This message is a reminder for all providers and physicians who bill Medicare contractors for their services.

A brief hold will be placed on Medicare payments for all claims during the last 9 days of the Federal fiscal year (September 22 through September 30, 2006).  These payment delays are mandated by section 5203 of the Deficit Reduction Act of 2005.  No interest will be accrued and no late penalties will be paid to an entity or individual by reason of this one-time hold on payments.  All claims held during this time will be paid on October 2, 2006.

This policy only applies to claims subject to payment.  It does not apply to full denials, no-pay claims, and other non-claim payments such as periodic interim payments, home health requests for anticipated payments, and cost report settlements.

Please note that payments will not be staggered and no advance payments will be allowed during this 9-day hold.
 
For more information, please view the MLN Matters Article at
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5047.pdf .

Proposed Changes to USP 797

For any of you who prepare/compound drugs in your clinics, and I assume that would be everyone, you might want to look at the proposed changes to USP 797.  Deadline for comments to this change due by August 15, 2006.  Physician offices are clearly mentioned regarding compliance.

An example of what is in store:  "Opened or needle-punctured single-dose containers such as ampuls, bags, bottles, syringes, and vials of sterile products and CSPs (compounded sterile preparation) shall be used within one hour if opened in worse than ISO Class 5 air quality and any remaining contents must be discarded." 

Another example:  "Because of known safety risks of hazardous drugs to health care workers and other non-patients who may be exposed to them, hazardous drugs such as cancer chemotherapy drugs and all those on the National Institute for Occupational Safety and Health List (NIOSH) shall not be prepared as immediate use CSP.  Hazardous drugs must be prepared using suitable ISO class 5 environment containment equipment and/or devices in a manner fully compliant with the standards in this chapter including the Hazardous drugs as CSPs section."

View all 64 pages by following the link www.usp.org/pdf/en/uspnf/pf797.pdf

CMS NPI Roundtable – September 26, 2006

August 23^rd marks 9 months remaining until the National Provider Identifier (NPI) compliance date.  Over 1 million NPIs have been issued so far --- do you have your NPI yet?  At this 9-month mark, the Centers for Medicare & Medicaid Services (CMS) would like to announce the following:

• CMS will host a national NPI Roundtable, open to all health care professionals, on Tuesday, September 26^th from 2:00-3:30PM ET. 
• To participate, you may call 1-877-203-0044, pass code 4795739
• CMS will address common questions related to Medicare’s guidance on Subparts.  While CMS will only address questions from a Medicare perspective, this information may be helpful to all providers.  Medicare providers, who have questions, should select the appropriate email below and send in questions by Friday, September 8^th.  Questions received after this date will not be considered. 
  • Medicare providers who bill a Fiscal Intermediary should send questions to:  NPIQuestionsfromFIBillers@cms.hhs.gov
  • Medicare providers who bill a Carrier should send questions to: NPIQuestionsfromCarrierBillers@cms.hhs.gov

Medicare Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals

Now available in print format free of charge from the Medicare Learning Network at http://www.cms.hhs.gov/mlngeninfo/ on the Centers for Medicare & Medicaid Services website.

Select "MLN Product Ordering Page" under "Related Links Inside CMS" to place your order.

24 August 2006 / CMS

• This article instructs your Medicare carrier to provide information for those providers identified in electronic claims, such as a billing, pay-to, rendering or other provider, that have already obtained NPIs. Prior to May 23, 2007, providers should report the Medicare legacy identifiers of those providers enrolled to submit claims to Medicare, as well as their NPI. (CR 5217)
  
  
• The updates have been posted for the Health Care Remittance Advice Remark Codes (RARCs) and the Health Care Claim Adjustment Reason codes (CARCs). (CR 5212)
  
  
• This article assists physicians, providers, other prescribers, and pharmacists to understand the CMS’ recommended approach to simplifying and expediting the coverage determination process for Medicare Part B versus Part D. (SE0652)
  
  
• This article clarifies for providers the information issued by the Centers for Medicare & Medicaid (CMS) regarding the date to end the contingency plan for ERAs. (SE0656)
  
