Hello Everyone,
Please enjoy the information contained in this edition of Frontier Focus. Please be sure to share it with your members, colleagues, providers and office billing staff. Thank you for your continued efforts to broadcast Medicare information to the providers in Region VIII.
Table of Contents
1. Medicare Learning Network Releases Three New Fact Sheets for the DMEPOS Competitive Bidding Program
2. DMEPOS CB Program Nat'l Education Call, Tue Nov 16
3. National Education Call for Referral Agents for the DMEPOS Competitive Bidding Program
4. Twelfth National Education Call on Medicare Fee-For-Service Implementation of HIPAA Version 5010 and D.0 Transactions: Taking EDI to the Next Level [Wed Nov 17]
5. Registration for ONC Personal Health Records Roundtable Now Open [Fri Dec 3]
6. New CMS Web Page Available for the Medicare Fee-For-Service Physician Feedback / Value Modifier Program!
7. CMS to Release Ambulance Services Comparative Billing Report
8. Five-Star Quality Rating System: News for November
9. Inpatient Psychiatric Facility PPS RY2011 PC Pricers Updated
10. Inpatient PPS FY2011 PC Pricers Updated
11. Updates from the Medicare Learning Network…
“End-Stage Renal Disease Prospective Payment System”
“End-Stage Renal Disease Composite Payment Rate System” Publication Revised
“5010: Taking Electronic Billing and Electronic Data Interchange to the Next Level”
Written Transcript of ESRD PPS 2011 Conference Call
12. A new "twist" in the law makes it easier to save on your prescription drug costs.
~~~~~~~~~~~~~~~~~~~~
1. Medicare Learning Network Releases Three New Fact Sheets for the DMEPOS Competitive Bidding Program
The Medicare Learning Network® has released three new fact sheets related to the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding program:
§ “The DMEPOS Competitive Bidding Program Non-Contract Supplier Fact Sheet,” which is designed to educate suppliers on a broad variety of requirements for non-contract suppliers under the DMEPOS competitive bidding program;
§ “The DMEPOS Competitive Bidding Program Enteral Nutrition Fact Sheet,” which is designed to educate suppliers on rules for providing enteral nutrition under the DMEPOS competitive bidding program; and
§ “The DMEPOS Competitive Bidding Program Mail Order Diabetic Supplies Fact Sheet,” which is designed to educate suppliers on rules regarding providing mail order diabetic supplies under the DMEPOS competitive bidding program.
To learn more, please visit the DMEPOS Competitive Bidding Educational Resources page at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp on the Centers for Medicare & Medicaid Services website, then select the “DMEPOS Competitive Bidding Fact Sheets” link in the “Downloads” section.
Also, CMS would like to remind all non-contract suppliers that furnish competitively bid rented durable medical equipment (DME) or oxygen and oxygen equipment to beneficiaries in competitive bidding areas (CBAs) of the following upcoming deadlines:
§ A non-contract supplier that elects to become a grandfathered supplier must provide a 30-day written notification to each Medicare beneficiary who resides in a CBA and is currently renting competitively bid oxygen and oxygen equipment or DME from that supplier. These notifications must be sent by Wed Nov 17, 2010. A non-contract supplier that elects to become a grandfathered supplier must also provide written notification to the Centers for Medicare & Medicaid Services (CMS) of this decision by Wed Nov 17, 2010.
§ A non-contract supplier that elects not to become a contract supplier is required to pick-up the item it is currently renting to the beneficiary from the beneficiary’s home after proper notification. Proper notification includes a 30-day, a 10-day, and a 2-day notice of the supplier’s decision not to become a grandfathered supplier to its Medicare beneficiaries who are currently renting competitively bid DME or oxygen and oxygen equipment and who reside in a CBA. The 30-day notification to the beneficiary must be sent by Wed Nov 17, 2010, and must be in writing.
For more information on grandfathering requirements, please see the “DMEPOS Competitive Bidding Program Grandfathering Requirements for Non-Contract Suppliers Fact Sheet,” which is now available, free of charge, from the Medicare Learning Network® at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp in the “Downloads” section.
