequently sent the wrong clinical records. We only need the copy of the laboratory report documenting the KRAS gene type. Please do not send pathology reports, clinic notes, discharge summaries or other unrelated materials. It may be beneficial for the clinicians to teach the billing staff what document to send for this review.
Access to the NCCN Compendium for UnitedHealthcare coverage
The National Comprehensive Cancer Network (NCCN) has announced that effective April 1, 2009 they will require a paid subscription for access to the NCCN Drugs and Biologics Compendium. As you already know, UnitedHealthcare uses this document as a reference for coverage decisions.
UHC recognizes the value of the NCCN Drugs and Biologics Compendium in physician practices and has purchased a group rate. We are pleased to offer FREE access to the NCCN compendium to our UHC participating physicians and their office staff.
To access the NCCN Drugs and Biologics Compendium under the UHC agreement, you will need to be a registered user of UnitedHealthcareonline. Once you are logged into our website, proceed to the NCCN Compendium page. From there, you can log in to www.NCCN.org for free access to the NCCN Drugs and Biologics Compendium.
If you are not a registered user of UnitedHealthcareonline, go to the New User link in the upper right corner of the home page and register.
Tuesday, March 31, 2009
Sunday, March 29, 2009
Corporate Member News
The following information has been received by ANCO.
All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available online at http://anco-online.blogspot.com/.
****CORPORATE NEWS****
Bristol-Myers Squibb Oncology is hosting State of the Art Management of Chronic Myeloid Leukemia with Neil Shah, M.D., UCSF, on April 23rd at the Hyatt Regency San Francisco. For more information and to register, visit www.dwrite.com/CMLSanFrancisco.
All ANCO Online LIstServ postings are archived at the ANCO Online ListSev blog available online at http://anco-online.blogspot.com/.
****CORPORATE NEWS****
Bristol-Myers Squibb Oncology is hosting State of the Art Management of Chronic Myeloid Leukemia with Neil Shah, M.D., UCSF, on April 23rd at the Hyatt Regency San Francisco. For more information and to register, visit www.dwrite.com/CMLSanFrancisco.
Thursday, March 26, 2009
ASCO, ASH, CMA, CMS News; Institutional Member News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe5b1579716505747210&m=ff311d707460&ls=fdf8137271640478771d727d&l=fe62157570620c7d7615&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe221672706c0c75771d71. ANCO is a state/regional affiliate of ASCO. This edition features:
ASCO President Testifies at Congressional Hearing on Funding for Cancer Research
House Small Business Committee Holds Hearing on Medicare's Impact on Providers
ASCO Member Testifies at IOM Public Hearing on Comparative Effectiveness Research
Update on Status of Prompt Pay Discount Legislation
Congressmen Introduce Bills that Allow for FDA Approval of Generic Biologics
Update on Tobacco Control Legislation
****ASH NEWS***
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/03262009.cfm#1. This edition features:
Register Now: Webinar to Ensure Hematologists Receive PQRI and E-Prescribing Bonuses for Participation
Average Sales Price Legislation Introduced in the House of Representatives
Senators Kennedy and Hutchison to Introduce Comprehensive Cancer Legislation
Health-Care Reform Debate Continues to Take Shape in Washington
Obama Administration Names Federal Coordinating Council for Comparative Effectiveness Research
ASH Signs On to Letter Urging Medicare Physician Payment Fix
ASH Signs On to Letter Expressing Concerns about RAC Program
Medicare Releases Quarterly CCI Update
New BCBS Predetermination Procedure for Red and White Cell Growth Factors
****CMA NEWS****
The California Medical Association and the American Medical Association have joined individual physicians and other state medical groups to file a class action lawsuit against health insurance company WellPoint, Inc. The lawsuit, filed today in Los Angeles federal court, alleges that WellPoint colluded with Ingenix, a unit of United Health Group, on a price-fixing scheme that relied on an obscure database to set artificially low reimbursement rates for out-of-network care.
“Health insurers are data manipulating to set rates artificially low, forcing patients to pay more than they bargained for when they go to a doctor of their choice,” said Dr. Dev GnanaDev, CMA president. “This undermines the patient choice that insurers promise when they tout their PPO products and under-compensates doctors for the care they provide.”
