Palmetto GBA E-mail Update: Tuesday, August 01, 2017

CMS National Provider Enrollment Conference: September 6 and 7, 2017
The Centers for Medicare & Medicaid Services (CMS) will hold a National Provider Enrollment Conference on Wednesday, September 6, 2017 from 8 a.m. to 5 p.m. EDT and Thursday, September 7, 2017 from 8 a.m. to 3 p.m. EDT. This session will be held at the Charleston Area Convention Center located at 5000 Coliseum Dr., North Charleston, SC 29418. Don’t miss this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts. Registration for this free conference ends August 29, 2017. Please plan to attend.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General

Rendering Physicians Can Now Review Their Individual Medicare Billing Activities!
Palmetto GBA is excited to announce that rendering physicians now have access to eReview functions via the eServices portal to review and analyze their Medicare billing activity. JM Part B rendering physicians who are currently listed in PECOS may register for a rendering physician account in eServices.

Applies to:

  • JM Part B//General

Palmetto GBA E-mail Update: Monday, July 31, 2017

Correct Date of Service for Specific Services
This article is applicable to physicians, non-physician practitioners, and others submitting claims on a CMS-1500 form for reimbursement for Medicare Part B services. Physicians and non-physician practitioners need to identify the correct date of service for the services they provide to a Medicare patient.Please review and share it with your staff.

Applies to:

  • JM Part B//General

Opt Out Listing
This article includes a listing of those providers who have elected to opt out of the Medicare program. If you’ve recently opted out of the Medicare Program it’s possible that your name will not appear on the website until the next quarterly update. Please share with appropriate staff.

Applies to:

  • JM Part B//General

New Waived Tests
Change Request (CR) 10198 informs MACs of new Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived tests approved by the Food and Drug Administration (FDA). Since these tests are marketed immediately after approval, the Centers for Medicare & Medicaid Services (CMS) must notify MACs of the new tests so that they can accurately process claims. Make sure that your billing staffs are aware of these CLIA-related changes.

Applies to:

  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

New Articles Posted to MLN

The following new articles have been added to the MLN Matters website:

MM10198 – New Waived Tests
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10198.pdf

MM10098 – Common Working File (CWF) to Modify CWF Provider Queries to Only Accept National Provider Identifier (NPI) as Valid Provider Number
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10098.pdf

MM10145 – Correcting Payment of Inpatient Prospective Payment System (IPPS) Transfer Claims Assigned to Medicare Severity-Diagnosis Related Group (MS DRG) 385
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10145.pdf

Follow this link for the complete list of articles available on the MLN Matters website.

Palmetto GBA E-mail Update: Friday, July 21, 2017

CMS National Provider Enrollment Conference: September 6 and 7, 2017
The Centers for Medicare & Medicaid Services (CMS) will hold a National Provider Enrollment Conference on Wednesday, September 6, 2017 from 8 a.m. to 5 p.m. EDT and Thursday, September 7, 2017 from 8 a.m. to 3 p.m. EDT. This session will be held at the Charleston Area Convention Center located at 5000 Coliseum Dr., North Charleston, SC 29418. Don’t miss this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts. Registration for this free conference ends August 29, 2017. Please plan to attend.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General

August 2017 Medicare Advisory
The August 2017 Medicare Advisory is now available. Please review this issue for Medicare policy and coverage updates as well as announcements for upcoming provider education opportunities. Please remember to share this information with your staff.

Applies to:

  • JM Part B//General

September 2017 Medicare Part B Updates, Changes and Reminders: September 20
Palmetto GBA will host the Medicare Administrative Contract Part B September 2017 Quarterly Updates, Changes and Reminders Webcast on September 20, 2017, at 10 am. ET. These updates, changes and reminders include any new billing regulations, hot topics that impact provider billing, and a Q & A segment for questions on covered material. Note: An NPI and PTAN are required to register. You should only enter ‘n/a’ if you do not have an NPI or PTAN. Please share with your staff, and register today.

Applies to:

  • JM Part B//General

Palmetto GBA Update – Proposed 2018 Policy and Payment Rate Changes

Hospital Outpatient, ASC: CMS Proposes 2018 Policy and Rate Changes

Proposed rule and Request for Information promote improvements to quality, accessibility, and affordability of care

On July 13, CMS issued a proposed rule that updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. The proposed rule is one of several for 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility and innovation in the delivery of care.