~~~~~~~~~~~~~~~~~~~~
2. DMEPOS CB Program Nat'l Education Call, Tue Nov 16
Tue Nov 16, 2-3:30pm EST
The Centers for Medicare & Medicaid Services (CMS) will host a national education call on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program for referral agents for the program. (Referral agents generally include Medicare-enrolled providers, physicians, treating practitioners, discharge planners, social workers, and pharmacists who refer beneficiaries for DMEPOS items and services in a competitive bidding area).
In advance of the call, participants are encouraged to visit the educational resources web page where they can review the latest educational tools including fact sheets. The presentation for the call will also be available at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp.
In order to receive the call-in information for this call, 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.
Registration will close at 2pm EST on Mon Nov 15, 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:
§ Visit http://www.eventsvc.com/palmettogba/111610.
§ Fill in all required data.
§ Verify that your time zone is displayed correctly in the drop down box.
§ Click “Register.”
§ You will be taken to the “Thank you for registering” page and will receive a confirmation e-mail shortly thereafter. Note: Please save this page, in the event that your server blocks the confirmation e-mails. If you do not receive the confirmation e-mail, please check your spam/junk mail filter as it may have been directed there.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business days before the event.
~~~~~~~~~~~~~~~~~~~~
3. National Education Call for Referral Agents for the DMEPOS Competitive Bidding Program
Tue Nov 16, 2-3:30pm EST
The Centers for Medicare & Medicaid Services (CMS) will host a national education call on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program for referral agents for the program. (Referral agents generally include Medicare-enrolled providers, physicians, treating practitioners, discharge planners, social workers, and pharmacists who refer beneficiaries for DMEPOS items and services in a competitive bidding area).
In advance of the call, participants are encouraged to visit the educational resources web page where they can review the latest educational tools including fact sheets. The presentation for the call will also be available at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp.
In order to receive the call-in information for this call, 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. Registration will close at 2pm EST on Mon Nov 15, 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:
§ Visit http://www.eventsvc.com/palmettogba/111610.
§ Fill in all required data.
§ Verify that your time zone is displayed correctly in the drop down box.
§ Click “Register.”
§ You will be taken to the “Thank you for registering” page and will receive a confirmation e-mail shortly thereafter. Note: Please save this page, in the event that your server blocks the confirmation e-mails. If you do not receive the confirmation e-mail, please check your spam/junk mail filter as it may have been directed there.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business days before the event.
~~~~~~~~~~~~~~~~~~~~
4. Twelfth National Education Call on Medicare Fee-For-Service Implementation of HIPAA Version 5010 and D.0 Transactions: Taking EDI to the Next Level [Wed Nov 17]
Wed Nov 17, 2pm-3:30pm EST
The Centers for Medicare & Medicaid Services (CMS) will host its twelfth national education call regarding Medicare FFS’s implementation of HIPAA Version 5010 and D.0 transaction standards on Wed Nov 17, focusing on the Coordination of Benefits (COB). Subject matter experts will review Medicare FFS specific changes, including those arising from the adoption of the HIPAA 5010 Errata, as well as general information to help the audience prepare for the transition; the presentation will be followed by a Q&A session. Target Audience includes vendors, clearinghouses, and providers who will need to make Medicare FFS specific changes in compliance with HIPAA version 5010 requirements. The presentation will be available on the CMS website at http://www.cms.gov/Versions5010andD0/V50/list.asp.
Agenda:
§ General Overview
§ Medicare Specific COB Changes
§ Timelines and Deadlines
§ What you need to do to prepare
§ Q & A
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. Registration will close at 2:00 p.m. ET on November 16, 2010, 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:
Visit http://www.eventsvc.com/palmettogba/111710.
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation e-mail shortly thereafter. Note: Please save this page, in the event that your server blocks the confirmation e-mails. If you do not receive the confirmation e-mail, please check your spam/junk mail filter as it may have been directed there.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event.
