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ListServ Message 08/22/2008
Riverbend GBA Listserv August 19, 2008Reminder:
The 3rd Quarter “Ask the Contractor Teleconference (ACT)” will be held on Thursday, August 21, 2008, at 2:00 PM EST. To enter the conference, please dial our toll free number 1-877-718-5099.
Please submit any questions (you would like answered on this call) in advance to our GM-Education e-mailbox before August 18, 2008 at: http://www.rgbagov.com/Education/Training/training.do . To type in a question or describe a scenario, please use the box located at the end of the listing labeled “other”.
Thank you, and we look forward to your questions and your participation on this call.
Riverbend GBA
August 19, 2008
J12 transition of NJ providers from Riverbend GBA to Highmark Medicare ServicesTo accommodate the J12 transition of NJ providers from Riverbend GBA to Highmark Medicare Services we need to adjust our normal system availability. Starting on Friday August 29th Riverbend system will be unavailable at 5 PM EST through the whole Labor Day Weekend. The system will be available at the normal times starting Tuesday September 2nd at 7 AM EST. This scheduled downtime will affect all Riverbend providers’ access to DDE Processing, and certain IVR functionality. Once the system is available on Tuesday, September 2nd, only the providers not moving to Highmark Medicare Services will be able to access Riverbend’s systems.
For NJ Providers moving to Highmark Medicare Services the cutoff for submitting EDI Claims to Riverbend will be 4 PM EST Friday August 29th. After this cutoff all EDI claims will have to be submitted to Highmark Medicare Services.
August 19, 2008
The following Listserv information is being distributed through Riverbend GBA. Please review to the end of this document for information that may affect your facility.
Information from CMS.
Date: 08/18/2008
Subject: CMS Updates to Coverage Pages
Click the hyperlink to view the full story: CMS Updates to Coverage Pages
Content: Update to Coverage pages for August 18, 2008
HHS Proposes Adoption of ICD-10 Code Sets and Updated Electronic Transaction Standards Proposed Changes Would Improve Disease Tracking and Speed Transition to an Electronic Health Care Environment
The Department of Health and Human Services (HHS) announced Friday a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10 code sets, effective October 1, 2011. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as health care claims. Version 5010 is essential to use of the ICD-10 codes.
In 2000, under authority provided by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the ICD-9-CM code sets were adopted for use in the administrative transactions by both the public and private sectors to report diagnoses and inpatient hospital procedures. Covered entities required to use the ICD-9-CM code sets include health plans, health care clearinghouses, and health care providers who transmit any electronic health information in connection with a transaction for which a standard has been adopted by HHS.
Developed almost 30 years ago, ICD-9 is now widely viewed as outdated because of its limited ability to accommodate new procedures and diagnoses. ICD-9 contains only 17,000 codes and is expected to start running out of available codes next year. By contrast, the ICD-10 code sets contain more than 155,000 codes and accommodate a host of new diagnoses and procedures. The additional codes will help to enable the implementation of electronic health records because they will provide more detail in the electronic transactions.
Comments on the ICD-10 code sets proposed rule are due by 5:00pm Eastern time on October 21, 2008. Comments on the updated transaction standards proposed are due by 5:00pm Eastern time on October 21, 2008.
Both regulations may be viewed at
www.cms.hhs.gov/TransactionCodeSetsStands/02_TransactionsandCodeSetsRegulations.asp.
To read the HHS press release issued, please click here: http://www.hhs.gov/news/press/2008pres/08/20080815a.html
Fact sheets describing both proposed rules will be forthcoming at
ttp://www.cms.hhs.gov/apps/media/fact_sheets.asp.
Department of Health & Human Services
Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mail Stop S3-02-01
Baltimore, Maryland 21244-1850
Office of Clinical Standards and Quality
Dear Renal Community:
The Centers for Medicare & Medicaid Services (CMS) will be hosting a series of End-Stage-Renal-Disease Stakeholder Meetings to discuss the End-Stage-Renal-Disease (ESRD) Network (NW) Program. The purpose of these meetings is to provide an opportunity for interested stakeholders to provide vital input and recommendations on the program moving forward.