WellPoint – which operates as Blue Cross in California – is legally bound to pay the usual and customary amount for care provided to their enrollees by an out of network physician. Patients pay any additional amounts over and above what WellPoint decides to pay for those services. To determine these rates, WellPoint uses a database run by Ingenix, a company owned and operated by United Health Group, another health insurance company.
A recent investigation by New York Attorney General Andrew Cuomo concluded that the Ingenix data is intentionally manipulated to allow health plans to scam physicians by shortchanging reimbursements on medical bills. A WellPoint executive acknowledged “conflicts of interest in the Ingenix database,” and the company agreed to pay $10 million to help fund a new database run by an independent non-profit organization to replace Ingenix. The company also agreed to quit feeding data into Ingenix and use the new system once it is up and running. The settlement with Cuomo did not seek redress for patients and doctors.
“As health care costs continue to rise, insurers appear to be scheming to find ways to shift resources to their bottom line rather than towards the health care of their enrollees. The CMA will continue fighting to obtain relief for patients and physicians who were harmed by the systemic flaws of the conflict ridden Ingenix database,” Dr. GnanaDev said.
The CMA and AMA have filed this litigation in partnership with the Medical Association of Connecticut, Georgia, North Carolina and the individual plaintiffs Dr. Stephen D. Henry and Dr. James G. Schwendig.
****CMS NEWS****
MM6394 – Program Overview: 2009 Physician Quality Reporting Initiative (PQRI) And The 2009 Electronic Prescribing (E-Prescribing) Incentive Program
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6394.pdf
MM6310 – Incorporation of Physician Fee Schedule Regulatory Changes into Chapter 10 of the Program Integrity Manual (PIM)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6310.pdf
CMS Provider Communications Group will host the fourth in a series national provider conference calls on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 2:30 p.m. – 4:30 p.m., EDT, on Wednesday, April 22, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
The topics covered on this national provider call will include:
An update on the prostate cancer measures-2008: Measure #101; 2008-2009: Measure #102, #104, and #105;
Tips for satisfactorily participating in the 2009 PQRI; and
Planning for the 2010 PQRI reporting options.
Following this presentation, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website, in the Educational Resources section. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: April 22, 2009
Conference Title: 2009 Physician Quality Reporting Initiative - National Provider Call
Time: 2:30 p.m. EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 2:30 p.m. EDT on April 21, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to: http://www2.eventsvc.com/palmettogba/042209
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 3:30 p.m. EDT 4/22/2009 until 11:59 p.m. EDT 4/29/2009. The call in data for the replay is (800) 642-1687 and the passcode is 90578004.
If you require services for the hearing impaired please send an email to:Medicare.TTT@PalmettoGBA.com.
PQRI Frequently Asked Question of the Week
Q: As required by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), the Centers for Medicare & Medicaid Services (CMS) established the criteria for satisfactorily reporting through the alternative reporting method using measures groups for the Physician Quality Reporting Initiative (PQRI). When referring to these measures groups, how is “consecutive” defined?
A: For Physician Quality Reporting Initiative (PQRI) measures groups, consecutive means in order by date of service. Patients are considered consecutive without regard to gender.
****INSTITUTIONAL MEMBER NEWS****
The University of California, San Francisco is organizing The 3rd International Symposium on Cancer Metastasis and the Lymphovascular System: Basis for Rational Therapy on May 6-9, 2009 at the Intercontinental San Francisco Hotel.