  
• Until September 30, 2006, CAP participating physicians who submitted claims for CAP drugs under the ASP (buy and bill) system may request that these claims be reopened and reprocessed as a CAP claim if the claims are submitted with the appropriate CAP information and the J2 modifier. (SE0657)
  
  
• CMS article on important guidance regarding National Provider Identifier (NPI) usage in Medicare claims. (SE0659)
  
  
• NPI: Get It. Share It. Use It. August 23^rd marks 9 months remaining until the National Provider Identifier (NPI) compliance date.  Over 1 million NPIs have been issued so far --- do you have your NPI yet?  At this 9-month mark, the Centers for Medicare & Medicaid Services (CMS) would like to announce the following: CMS NPI Roundtable – September 26, 2006. (CMS Message 200608-10)

24 Aug 2006 / NHIC

• We have added a list of active Local Coverage Determinations (LCDs) with their corresponding procedure codes. 
  
  
• We have updated the Interactive Voice Recognition (IVR) Instructions.
  
  
• Educational articles have been revised/added: Darbepoetin Alfa (Aranesp) and Epoetin Alfa (Epogen, EPO) – Revised ESRD Billing and Locum Tenens & Reciprocal Billing for Absentee Physicians.

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17 August 2006 / CMS

• The updated Clinical Laboratory Improvement Amendments (CLIA) brochure which has been available in a downloadable format is now available in print format on the Medicare Learning Network’s (MLN).  A print version of the brochure is available for ordering on the MLN Publications Page at http://www.cms.hhs.gov/MLNProducts/and access the MLN Products Ordering Page. The brochure includes an overview of CLIA, why it is important, how test methods are categorized, enrollment information, as well as information regarding the five types of laboratory certificates. (CMS Message 200608-07)
  
  
• The website wheel has been updated and is now available for order through the Medicare Learning Network website at www.cms.hhs.gov/MLNProducts. (CMS Message 200608-06)
  

17 Aug 2006 / NHIC

• The September 2006 edition of the Medicare B Resource is now available.
  
  
• Some of the Medical Review FAQs have been updated.
  
  
• A new educational article has been posted: Top 10 Duplicate Claim Submitters by Specialty .

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10 August 2006 / CMS

• This article updates Publication 100-04, The Medicare Claims Processing Manual, Chapter 13, Section 60.3.2 (Tracer Codes Required for PET Scans) to include two new HCPCS codes for radiopharmaceutical diagnosis imaging agents (tracers) applicable to PET scan services. (CR 5054)
  
  
• This article discusses a new and more convenient web address and site that houses toll-free numbers that physicians, providers, and suppliers can use to contact their Medicare contractor (carriers including durable medical equipment (DME) regional carriers and DME Medicare administrative contractors (DME MACs), and fiscal intermediaries, including regional home health intermediaries (RHHIs). (SE 0655)

10 Aug 2006 / NHIC

• The Questions and Answers from the Medicare Easy Remit Print (MREP) ACT have been posted.

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03 August 2006 / CMS

• CMS is implementing the revised Form CMS-1500, which accommodates the reporting of the National Provider Identifier (NPI). The Form CMS-1500 (08-05) version will be effective January 1, 2007, but will not be mandated for use until April 2, 2007, and some additional requirements have been added. (CR 5060)
  
  
• When you call or write a Medicare fee-for-service provider contact center (PCC) to request beneficiary protected health information, the PCC staff, in order to comply with the requirements of the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act, will authenticate your identity prior to disclosure. (CR 5089)
  
  
• Effective January 1, 2007, Medicare will waive the annual Medicare Part B deductible for colorectal cancer screening tests billed with specific HCPCS codes. While the deductible will be waived, and will not apply for colorectal cancer screening test services furnished on or after January 1, 2007, the Medicare Part B coinsurance still applies for these screening tests. (CR 5127)
  
  
• CMS has provided instructions for additional limitations on outpatient therapy services, consistent with the provisions of the Deficit Reduction Act of 2005. Certain services are limited to certain numbers of units per day for physical therapy, occupational therapy and speech-language pathology, separately to control inappropriate billing. (CR 5253)
  