The Office of Clinical Standards and Quality (OCSQ), is currently conducting an evaluation of the ESRD NW program. The results and recommendations developed from the evaluation will provide the steps to improving the program. OCSQ recognizes this assessment is essential to moving the program forward to meet the present needs and demands of Medicare beneficiaries in the rapidly growing field of end stage renal disease. As well as, transitioning the program to achieve even greater strength in the following areas:
Value
Attribution
Oversight
Improved Outcomes
Since 2006, OCSQ has been engaged in redesigning the QIO program. The redesign efforts have been essential in developing the framework for the new contract period. These changes are captured in the recently released 9th SoW Request for Proposal (RFP). The changes are not limited to only the RFP documents. Change extends to several other areas as well, including the principles under which the scope of work is developed, fundamental methods of contracting, (including methods of contract awards), and, especially, contract evaluation and monitoring. Our goal is to apply these concepts to the ESRD NW program. We welcome your feedback during the stakeholder meetings to discuss how these changes can be applied to the program.
These meetings will occur during the months of August and September 2008. We will conduct five separate meetings targeted for the following groups:
| Stakeholder |
Date |
Location |
| CMS ESRD NW Contractors |
8/28/08 |
CMS Quality-Net Conference |
| ESRD Advocates / Patients |
9/4/08 |
Centers for Medicare & Medicaid Services |
| CMS ESRD NW Contractors |
9/16/08 |
Web-Ex Conference |
| ESRD Providers / Facilities |
9/11/08 |
Centers for Medicare & Medicaid Services |
ESRD Researchers
|
9/19/08 |
Centers for Medicare & Medicaid Services |
Each meeting will be a participatory dialogue focused on key questions; we encourage you to review the materials in advance of each meeting and come prepared to share your feedback and recommendations during the dialogue session at the meeting. To assist you in determining the appropriate representatives, we have enclosed the agendas and questions for each stakeholder session.
For the meetings held at CMS Headquarters in the Multipurpose Room, we must limit participants to four individuals from your organization who can communicate quality insights that your organization can contribute. You may access up-to-date information on these meetings at http://esrdncc.org, under the section titled “Events”. All participants must register at ESRDNW_StakeholderMeeting2008@cms.hhs.gov, in order to attend.
I look forward to these meetings and how we can work collectively in improving the quality of care for Medicare beneficiaries. If you have questions regarding these meetings, please contact Cheryl Bodden at (410) 786-6875, Cheryl.Bodden@cms.hhs.gov
Sincerely,
Barry M. Straube, M.D.
CMS Chief Medical Officer
Director, Office of Clinical Standards and Quality
Centers for Medicare & Medicaid Services
LOWER MEDICARE PART D COSTS THAN EXPECTED IN 2009 Beneficiary Satisfaction Remains High
The Centers for Medicare & Medicare Services (CMS) recently announced that as Medicare’s Part D prescription drug program enters its fourth year, beneficiary satisfaction rates remain high, program costs remain lower than originally expected, and Medicare prescription drug plan bids reflect nationwide drug price trends. Based on the bids submitted by Part D plans, CMS estimates that the average monthly premium that beneficiaries will pay for standard Part D coverage in 2009 will be $28. This is about 37 percent lower than originally projected when the benefit was established in 2003.
The estimated average monthly premium for 2009 of roughly $28 for basic coverage is far below the original estimate for 2009 of $44.12, which was made at the time the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) was enacted in 2003. The average expected premium for basic coverage in 2009 is about $3 higher than the actual average for 2008. The $3 premium increase is due to general trends in drug costs, the phase-out of a CMS demonstration project, and higher plan estimates for catastrophic coverage based on prior experience.
In addition to average premiums for 2009, CMS has announced: the 2009 national average monthly bid; the base beneficiary premium; the regional low-income subsidy premium amounts for 2009; and the 2009 Medicare Advantage regional preferred provider organization benchmarks. These data can be found at: http://www.cms.hhs.gov/MedicareAdvtgSpecRateStats/RSD/list.asp
To read the CMS Press release issued on August 14, 2008, go to:
http://www.cms.hhs.gov/apps/media/press_releases.asp
Pricer Updates:
The provider data distributed with the IPF PPS PC Pricer has been updated as of July 2008. The RY2008 IPF PPS PC Pricer on the web page: http://www.cms.hhs.gov/PCPricer/09_inppsy.asp, under “Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) PC PRICER,” has been updated with the latest provider data. If you use the IPF PPS PC Pricer, please go to the page above and download the latest version of the IPF PPS PC Pricer posted 08/12/2008.