Visit www.ucsfcme.com/blast2009/MSU09002.htm for more information and to register.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Cancer Policy Today was published and is available online at http://view.exacttarget.com/?j=fe5b1579716505747210&m=ff311d707460&ls=fdf8137271640478771d727d&l=fe62157570620c7d7615&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe221672706c0c75771d71. ANCO is a state/regional affiliate of ASCO. This edition features:
ASCO President Testifies at Congressional Hearing on Funding for Cancer Research
House Small Business Committee Holds Hearing on Medicare's Impact on Providers
ASCO Member Testifies at IOM Public Hearing on Comparative Effectiveness Research
Update on Status of Prompt Pay Discount Legislation
Congressmen Introduce Bills that Allow for FDA Approval of Generic Biologics
Update on Tobacco Control Legislation
****ASH NEWS***
The American Society of Hematology's (ASH) Practice Update was published and is available online at http://www.hematology.org/policy/practice/03262009.cfm#1. This edition features:
Register Now: Webinar to Ensure Hematologists Receive PQRI and E-Prescribing Bonuses for Participation
Average Sales Price Legislation Introduced in the House of Representatives
Senators Kennedy and Hutchison to Introduce Comprehensive Cancer Legislation
Health-Care Reform Debate Continues to Take Shape in Washington
Obama Administration Names Federal Coordinating Council for Comparative Effectiveness Research
ASH Signs On to Letter Urging Medicare Physician Payment Fix
ASH Signs On to Letter Expressing Concerns about RAC Program
Medicare Releases Quarterly CCI Update
New BCBS Predetermination Procedure for Red and White Cell Growth Factors
****CMA NEWS****
The California Medical Association and the American Medical Association have joined individual physicians and other state medical groups to file a class action lawsuit against health insurance company WellPoint, Inc. The lawsuit, filed today in Los Angeles federal court, alleges that WellPoint colluded with Ingenix, a unit of United Health Group, on a price-fixing scheme that relied on an obscure database to set artificially low reimbursement rates for out-of-network care.
“Health insurers are data manipulating to set rates artificially low, forcing patients to pay more than they bargained for when they go to a doctor of their choice,” said Dr. Dev GnanaDev, CMA president. “This undermines the patient choice that insurers promise when they tout their PPO products and under-compensates doctors for the care they provide.”
WellPoint – which operates as Blue Cross in California – is legally bound to pay the usual and customary amount for care provided to their enrollees by an out of network physician. Patients pay any additional amounts over and above what WellPoint decides to pay for those services. To determine these rates, WellPoint uses a database run by Ingenix, a company owned and operated by United Health Group, another health insurance company.
A recent investigation by New York Attorney General Andrew Cuomo concluded that the Ingenix data is intentionally manipulated to allow health plans to scam physicians by shortchanging reimbursements on medical bills. A WellPoint executive acknowledged “conflicts of interest in the Ingenix database,” and the company agreed to pay $10 million to help fund a new database run by an independent non-profit organization to replace Ingenix. The company also agreed to quit feeding data into Ingenix and use the new system once it is up and running. The settlement with Cuomo did not seek redress for patients and doctors.
“As health care costs continue to rise, insurers appear to be scheming to find ways to shift resources to their bottom line rather than towards the health care of their enrollees. The CMA will continue fighting to obtain relief for patients and physicians who were harmed by the systemic flaws of the conflict ridden Ingenix database,” Dr. GnanaDev said.
The CMA and AMA have filed this litigation in partnership with the Medical Association of Connecticut, Georgia, North Carolina and the individual plaintiffs Dr. Stephen D. Henry and Dr. James G. Schwendig.
****CMS NEWS****
MM6394 – Program Overview: 2009 Physician Quality Reporting Initiative (PQRI) And The 2009 Electronic Prescribing (E-Prescribing) Incentive Program
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6394.pdf
MM6310 – Incorporation of Physician Fee Schedule Regulatory Changes into Chapter 10 of the Program Integrity Manual (PIM)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6310.pdf
CMS Provider Communications Group will host the fourth in a series national provider conference calls on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 2:30 p.m. – 4:30 p.m., EDT, on Wednesday, April 22, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period. The 2009 PQRI consists of 153 quality measures and 7 measures groups.
The topics covered on this national provider call will include:
An update on the prostate cancer measures-2008: Measure #101; 2008-2009: Measure #102, #104, and #105;
Tips for satisfactorily participating in the 2009 PQRI; and
Planning for the 2010 PQRI reporting options.
Following this presentation, the lines will be opened to allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated web page located at http://www.cms.hhs.gov/PQRI , on the CMS website, in the Educational Resources section. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
Conference call details:
Date: April 22, 2009
Conference Title: 2009 Physician Quality Reporting Initiative - National Provider Call
Time: 2:30 p.m. EDT
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below.
Registration will close at 2:30 p.m. EDT on April 21, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to: http://www2.eventsvc.com/palmettogba/042209
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 3:30 p.m. EDT 4/22/2009 until 11:59 p.m. EDT 4/29/2009. The call in data for the replay is (800) 642-1687 and the passcode is 90578004.
If you require services for the hearing impaired please send an email to:Medicare.TTT@PalmettoGBA.com.