The OPPS and ASC payment system are updated annually to include changes to payment policies, payment rates, and quality provisions for those Medicare patients who receive care at hospital outpatient departments or receive care at surgical centers. Among the provisions in this rule, CMS is proposing to change the payment rate for certain Medicare Part B drugs purchased by hospitals through the 340B program. The proposed rule also includes a provision that would alleviate some of the burdens rural hospitals experience in recruiting physicians by placing a two-year moratorium on the direct supervision requirement currently in place at rural hospitals and critical access hospitals. In addition, CMS is releasing within the proposed rule a Request for Information to welcome continued feedback on flexibilities and efficiencies in the Medicare program.

For More Information:

Physician Fee Schedule: CMS Proposes 2018 Payment and Policy Updates

Proposed rule & Request for Information provide flexibility, support strong patient-doctor relationships

On July 13, CMS issued a proposed rule that would update Medicare payment and policies for doctors and other clinicians who treat Medicare patients in CY 2018. The proposed rule is one of several Medicare payment rules for CY 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery of care.

The Physician Fee Schedule is updated annually to include changes to payment policies, payment rates, and quality provisions for services furnished to Medicare beneficiaries. This proposed rule would provide greater potential for payment system modernization and seeks public comment on reducing administrative burdens for providing patient care, including visits, care management, and telehealth services. The rule takes steps to better align incentives and provide clinicians with a smoother transition to the new Merit-based Incentive Payment System under the Quality Payment Program. The rule encourages fairer competition between hospitals and physician practices by promoting greater payment alignment, and it would improve the payment for office-based behavioral health services that are often the therapy and counseling services used to treat opioid addiction and other substance use disorders. In addition, the proposed rule makes additional proposals to implement the Center for Medicare and Medicaid Innovation’s Medicare Diabetes Prevention Program expanded model starting in 2018.

For More Information:

MLN Connects for Thursday, July 13, 2017

News & Announcements

  • New Medicare Cards with New Numbers: 3 Changes You May Need to Make
  • QRDA III Implementation Guide Available
  • Quality Payment Program: View Recent Webinar Recordings
  • Hospital Discharge Notices
  • IPPS Hospitals: FY 2014 S-10 Revisions
  • Recognizing National HIV Testing Day

Provider Compliance

  • OIG Video: Reporting Fraud to the Office of the Inspector General

Claims, Pricers & Codes

  • ICD-10-CM Errata Available

Upcoming Events

  • Revised Interpretive Guidance for Nursing Homes and New Survey Process Call — July 25
  • ESRD QIP: Proposed Rule for Payment Year 2021 Listening Session — July 26
  • IRF Quality Reporting Program Refresher Training Webinar — August 15
  • Comparative Billing Report on Drugs of Abuse Testing Webinar — August 23

Medicare Learning Network Publications & Multimedia

  • CLIA Webcast: Audio Recording and Transcript — New
  • Appeals Call: Audio Recording and Transcript — New
  • Acute Care Hospital Inpatient Prospective Payment System Booklet — Reminder
  • Skilled Nursing Facility Prospective Payment System Booklet — Reminder
  • Ambulatory Surgical Center Fee Schedule Fact Sheet — Reminder
  • Ambulance Fee Schedule Fact Sheet — Reminder
  • Health Professional Shortage Area Physician Bonus Program Fact Sheet — Reminder
  • Suite of Products & Resources for Billers & Coders Educational Tool — Reminder

MLN Connects Newsletter: Thursday, July 6, 2017

News & Announcements

  • ESRD: Proposed 2018 Policy and Payment Rate Changes
  • ESRD QIP: Prepare for the PY 2018 Preview Period
  • QPP: New Resources to Help Clinicians Participate in MIPS
  • QPP: New Webpage for Clinicians in Small, Rural, or Underserved Areas
  • Open Payments Program Posts 2016 Financial Data

Provider Compliance

  • Chiropractic Services: High Improper Payment Rate within Medicare FFS Part B

Upcoming Events

  • ESRD QIP: Reviewing Your Facility’s PY 2018 Performance Data Call — July 10
  • Creating and Verifying Your National Provider Identifier Call — July 12
  • Assessing Your Ability to Support Patient Self-Management Webinar — July 19
  • ESRD QIP: Proposed Rule for Payment Year 2021 Listening Session — July 26

Medicare Learning Network Publications & Multimedia

  • Modernized National Plan and Provider Enumeration System MLN Matters Article — New
  • Infection Control: Hand Hygiene Video — New
  • PECOS for Provider and Supplier Organizations Booklet — Reminder
  • Medicare Vision Services Fact Sheet — Reminder
  • Mass Immunizers and Roster Billing Booklet — Reminder