Due to receiving updated quarterly provider data, the SNF PPS PC Pricer has been revised. See the FY 2008.2 SNF PPS PC Pricer on the web page, http://www.cms.hhs.gov/PCPricer/04_SNF.asp, under the “Downloads” section. If you use the FY 2008.2 SNF PPS PC Pricer, please go to the page above and download the latest version of the PC Pricer.
Upcoming Training for the Medicare Part B Drugs Competitive Acquisition Program (CAP)
Noridian Administrative Services, the designated carrier for the CAP, offers interactive, online workshops about the CAP for Part B Drugs and Biologicals. These workshops train CAP vendors and elected physicians on a variety of CAP topics, and NAS staff can also answer questions. Interested parties may view additional information about and register for these workshops at https://www.noridianmedicare.com/cap_drug/train/workshops/index.html
An upcoming workshop will be held on the following date:
8/21/08 at 2:00PM CST
Article MM6139 was initially posted on Aug 12th and updated the following day and, so, appears as both New and Revised because the revision occurred before we could post the article as new.
Paul
New:
MM6129 New Requirement for Ordering/Referring Information on Ambulatory Surgical Center (ASC) Claims for Diagnostic Serviceshttp://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6129.pdf
MM6126 Fiscal Year (FY) 2006 Supplemental Security Income (SSI) Data
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6126.pdf
MM6139 Implementation of New Provider Authentication Requirements for Medicare Contractor provider Telephone and Written Inquiries
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6139.pdf
MM5849 Transition of Responsibility for Medical Review from Quality Improvement Organizations (QIOs)http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5849.pdf
Revised:
MM6139 Implementation of New Provider Authentication Requirements for Medicare Contractor Provider Telephone and Written Inquiries http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6139.pdf
The next CMS Hospital/Hospital Quality Open Door Forum scheduled for…
Date: August 28, 2008
Start Time: 2:00 PM Eastern Daylight Time (EDT)
[Please dial-in at least 15 minutes before call start time.]
Conference Leader(s): Jeffrey Rich, M.D./Charlotte Yeh, M.D./Natalie Highsmith
Open Door Participation Instructions:
There are 2 ways to participate, by phone or onsite.
1. To participate by phone:
Dial: 1-800-837-1935 & Reference Conference ID 55465422Persons participating by phone do not need to RSVP. Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html A Relay Communications Assistant will help.
2. To participate onsite:
Your RSVP is required. Please send a reply to CMS HOSPITALODF-L@cms.hhs.gov by 2:00 PM EDT, August 26, 2008. Be sure to include the title of the forum "Hospital/Hospital Quality" in the subject line of your message, and send us your name, organization/representation and telephone number. Please arrive no later than 1:30 PM.
ADDRESS:
Hubert H. Humphrey Bldg.
200 Independence Avenue S.W.
Washington, D.C. 20201
Map & Directions: http://www.hhs.gov/about/hhhmap.html
Encore is an audio recording of this call that can be accessed by dialing 1-800-642-1687 and entering the Conf. ID. This recording will be accessible beginning Tuesday, September 2, 2008 and will expire after for 3 business days.For Forum Schedule updates, Listserv registration and Frequently Asked Questions please visit our website at www.cms.hhs.gov/OpenDoorForums/.
Thank You.
End of Listserv
The following Listserv information is being distributed through Riverbend GBA. Please review to the end of this document for information that may affect your facility.
Riverbend GBA Closed September 1, 2008 – Payment cycle changes
Riverbend Government Benefits Administrator will be closed on September 1, 2008 in recognition of Labor Day. As a result, there will be some changes to our normal payment cycle.
For the week ending September 5, there will be 2 payment runs: September 3 and September 5, 2008. Remittance advices will be mailed on Friday September 5, 2008. For the week ending September 12, we will resume with our normal payment cycle with a payment run on September 8, 2008.