~~~~~~~~~~~~~~~~~~~~
5. Registration for ONC Personal Health Records Roundtable Now Open [Fri Dec 3]
Fri Dec 3, 8:30am-4:30pm
Online registration is now open for the roundtable on “Personal Health Records – Understanding the Evolving Landscape.” This free day-long public roundtable, hosted by the Office of the National Coordinator for Health Information Technology (ONC), will be held on Fri Dec 3 at the FTC Conference Center in Washington DC (601 New Jersey Avenue NW, Washington, DC 20001).
Register to attend in person or via webcast by visiting http://healthit.hhs.gov/PHRroundtable. The webcast will be hosted at http://healthit.hhs.gov/blog/phr-roundtable.
~~~~~~~~~~~~~~~~~~~~
6. New CMS Web Page Available for the Medicare Fee-For-Service Physician Feedback / Value Modifier Program!
CMS uses claims data to create confidential reports measuring the resources and quality of care involved in furnishing care. In 2010, the Physician Feedback Program is limited to physicians and groups that have been notified – and if you have not received notification then you will not receive a report. Feedback reports will be distributed in a multi-year, phased, implementation schedule to medical professionals and medical group practices.
To learn more about these reports and the legislatively-mandated Value Modifier, visit the new web page at http://www.cms.gov/PhysicianFeedbackProgram on the CMS website.
~~~~~~~~~~~~~~~~~~~~
7. CMS to Release Ambulance Services Comparative Billing Report
In November, the Centers for Medicare & Medicaid Services will release its third national provider Comparative Billing Report (CBR). This report is centered on emergency and end-stage renal disease-related non-emergency transports provided by ambulance providers. The CBRs will be released to approximately 5,000 ambulance providers nationwide.
The CBRs, produced by SafeGuard Services under contract with CMS, provide comparative data on how an individual health care provider compares to other providers by looking at utilization patterns for services, beneficiaries, and diagnoses billed. CMS has received feedback from a number of providers that this kind of data is very helpful to them and encouraged us to produce more CBRs and make them available to providers.
These reports are not available to anyone but the provider who receives them. To ensure privacy, CMS presents only summary billing information. No patient or case-specific data is included. These reports are an example of a tool that helps providers comply with Medicare billing rules and improve the level of care they furnish to their Medicare patients. For more information and to review a sample of the ambulance CBR, please visit the CBR Services website (www.cbrservices.com), or call the SafeGuard Services’ Provider Help Desk CBR Support Team (530-896-7080).
~~~~~~~~~~~~~~~~~~~~
8. Five-Star Quality Rating System: News for November
November news about the Five-Star Quality Rating System:
§ Starting November 2010, the Five-Star ratings will update on Nursing Home Compare on the third Thursday of every month.
§ The Five-Star Preview Reports for November will be available no later than Mon Nov 15. Providers, in order to access your Five-Star Preview report, go to the MDS State Welcome page available on the state servers where you submit MDS data and select the CASPER Reporting link located at the bottom of the page. Once in the CASPER Reporting System, click on the ‘Folders’ button. Then click on ‘My Inbox’ on the left hand side of the screen and access the Five Star Report in your ‘st LTC facid’ folder, where ‘st’ is the 2-digit postal code of the state in which your facility is located and ‘facid’ is the state assigned facid of your facility.
§ Nursing Home Compare will update with November’s Five-Star data on Thu Nov 18.
Important Note: The Five-Star Help Line will be available from Mon Nov 15 through Fri Nov 19. Provider preview reports will continue to be available on a monthly basis in advance of public posting and will include the dates and hours of helpline availability. BetterCare@cms.hhs.gov is an alternative communication medium to direct inquiries.
~~~~~~~~~~~~~~~~~~~~
9. Inpatient Psychiatric Facility PPS RY2011 PC Pricers Updated
The Inpatient Psychiatric Facility (IPF) PPS PC Pricer needed corrected provider data for RY2011 and has been updated on the CMS Website for claims dates from 2010-07-01 to 2010-06-30 and 2010-10-01 to 2011-06-30. If you use the IPF PPS PC Pricer for RY2011, please visit http://www.cms.hhs.gov/PCPricer/09_inppsy.asp, under the Downloads section, and download the latest versions of the IPF PPS RY2011 PC Pricers, posted 2010-11-08.
