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
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