PQRI Frequently Asked Question of the Week
Q: As required by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), the Centers for Medicare & Medicaid Services (CMS) established the criteria for satisfactorily reporting through the alternative reporting method using measures groups for the Physician Quality Reporting Initiative (PQRI). When referring to these measures groups, how is “consecutive” defined?
A: For Physician Quality Reporting Initiative (PQRI) measures groups, consecutive means in order by date of service. Patients are considered consecutive without regard to gender.
****INSTITUTIONAL MEMBER NEWS****
The University of California, San Francisco is organizing The 3rd International Symposium on Cancer Metastasis and the Lymphovascular System: Basis for Rational Therapy on May 6-9, 2009 at the Intercontinental San Francisco Hotel.
Visit www.ucsfcme.com/blast2009/MSU09002.htm for more information and to register.
Monday, March 23, 2009
ACCC & CMA News plus Employment Opportunity
The following information has been received by ANCO.
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-23-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Consensus and Contention on Healthcare Reform at ACCC's Annual Meeting
ACCC Seeks Five Sites for its Community-based Prostate Cancer Project
Annual National Meeting Presentations Available Online
Meeting Attendees Voice Concerns About Private Payers
Arizona Nurse and Cancer Survivorship Advocate Susan Leigh Honored
ACCC Honors Community Oncologist and Researcher James E. Radford, Jr.
Sign Up for ACCC's Regional Oncology Symposia
ACCC Supports Bill to Protect Children with Chronic Medical Conditions
Q&A on ACCC's Listserv: RVUs and Staffing Calculations
ACCC's CE Blackboard: New Course on Hematologic Malignancies
Join Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****CMA NEWS****
The California Medical Association (CMA) Alert was published today and is available online at http://www.calphys.org/html/news.asp. This edition features:
CMA Advises MDs to Begin the EHR Needs Assessment Process Now
FTC Says Physicians Must Comply with “Red Flag” Identity Theft Rules
Blue Shield Will Reprocess Denied Claims for New CPT Codes
Court Bars Hospital from Enforcing Economic Credentialing Policy
Federal Health Reform Update
Friday Is Early-Bird Deadline for CMA’s 12th Annual Health Care Leadership Academy
Webinar: Legislative Update
Deadline to RSVP for CMA’s 35th Annual Legislative Leadership Day Is March 27
Save the Date: Ethnic Physician Summit
IMQ Recruiting Physicians to Serve on Correctional Health Judicial Review Committees
Benefit of the Week: Rental Car Discounts
****ACCC NEWS****
The Association of Community Cancer Center's (ACCC) This Week At ACCC was published and is available online at http://www.accc-cancer.org/mediaroom/newsletters/2009/media_ACCCNEWSLETTER_3-23-2009.html. ANCO is an Institutional Member of ACCC. This edition features:
Consensus and Contention on Healthcare Reform at ACCC's Annual Meeting
ACCC Seeks Five Sites for its Community-based Prostate Cancer Project
Annual National Meeting Presentations Available Online
Meeting Attendees Voice Concerns About Private Payers
Arizona Nurse and Cancer Survivorship Advocate Susan Leigh Honored
ACCC Honors Community Oncologist and Researcher James E. Radford, Jr.
Sign Up for ACCC's Regional Oncology Symposia
ACCC Supports Bill to Protect Children with Chronic Medical Conditions
Q&A on ACCC's Listserv: RVUs and Staffing Calculations
ACCC's CE Blackboard: New Course on Hematologic Malignancies
Join Us on Facebook and LinkedIn
State Medical Oncology Societies Host Membership Meetings
****CMA NEWS****
The California Medical Association (CMA) Alert was published today and is available online at http://www.calphys.org/html/news.asp. This edition features:
CMA Advises MDs to Begin the EHR Needs Assessment Process Now
FTC Says Physicians Must Comply with “Red Flag” Identity Theft Rules
Blue Shield Will Reprocess Denied Claims for New CPT Codes
Court Bars Hospital from Enforcing Economic Credentialing Policy
Federal Health Reform Update
Friday Is Early-Bird Deadline for CMA’s 12th Annual Health Care Leadership Academy
Webinar: Legislative Update
Deadline to RSVP for CMA’s 35th Annual Legislative Leadership Day Is March 27
Save the Date: Ethnic Physician Summit
IMQ Recruiting Physicians to Serve on Correctional Health Judicial Review Committees
Benefit of the Week: Rental Car Discounts
Sunday, March 22, 2009
Palmetto/J1MAC News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
Medicare Remit EasyPrint (MREP) Software for J1 Part B
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~Software%20Manuals~Medicare%20Remit%20EasyPrint%20(MREP)%20Software%20for%20J1%20Part%20B?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852574B800674EB2?opendocument
Palmetto GBA Announces New Dates and Times for Spring Workshop Series
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Learning%20Education~Workshops~Palmetto%20GBA%20Announces%20New%20Dates%20and%20Times%20for%20Spring%20Workshop%20Series?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525757F0071CCC3?opendocument
Palmetto GBA has added new dates and times for our 2009 Understanding the
Rules and Using the Tools workshop series.