New:
MM6109 Remittance Advice Remark Code and Claim Adjustment Reason Code Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6109.pdf
MM6158 Part B Drug Competitive Acquisition Program (CAP) Quarterly Drug Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6158.pdf
MM6125 Reporting Withholding Due to IRS Federal Payment Levy Program (FPLP) on the Remittance advice http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6125.pdf
MM6131 Implementation of a New Claim Adjustment Reason Code (CARC) No.213. "Non-compliance ith the physician self-referral prohibition legislation or payer policy"
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6131.pdf
MM6124 Revisions to the Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6124.pdf
MM6121 2008 Reminder for Roster Billing and Centralized Billing for Influenza and Pneumococcal Vaccinations http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6121.pdf
End of Listserv Message.
Riverbend GBA Listserv August 19, 2008
Reminder:
The 3rd Quarter “Ask the Contractor Teleconference (ACT)” will be held on Thursday, August 21, 2008, at 2:00 PM EST. To enter the conference, please dial our toll free number 1-877-718-5099.
Please submit any questions (you would like answered on this call) in advance to our GM-Education e-mailbox before August 18, 2008 at: http://www.rgbagov.com/Education/Training/training.do . To type in a question or describe a scenario, please use the box located at the end of the listing labeled “other”. Thank you, and we look forward to your questions and your participation on this call. Riverbend GBA
August 19, 2008
J12 transition of NJ providers from Riverbend GBA to Highmark Medicare Services
To accommodate the J12 transition of NJ providers from Riverbend GBA to Highmark Medicare Services we need to adjust our normal system availability. Starting on Friday August 29th Riverbend system will be unavailable at 5 PM EST through the whole Labor Day Weekend. The system will be available at the normal times starting Tuesday September 2nd at 7 AM EST. This scheduled downtime will affect all Riverbend providers’ access to DDE Processing, and certain IVR functionality. Once the system is available on Tuesday, September 2nd, only the providers not moving to Highmark Medicare Services will be able to access Riverbend’s systems.
For NJ Providers moving to Highmark Medicare Services the cutoff for submitting EDI Claims to Riverbend will be 4 PM EST Friday August 29th. After this cutoff all EDI claims will have to be submitted to Highmark Medicare Services.
August 19, 2008
The following Listserv information is being distributed through Riverbend GBA. Please review to the end of this document for information that may affect your facility.
Information from CMS.
Date: 08/18/2008
Subject: CMS Updates to Coverage Pages
Click the hyperlink to view the full story: CMS Updates to Coverage Pages
Content: Update to Coverage pages for August 18, 2008
HHS Proposes Adoption of ICD-10 Code Sets and Updated Electronic Transaction Standards posed Changes Would Improve Disease Tracking and Speed Transition to an Electronic Health Care Environment
The Department of Health and Human Services (HHS) announced Friday a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10 code sets, effective October 1, 2011. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as health care claims. Version 5010 is essential to use of the ICD-10 codes.
In 2000, under authority provided by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the ICD-9-CM code sets were adopted for use in the administrative transactions by both the public and private sectors to report diagnoses and inpatient hospital procedures. Covered entities required to use the ICD-9-CM code sets include health plans, health care clearinghouses, and health care providers who transmit any electronic health information in connection with a transaction for which a standard has been adopted by HHS.
Developed almost 30 years ago, ICD-9 is now widely viewed as outdated because of its limited ability to accommodate new procedures and diagnoses. ICD-9 contains only 17,000 codes and is expected to start running out of available codes next year. By contrast, the ICD-10 code sets contain more than 155,000 codes and accommodate a host of new diagnoses and procedures. The additional codes will help to enable the implementation of electronic health records because they will provide more detail in the electronic transactions.
Comments on the ICD-10 code sets proposed rule are due by 5:00pm Eastern time on October 21, 2008.
Comments on the updated transaction standards proposed are due by 5:00pm Eastern time on October 21, 2008.
Both regulations may be viewed at w.cms.hhs.gov/TransactionCodeSetsStands/02_TransactionsandCodeSetsRegulations.asp.
To read the HHS press release issued, please click here:
//www.hhs.gov/news/press/2008pres/08/20080815a.html
Fact sheets describing both proposed rules will be forthcoming at ttp://www.cms.hhs.gov/apps/media/fact_sheets.asp.
