Riverbend

ListServ Messages 07/11/2008

Riverbend GBA Listserv July 9, 2008. Please view the entire document for information that may affect your provider.

Dont miss the last opportunity to hear the latest Medicare information from Riverbend Government Benefits Administrator and CIGNA Government Services personnel. The last session of this year will be held on Tuesday, July 15, 2008 in Jackson, TN. Space is still available but please make your reservation by 4:00 pm (Eastern) on Thursday July 10th so that we can make the final preparation for the meeting.

Tuesday, July 15, 2008

Carl Perkins Civic Center, 400 South Highland, Jackson, TN 38301, 731-485-8580

Times: 9:00 am to 3:30 pm local time

Cost: $90.00

The meeting information and registration is now available at www.tnhfma.org website. Once again this year, the presentation material may be downloaded from a link you will receive after you register for the meeting.

We are exited about providing this great educational opportunity to you.  TN Chapter HFMA

Medicare Guide to Rural Health Services Information for Providers, Suppliers, and PhysiciansThe print version of the revised Medicare Guide to Rural Health Services Information for Providers, Suppliers, and Physicians (April 2008) is now available from the Centers for Medicare & Medicaid Services Medicare Learning Network. This guide contains rural health information pertaining to rural health facility types, coverage and payment policies, and rural provisions under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and the Deficit Reduction Act of 2005. To place your order, visit http://www.cms.hhs.gov/mlngeninfo/ , scroll down to Related Links Inside CMS and select MLN Product Ordering Page.

Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Accreditation 101 Audio Conference/ Q&A Session

The Centers for Medicare & Medicaid Services (CMS) will host an audio conference/Q&A session regarding Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) supplier accreditation.

This audio conference is the third in a series of four designed to provide guidance to DMEPOS suppliers regarding accreditation. We will be discussing compliance with the DMEPOS Quality Standards and the accreditation process, and will provide ample time to answer questions from the supplier audience. To view the presentation materials, please click on the following link: http://www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/DMEPOSAccreditationPresentation.pdf .

Please note: This is the same presentation that was made on two prior Accreditation 101

Audio Conference/ Q&A Session calls. This call will focus on accreditation issues for new suppliers.

Conference call details:

Date: July 15, 2008

Conference Title: DMEPOS Accreditation 101

Time: 1:30-3:00 p.m. EDT

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. If you cannot attend the call, replay information is available below.

Registration will close at 1:00 p.m. EDT on July 14, 2008, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.

1. To register for the call participants need to go to: http://www2.eventsvc.com/palmettogba/071508

2. Fill in all required data.

3. Verify your time zone is displayed correctly the drop down box.

4. Click Register.

5. You will be taken to the Thank you for registering page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.

For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 4:00 p.m. EDT 7/15/2008 until 11:59 p.m. EDT 7/22/2008. The call in data for the replay is (800) 642-1687 and the passcode is 493649052008 Physician Quality Reporting Initiative (PQRI) National Provider Call PowerPoint Presentation July 9^th, 2008 is now available

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that PowerPoint presentation that will be used during the July 9^h, 2008 PQRI National Provider call is now available on the CMS website.

This call will provide information on accessing your 2007 PQRI Feedback Report (for those of you who participated in 2007); an overview of the 2008 PQRI participation options, and a question and answer session.

The Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) (P.L. 110-173), which was enacted on December 29, 2007, requires that for 2008 and 2009 the Secretary establish alternative reporting periods and alternative criteria for satisfactorily reporting groups of measures. It also requires that for 2008 and 2009 the Secretary establish alternative reporting periods and alternative criteria for satisfactorily reporting quality measures data through registries.

To access the presentation, go to, http://www.cms.hhs.gov/PQRI, and select the CMS Sponsored Calls tab on the left side of the page. Next, scroll down to the Downloads section under the heading PowerPoint Presentations and select National Provider Call 07/08/2008

Important Information from The CMS. In the final physician fee schedule regulation published in the Federal Register on November 2, 1999, the Centers for Medicare & Medicaid Services (CMS) stated that it would implement a policy to pay only the hospital for the technical component (TC) of physician pathology services furnished to hospital patients. Prior to this proposal, any independent laboratory could bill the carrier under the physician fee schedule for the TC of physician pathology services for hospital patients. At the request of the industry, to allow independent laboratories and hospitals sufficient time to negotiate arrangements, the implementation of this rule was administratively delayed. Subsequent legislation formalized a moratorium on the implementation of the rule. As such, during this time, the carriers and, more recently, Medicare Administrative Contractors (MAC) have continued to pay for the TC of physician pathology services when an independent laboratory furnishes this service to an inpatient or outpatient of a covered hospital.

