Some Doctors Stop In-Office Injection Services Due to Costs  Added June 3 , 2007
The Wall Street Journal ran this recent article regarding doctors who no longer provide injection services in their office. Read the article>>
NPI Look-Up Tool Available Soon Added June 3 , 2007
So, you’ve gotten your National Provider Identifier (NPI), right? Did you know you will also have to include the NPIs of referring physicians and health care facilities on your claim forms?
Obtaining NPIs from referring providers can be a time consuming hassle. This has been a major obstacle in the implementation of the NPI rule.
This week, the Centers for Medicare & Medicaid Services (CMS) finally — after many frustrating delays — announced that physicians and other covered entities will soon be able to look up NPIs by simply entering the provider or facility name into an online database. This online lookup will be available on June 28, 30-days after CMS’s official NPI data dissemination policy was published in the Federal Register.
The online lookup will return NPIs and relevant demographic information, but it will not disclose social security numbers, dates of birth, or IRS taxpayer identification numbers, according to CMS.
Physicians are encouraged to look up their information at the NPI enumerator’s website, https://nppes.cms.hhs.gov, and make any necessary updates or corrections to ensure that their information is accurate before it is disclosed by CMS.
Click here for more information.
Old CMS-1500 Forms Will Not Be Accepted After July 1 Added June 3 , 2007
The Centers for Medicare and Medicaid Services (CMS) yesterday told carriers to stop accepting the old CMS-1500 forms on July 2.
As reported earlier this year in CMA Alert, CMS announced it would continue accepting the old CMS-1500 claim forms past the original April 1 deadline because of formatting errors in some of the new forms being distributed by the Government Printing Office and other vendors. The form was updated to accommodate the mandated National Provider Identifiers (NPIs).
According to CMS, the problem is not as widespread as previously suspected. Still, physicians should make sure that they have the new and correctly formatted forms before the July 2 implementation date.
The best way to identify badly formatted forms is to look at the upper right-hand corner of the form. If the tip of the red arrow above the vertically stacked word “CARRIER” is touching or close to touching the top edge of the form, then the form is not printed to specifications. There should be approximately a quarter of an inch between the tip of the arrow and the top edge of the paper on properly formatted forms.
Please note that this issue involves the paper claim form only and does not affect the NPI implementation date. Medicare carriers can continue accepting legacy provider identification numbers until May 31, 2008.
CMA-Sponsored Bill Introduced Into U.S. Congress Would Bring Equity to Geographic Payment Formula Added June 3 , 2007
Rep. Sam Farr (D-Carmel) last week introduced a CMA-sponsored bill to fix the inequitable and outdated Medicare geographic payment formula. The bill, which has bipartisan support from key members of the California congressional delegation, would allow currently underpaid counties to be reimbursed based on more accurate geographic practice costs. Read entire article>>
Survey Results Confirms Blue Cross’s Widespread Failure to Adequately Notify Physicians of Fee Schedule Changes Added June 3 , 2007
CMA would like to thank all of you who completed the Blue Cross fee schedule survey last week. The survey results clearly demonstrate that Blue Cross has failed to provide physicians with timely access to the proposed fee schedule, leaving many physicians unable to assess the financial impact that the fee schedule changes will have on their practices. CMA has urged the Department of Managed Health Care to delay implementation of this new fee schedule, which is scheduled to take effect June 1.
Ninety-two percent of the 174 practices that responded said that Blue Cross failed to provide them with enough information to calculate their new reimbursement rates, and 75 percent of practices that requested additional information did not receive a satisfactory response in a timely manner.
CMA has provided DMHC with the survey results and urged them to take immediate action.
Click here for more information, including detailed survey results.
Blue Cross Fails to Make New Fee Schedule Available to Physicians, CMA Urges Insurer to Delay Implementation Added May 23 , 2007
CMA is urging Blue Cross of California to delay implementation of fee schedule changes due to take effect June 1, because the insurer has failed to make a full and complete schedule available to physicians. This failure has prevented many physicians from assessing the impact that the fee schedule changes will have on their practices. Read entire article>>
Welcome to the Cancer Schmancer Movement Added May 21 , 2007
Letter from the President
Dear Colleagues,
I wanted to bring you up to date on where we're at and where we need to go! Check out our newly launched website at www.CancerSchmancer.org.
We are now up and running thanks to your help. But now we need to drive EVERYONE we know and everyone THEY know to JOIN! Membership is FREE so let's start making Cancer Schmancer a loud voice on Capitol Hill.
Until we have millions of members, we are not a movement. Together we can empower women with education, sign petitions, change policy and become a powerful collective voice in Congress. Remember our mission: "To ensure that ALL women's cancers get diagnosed in STAGE 1, when they are most curable." Please do your part and forward this email to all of your friends and loved ones and encourage them to click here and become members
United we stand! Thank You and Be Well, Fran Drescher President, Cancer Schmancer Movement
Cancer Schmancer Fran Drescher,President
Cancer Schmancer Shikha Gulati, Executive Director
Cancer Schmancer | Po Box 2760 | Reston | VA | 20195
PQRI Information Save The Date!!!! Updated May 23, 2007
Pay for Quality/Performance Office Resource Presentation (PQRI) Teleconference
Topic: Preparing for Medicare’s Physician Quality Reporting Initiative
Overview: A voluntary pay-for reporting project that may allow physicians and other healthcare providers to earn 1.5% of their Medicare allowables for many services for dates of service between July 1 and December 31, 2007 .
Date: June 12, 13, 14 at 12 noon PDT
Call-in number: 1-866-222-5350
Access Code: 6724228
Please RSVP by Friday, June 8 to MOASC Administration at moasc@moasc.org
Presented by Lash Group healthcare Consultants and AstraZeneca Cancer Support Network, and available to membership of MOASC and any other oncology practice.
For the most up to date information on PQRI which becomes effective July 1, 2007 please go to www.cms.hhs.gov/PQRI.
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