****PALMETTO/J1MAC NEWS****
Medicare Remit EasyPrint (MREP) Software for J1 Part B
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~EDI~Software%20Manuals~Medicare%20Remit%20EasyPrint%20(MREP)%20Software%20for%20J1%20Part%20B?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA3852574B800674EB2?opendocument
Palmetto GBA Announces New Dates and Times for Spring Workshop Series
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Learning%20Education~Workshops~Palmetto%20GBA%20Announces%20New%20Dates%20and%20Times%20for%20Spring%20Workshop%20Series?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525757F0071CCC3?opendocument
Palmetto GBA has added new dates and times for our 2009 Understanding the
Rules and Using the Tools workshop series.
Thursday, March 19, 2009
Palmetto/J1MAC & Corporate Member News
The following information has been received by ANCO.
****PALMETTO/J1MAC NEWS****
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.1,
Effective April 1, 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Quarterly%20Update%20to%20Correct%20Coding%20Initiative%20(CCI)%20Edits%20Version%2015.1%20Effective%20April%201%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525757C005E80D3?opendocument
CR6388, Quarterly Update to Correct Coding Initiative (CCI) Edits, Version
15.1, Effective April 1, 2009, provides a reminder for physicians to take
note of the quarterly updates to Correct Coding Initiative (CCI) edits.
****CORPORATE MEMBER NEWS****
Novartis Oncology cordially invites you to attend a speaker program entitled Gleevec GIST Perspectives with Shreyaskumar Patel, M.D., Medical Director, Sarcoma Center, & Deputy Chair, Department of Sarcoma Medical Oncology, MD Anderson Cancer Center. The program takes place on Wednesday, April 1st, at 6:30PM at Chantilly, 3001 El Camino Real, (at Selby Lane), Redwood City, (650) 321-4080. Please RSVP by March 29th to Linda Karrer, Novartis Oncology, at (408) 482-7680.
****PALMETTO/J1MAC NEWS****
Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.1,
Effective April 1, 2009
http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~MLNs~All%20Part%20B%20MLNs~Quarterly%20Update%20to%20Correct%20Coding%20Initiative%20(CCI)%20Edits%20Version%2015.1%20Effective%20April%201%202009?opendocument
If the above link does not work in your e-mail program, please use the
temporary alternate link provided below.
http://www.palmettogba.com/palmetto/providers.nsf/docsCat/8525746A00550AA38525757C005E80D3?opendocument
CR6388, Quarterly Update to Correct Coding Initiative (CCI) Edits, Version
15.1, Effective April 1, 2009, provides a reminder for physicians to take
note of the quarterly updates to Correct Coding Initiative (CCI) edits.
****CORPORATE MEMBER NEWS****
Novartis Oncology cordially invites you to attend a speaker program entitled Gleevec GIST Perspectives with Shreyaskumar Patel, M.D., Medical Director, Sarcoma Center, & Deputy Chair, Department of Sarcoma Medical Oncology, MD Anderson Cancer Center. The program takes place on Wednesday, April 1st, at 6:30PM at Chantilly, 3001 El Camino Real, (at Selby Lane), Redwood City, (650) 321-4080. Please RSVP by March 29th to Linda Karrer, Novartis Oncology, at (408) 482-7680.