Department of Health & Human Services Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mail Stop S3-02-01
Baltimore, Maryland 21244-1850
Office of Clinical Standards and Quality
Dear Renal Community:
The Centers for Medicare & Medicaid Services (CMS) will be hosting a series of End-Stage-Renal-Disease Stakeholder Meetings to discuss the End-Stage-Renal-Disease (ESRD) Network (NW) Program. The purpose of these meetings is to provide an opportunity for interested stakeholders to provide vital input and recommendations on the program moving forward.
The Office of Clinical Standards and Quality (OCSQ), is currently conducting an evaluation of the ESRD NW program. The results and recommendations developed from the evaluation will provide the steps to improving the program. OCSQ recognizes this assessment is essential to moving the program forward to meet the present needs and demands of Medicare beneficiaries in the rapidly growing field of end stage renal disease. As well as, transitioning the program to achieve even greater strength in the following areas:
Value
Attribution
Oversight
Improved Outcomes
Since 2006, OCSQ has been engaged in redesigning the QIO program. The redesign efforts have been essential in developing the framework for the new contract period. These changes are captured in the recently released 9th SoW Request for Proposal (RFP). The changes are not limited to only the RFP documents. Change extends to several other areas as well, including the principles under which the scope of work is developed, fundamental methods of contracting, (including methods of contract awards), and, especially, contract evaluation and monitoring. Our goal is to apply these concepts to the ESRD NW program. We welcome your feedback during the stakeholder meetings to discuss how these changes can be applied to the program.
These meetings will occur during the months of August and September 2008. We will conduct five separate meetings targeted for the following groups:
|
Stakeholder |
Date |
Location |
|
CMS ESRD NW Contractors |
8/28/08 |
CMS Quality-Net Conference |
|
ESRD Advocates / Patients |
9/4/08 |
Centers for Medicare & Medicaid Services |
|
CMS ESRD NW Contractors |
9/16/08 |
Web-Ex Conference |
|
ESRD Providers / Facilities |
9/11/08 |
Centers for Medicare & Medicaid Services |
|
ESRD Researchers
|
9/19/08 |
Centers for Medicare & Medicaid Services |
Each meeting will be a participatory dialogue focused on key questions; we encourage you to review the materials in advance of each meeting and come prepared to share your feedback and recommendations during the dialogue session at the meeting. To assist you in determining the appropriate representatives, we have enclosed the agendas and questions for each stakeholder session.
For the meetings held at CMS Headquarters in the Multipurpose Room, we must limit participants to four individuals from your organization who can communicate quality insights that your organization can contribute. You may access up-to-date information on these meetings at http://esrdncc.org, under the section titled “Events”. All participants must register at
ESRDNW_StakeholderMeeting2008@cms.hhs.gov, in order to attend.
I look forward to these meetings and how we can work collectively in improving the quality of care for Medicare beneficiaries. If you have questions regarding these meetings, please contact Cheryl Bodden at (410) 786-6875, Cheryl.Bodden@cms.hhs.gov
Sincerely,
Barry M. Straube, M.D.
CMS Chief Medical Officer
Director, Office of Clinical Standards and Quality
Centers for Medicare & Medicaid Services
LOWER MEDICARE PART D COSTS THAN EXPECTED IN 2009 Beneficiary Satisfaction Remains High
The Centers for Medicare & Medicare Services (CMS) recently announced that as Medicare’s Part D prescription drug program enters its fourth year, beneficiary satisfaction rates remain high, program costs remain lower than originally expected, and Medicare prescription drug plan bids reflect nationwide drug price trends. Based on the bids submitted by Part D plans, CMS estimates that the average monthly premium that beneficiaries will pay for standard Part D coverage in 2009 will be $28. This is about 37 percent lower than originally projected when the benefit was established in 2003.
The estimated average monthly premium for 2009 of roughly $28 for basic coverage is far below the original estimate for 2009 of $44.12, which was made at the time the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) was enacted in 2003. The average expected premium for basic coverage in 2009 is about $3 higher than the actual average for 2008. The $3 premium increase is due to general trends in drug costs, the phase-out of a CMS demonstration project, and higher plan estimates for catastrophic coverage based on prior experience.