~~~~~~~~~~~~~~~~~~~~
10. Inpatient PPS FY2011 PC Pricers Updated
The Fiscal Year 2011 Inpatient (INP) PPS PC Pricers have been updated on the CMS website. If you use the FY 2011 INP PPS PC Pricers, please visit http://www.cms.hhs.gov/PCPricer/03_inpatient.asp and download the latest version of the FY2011 PC Pricer. This PC Pricer is for claims dated from 2010-10-01 to 2011-09-30. The update is dated 2010-11-08.
~~~~~~~~~~~~~~~~~~~~
11. Updates from the Medicare Learning Network…
“End-Stage Renal Disease Prospective Payment System”
The new publication titled “End-Stage Renal Disease Prospective Payment System” (September 2010) provides information about the Medicare End-Stage Renal Disease Prospective Payment System that will be implemented on Jan 1, 2011, including the one-time election and transition period, payment rates for adult and pediatric patients, home dialysis, laboratory services and drugs, and beneficiary deductible and coinsurance. This fact sheet is now available in print format from the Medicare Learning Network®. To place your order, visit http://www.cms.gov/MLNGenInfo, scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”
# # # # # #
“End-Stage Renal Disease Composite Payment Rate System” Publication Revised
The revised publication titled “End-Stage Renal Disease Composite Payment Rate System” (September 2010) (previously titled “Outpatient Maintenance Dialysis - End-Stage Renal Disease”) provides information about the Medicare End-Stage Renal Disease composite payment rate system, the one-time election and transition period, and separately billable items and services. This fact sheet is now available in print format by visiting http://www.cms.gov/MLNGenInfo, scrolling to “Related Links Inside CMS” and selecting “MLN Product Ordering Page.”
# # # # # #
“5010: Taking Electronic Billing and Electronic Data Interchange to the Next Level”
Now available to order in hardcopy! The new Medicare Learning Network® product titled “5010: Taking Electronic Billing and Electronic Data Interchange (EDI) to the Next Level” is now available in both downloadable and hardcopy formats. This educational tool is designed to provide education on the upcoming implementation of Versions 5010 and D.0, which will replace the current version that covered entities must use when conducting electronic HIPPA transactions. It includes a timeline and list of resources related to the implementation and is suggested for all Medicare Fee-For-Service Providers. To order a hardcopy, free of charge, please visit http://www.cms.gov/MLNGenInfo and click on “MLN Product Ordering Page” under the “Related Links Inside CMS” section at the bottom of the page. This product is also available in downloadable format at http://www.cms.gov/MLNProducts/downloads/5010EDI_RefCard_ICN904284.pdf.
# # # # # #
Written Transcript of ESRD PPS 2011 Conference Call
The written transcript of the Medicare Program End-Stage Renal Disease Prospective Payment System (ESRD PPS) 2011 Conference Call, which provides an overview of the ESRD PPS that will be effective on Jan 1, 2011, is now available at http://www.cms.gov/ESRDPayment/10_CMS_Sponsored_Calls.asp.
~~~~~~~~~~~~~~~~~~~~
12. A new "twist" in the law makes it easier to save on your prescription drug costs.
http://www.ssa.gov/prescriptionhelp/
Under a new law, more Medicare beneficiaries could qualify for Extra Help with their Medicare prescription drug plan costs because some things no longer count as income and resources. The Extra Help is estimated to be worth an average of $3,900 per year. To qualify for the Extra Help, a person must be on Medicare, have limited income and resources, and reside in one of the 50 states or the District of Columbia.
~~~~~~~~~~~~~~~~~~~~
Professor Emeritus -- Dr. Tom Seymour from West Fargo, North Dakota -- Professor, Minot State University, MSU Faculty Regents Award (2015) -- PAST Peer Reviewer (Higher Learning Commission - Chicago); - Author and Presenter Board of Directors, SRT Communications, Inc and Minot City Alderman - Ward 5 (2010-June, 2016) PAST - Editor-in-Chief (North Dakota State Senator (2002-2010) 2017-Cass County Electric Cooperative- Board of Directors
No comments:
Post a Comment