Wednesday, March 18, 2009
ASCO & CMS News
The following information has been received by ANCO.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider was published today and is available online at http://view.exacttarget.com/?j=fe6515797666007d7016&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2f1672716d027f771475. ANCO is a state/regional affiliate of ASCO. This edition features:
1. Support Legislation to Remove Prompt-Pay Discounts from ASP
2. Leucovorin Shortage Update
3. Coalition Expresses Concern over Medical Imaging Policy Proposals
4. ASCO Comments on CMS' RAC Program
5. ASCO Opposes Red Flags Rule
6. Medicare's Carrier/Contractor Advisory Committee (CAC) Process
7. Patient Satisfaction Surveys
8. CMS Announces New Web Page on the E-Prescribing Incentive Program
9. Upcoming CMS Open Door Forum Calls
10. 2009 PQRI National Provider Conference Call
11. Billing and Coding Q&A
12. From the practice manager's desk
13. What do you think...?
14. Did you know...?
****CMS NEWS****
MM6388 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.1, Effective April 1, 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6388.pdf
On January 15, the U.S. Department of Health and Human Services released two final rules that will facilitate theUnited States’ ongoing transition to an electronic health care environment through adoption of an updated set of diagnosis and procedure codes and updated standards for electronic health care and pharmacy transactions.
In accordance with the White House Chief of Staff’s memorandum of January 20, 2009 entitled “Regulatory Review,” a determination has been made that the effective date will not be extended and the comment period will not be reopened for either of these rules.
The first rule finalizes new code sets to be used for reporting diagnoses and procedures on health care transactions. This final rule replaces the ICD-9-CM code sets, developed nearly 30 years ago, with greatly expanded ICD-10 code sets. The second final rule adopts updated versions of the standards governing electronic transactions under the authority of the Health Insurance Portability and Accountability Act of 1996. The updated versions replace the current standards and will promote greater use of electronic transactions. In response to public comments suggesting that more time would be needed for effective industry implementation, the final rules include later compliance dates. More specifically, the final rules provide compliance dates of Jan. 1, 2012, for the transaction standards and Oct. 1, 2013, for the ICD-10 code set.
****ASCO NEWS****
The American Society of Clinical Oncology's (ASCO) Oncology Practice Insider was published today and is available online at http://view.exacttarget.com/?j=fe6515797666007d7016&m=ff311d707460&ls=fde71372736202747417777c&l=fe5e1575706c067d7d10&s=fe1f15797d620479731d75&jb=ffcf14&ju=fe2f1672716d027f771475. ANCO is a state/regional affiliate of ASCO. This edition features:
1. Support Legislation to Remove Prompt-Pay Discounts from ASP
2. Leucovorin Shortage Update
3. Coalition Expresses Concern over Medical Imaging Policy Proposals
4. ASCO Comments on CMS' RAC Program
5. ASCO Opposes Red Flags Rule
6. Medicare's Carrier/Contractor Advisory Committee (CAC) Process
7. Patient Satisfaction Surveys
8. CMS Announces New Web Page on the E-Prescribing Incentive Program
9. Upcoming CMS Open Door Forum Calls
10. 2009 PQRI National Provider Conference Call
11. Billing and Coding Q&A
12. From the practice manager's desk
13. What do you think...?
14. Did you know...?
****CMS NEWS****
MM6388 – Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 15.1, Effective April 1, 2009
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6388.pdf
On January 15, the U.S. Department of Health and Human Services released two final rules that will facilitate theUnited States’ ongoing transition to an electronic health care environment through adoption of an updated set of diagnosis and procedure codes and updated standards for electronic health care and pharmacy transactions.
In accordance with the White House Chief of Staff’s memorandum of January 20, 2009 entitled “Regulatory Review,” a determination has been made that the effective date will not be extended and the comment period will not be reopened for either of these rules.
The first rule finalizes new code sets to be used for reporting diagnoses and procedures on health care transactions. This final rule replaces the ICD-9-CM code sets, developed nearly 30 years ago, with greatly expanded ICD-10 code sets. The second final rule adopts updated versions of the standards governing electronic transactions under the authority of the Health Insurance Portability and Accountability Act of 1996. The updated versions replace the current standards and will promote greater use of electronic transactions. In response to public comments suggesting that more time would be needed for effective industry implementation, the final rules include later compliance dates. More specifically, the final rules provide compliance dates of Jan. 1, 2012, for the transaction standards and Oct. 1, 2013, for the ICD-10 code set.
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