The most recent extension of the moratorium was established by the Medicare, Medicaid, and SCHIP Extension Act (MMSEA). Section 104 of the MMSEA expired on June 30, 2008, thus ending the moratorium. Therefore, independent laboratories may no longer bill Medicare for the TC of physician pathology services furnished to patients of a covered hospital, regardless of the beneficiary's hospitalization status (inpatient or outpatient) on the date that the service was performed. This prohibition is effective for claims with dates of service on and after July 1, 2008.

July 10, 2008

New Listserv Format from RGBA!

Reminder Be sure to review to the end of this e-mail document for information that may affect your provider.

Medicare Workshop dont miss the last opportunity to hear the latest Medicare information from Riverbend Government Benefits Administrator and CIGNA Government Services personnel. The last session of this year will be held on Tuesday, July 15, 2008 in Jackson, TN. Space is still available but please make your reservation by 4:00 pm (Eastern) on Thursday July 10th so that we can make the final preparation for the meeting.

Tuesday, July 15, 2008

Carl Perkins Civic Center, 400 South Highland, Jackson, TN 38301, 731-485-8580

Times: 9:00 am to 3:30 pm local time

Cost: $90.00

The meeting information and registration is now available at www.tnhfma.org website. Once again this year, the presentation material may be downloaded from a link you will receive after you register for the meeting.

We are exited about providing this great educational opportunity to you. TN Chapter HFMAExpiration of Moratorium That Allowed Independent Laboratories to Bill for the TC of Physician Pathology Services Furnished to Hospital Patients.

In the final physician fee schedule regulation published in the Federal Register on November 2, 1999, the Centers for Medicare & Medicaid Services (CMS) stated that it would implement a policy to pay only the hospital for the technical component (TC) of physician pathology services furnished to hospital patients. Prior to this proposal, any independent laboratory could bill the carrier under the physician fee schedule for the TC of physician pathology services for hospital patients. At the request of the industry, to allow independent laboratories and hospitals sufficient time to negotiate arrangements, the implementation of this rule was administratively delayed. Subsequent legislation formalized a moratorium on the implementation of the rule. As such, during this time, the carriers and, more recently, Medicare Administrative Contractors (MAC) have continued to pay for the TC of physician pathology services when an independent laboratory furnishes this service to an inpatient or outpatient of a covered hospital.

The most recent extension of the moratorium was established by the Medicare, Medicaid, and SCHIP Extension Act (MMSEA). Section 104 of the MMSEA expired on June 30, 2008, thus ending the moratorium. Therefore, independent laboratories may no longer bill Medicare for the TC of physician pathology services furnished to patients of a covered hospital, regardless of the beneficiary's hospitalization status (inpatient or outpatient) on the date that the service was performed. This prohibition is effective for claims with dates of service on and after July 1, 2008.

2008 Physician Quality Reporting Initiative (PQRI): New Educational Product is now available

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that a new educational resource has been posted to the PQRI webpage on the CMS website and is available for ordering through the Medicare Learning Network product ordering system.

The following item is available for download on the PQRI Educational Resources web page:

2008 PQRI Reporting Options Quick Reference Chart- This two-sided laminated reference chart gives Eligible Professionals and practice staff a quick reference to the new reporting options available for 2008 PQRI with their corresponding alternative reporting periods.

To access this new, and all available, educational resource, visit http://www.cms.hhs.gov/PQRI on the CMS website and click on the Educational Resources tab. Once on the Educational Resources page, scroll down to the Downloads section and click on the 2008 PQRI Quick Reference Chart link.

To order this product, visit http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident=kc0001&loc=5 on the CMS website and click on the 2008 Physician Quality Reporting Initiative (PQRI) Reporting Quick Option Reference Chart (ICN# 900843)(May 2008)

The following Local Coverage Determinations have been updated to reflect the current certification and recertification timeframe requirements found in the CMS Change Request 5921, published May 1, 2008.

L 17637  Occupational Therapy http://www.rgbagov.com/publications/lcd/lcd-files/17637.html

L 17639  Physical Medicine and Rehabilitation Modalitieshttp://www.rgbagov.com/publications/lcd/lcd-files/17639.html

The time intervals for reporting timed treatment modalities (direct one-on-one patient contact each 15 minutes), were corrected in L17637. The Frequently Asked Questions link was removed from the Appendices in both LCDs as this link could not be restored