  
• NPI: Get It. Share It. Use It.  As the industry transitions to NPI compliance, remember that there is no charge to get an NPI. (CMS Message 200607-15)
  
  
• CMS Announces that Medicare Nursing Home Payments to Increase in 2007 Medicare payments to nursing homes will increase by approximately $560 million in 2007, the Centers for Medicare & Medicaid Services (CMS) announced today. The annual update notice of the new payment rates is on display today at the offices of the Federal Register. The 3.1 percent increase will be reflected in Medicare payment rates to nursing facilities that furnish certain skilled nursing and rehabilitation care to Medicare beneficiaries recovering from serious health problems.  For further information, please click below to view the Press Release: http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=1918  The SNF PPS update notice is available on the CMS website at http://www.cms.hhs.gov/providers/snfpps. (CMS Message 200607-16)
  
  
• The Centers for Medicare & Medicaid Services (CMS) today announced the award of the first of 15 contracts for the combined handling in six states of both Part A and Part B Medicare claims. The winning contractor is Noridian Administrative Services, LLC, (NAS), headquartered in Fargo, N.D.  (CMS Message 200607-17)

03 Aug 2006 / NHIC

• The LCD Allergy Testing - (NCA L19094; SCA L19096) has been revised. The ICD-9-CM code 599.82 has been added,to the list of covered codes for CPT codes 95004-95028, 95060, 95065, and 95070-95075, as it was inadvertently omitted.  The entire LCD can be accessed from the A ctive LCD Index on the CMS website: Northern California – 31140  | Southern California – 31146
  
  
• The newest edition of the CERT newsletter is now available.
  
  
• An article on the Appeals Process for 2006 has been added.

 

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27 July 2006 / CMS

CMS has issued an article on Stage 2 National Provider Identifier (NPI) Changes for Transaction 835, and Standard Paper Remittance Advice. (CR 5081)

Medicare announces disaster response plan for individuals with kidney failure. (CMS Message 200607-14)

27 July 2006 / NHIC

• New quarterly customer service FAQs  have been posted.
  
  
• Information on the October CAC has been posted.
  
  
• The Events Calendar has been updated.

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20 July 2006 / CMS

CMS has issued an update on Medicare Telehealth Services (CR 5122)

The Medicare Physician Guide:  A Resource for Residents, Practicing Physicians, and Other Health Care Professionals is now available in print format free of charge from the Medicare Learning Network at www.cms.hhs.gov/mlngeninfo on the Centers for Medicare & Medicaid Services website. Select "MLN Product Ordering Page" under the Related Links Inside CMS section to place your order. (CMS Message 200607-09)

Effective July 19, 2006 the Medicare interest rate for overpayments and underpayments has been changed to 12.625 percent. (CR 4076)

CMS has revised the article on the updated payment allowance limits for Medicare Part B drugs, effective July 1, 2006. (CR 5110)

CMS has revised the article about NPPs billing for physician home health care plan oversight (CPO). (CR 4374)

20 July 2006 / NHIC

• The Related Web Sites page has been updated.
  
  
• The Radiopharmaceuticals fees have been revised to correct the pricing of A9502.
  
  
• The "Introduction to Medicare" Billing Guide has been revised.
  
  
• The June edition of the CERT newsletter has been posted.
  
  
• Two Educational Articles have been posted: Care Plan Oversight (CPO) and Related Services and Tetanus Toxoid Injections

 

City of Hope’s Fourth Annual Conferenceon theAdvances in theMultidisciplinary Treatment of Gastrointestinal Neoplasms

OVERVIEW : There were more than 165,000 new cases of gastrointestinal cancer diagnosed in 2005, so this remains an important public health issue in the United States . Heterogeneous in nature, the management of these cancers present complex clinical problems, which require an ever-evolving multidisciplinary approach in diagnosis and treatment.

WHO SHOULD ATTEND : gastroenterologists / general surgeons / surgical oncologists / internists / medical oncologists / diagnostic radiologists / radiation oncologists / other allied health care professionals who treat patients with gastrointestinal neoplasms

Download the flyer here >>

FOR FULL COURSE DETAILS AND TO REGISTER GO TO:

www.cityofhope.org/GIconference2006

ION Meetings For Physicians Only