In addition to average premiums for 2009, CMS has announced: the 2009 national average monthly bid; the base beneficiary premium; the regional low-income subsidy premium amounts for 2009; and the 2009 Medicare Advantage regional preferred provider organization benchmarks. These data can be found at: http://www.cms.hhs.gov/MedicareAdvtgSpecRateStats/RSD/list.asp
To read the CMS Press release issued on August 14, 2008, go to: http://www.cms.hhs.gov/apps/media/press_releases.asp
Pricer Updates
The provider data distributed with the IPF PPS PC Pricer has been updated as of July 2008. The RY2008 IPF PPS PC Pricer on the web page: http://www.cms.hhs.gov/PCPricer/09_inppsy.asp, under “Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) PC PRICER,” has been updated with the latest provider data. If you use the IPF PPS PC Pricer, please go to the page above and download the latest version of the IPF PPS PC Pricer posted 08/12/2008.
Due to receiving updated quarterly provider data, the SNF PPS PC Pricer has been revised. See the FY 2008.2 SNF PPS PC Pricer on the web page, http://www.cms.hhs.gov/PCPricer/04_SNF.asp, under the “Downloads” section. If you use the FY 2008.2 SNF PPS PC Pricer, please go to the page above and download the latest version of the PC Pricer.
Upcoming Training for the Medicare Part B Drugs Competitive Acquisition Program (CAP)
Noridian Administrative Services, the designated carrier for the CAP, offers interactive, online workshops about the CAP for Part B Drugs and Biologicals. These workshops train CAP vendors and elected physicians on a variety of CAP topics, and NAS staff can also answer questions. Interested parties may view additional information about and register for these workshops at https://www.noridianmedicare.com/cap_drug/train/workshops/index.html
An upcoming workshop will be held on the following date:
8/21/08 at 2:00PM CST
Article MM6139 was initially posted on Aug 12th and updated the following day and, so, appears as both New and Revised because the revision occurred before we could post the article as new.
Paul
New:
MM6129 New Requirement for Ordering/Referring Information on Ambulatory Surgical Center (ASC) Claims for Diagnostic Services
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6129.pdf
MM6126 Fiscal Year (FY) 2006 Supplemental Security Income (SSI) Data
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6126.pdf
MM6139 Implementation of New Provider Authentication Requirements for Medicare Contractor Provider Telephone and Written Inquiries
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6139.pdf
MM5849 Transition of Responsibility for Medical Review from Quality Improvement Organizations (QIOs)
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5849.pdf
Revised:
MM6139 Implementation of New Provider Authentication Requirements for Medicare Contractor Provider Telephone and Written Inquiries
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6139.pdf
The next CMS Hospital/Hospital Quality Open Door Forum scheduled for…
Date: August 28, 2008
Start Time: 2:00 PM Eastern Daylight Time (EDT)
Please dial-in at least 15 minutes before call start time.
Conference Leader(s): Jeffrey Rich, M.D./Charlotte Yeh, M.D./Natalie Highsmith
Open Door Participation Instructions:
There are 2 ways to participate, by phone or onsite.
1. To participate by phone:
Dial: 1-800-837-1935 & Reference Conference ID 55465422
Persons participating by phone do not need to RSVP.
Note: TTY Communications Relay Services are available for the Hearing Impaired.
or TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click
here http://www.consumer.att.com/relay/which/index.html .
A Relay Communications Assistant will help.
2. To participate onsite:
Your RSVP is required. Please send a reply to CMS HOSPITALODF-L@cms.hhs.gov
by 2:00 PM EDT, August 26, 2008. Be sure to include the title of the forum
Hospital/Hospital Quality" in the subject line of your message, and send us your
ame, organization/representation and telephone number.
Please arrive no later than 1:30 PM.
ADDRESS:
Hubert H. Humphrey Bldg.
200 Independence Avenue S.W.
Washington, D.C. 20201
Map & Directions: http://www.hhs.gov/about/hhhmap.html
ENCORE: 1-800-642-1687; Conf. ID# 55465422
Encore is an audio recording of this call that can be accessed by dialing 1-800-642-1687 and entering the Conf. ID. This recording will be accessible beginning Tuesday, September 2, 2008 and will expire after for 3 business days.
For Forum Schedule updates, Listserv registration and Frequently Asked Questions please visit our website at www.cms.hhs.gov/OpenDoorForums/.
Thank you.
End of Listserv
The following Listserv information is being distributed through Riverbend GBA. Please review to the end of this document for information that may affect your facility.
Riverbend GBA Closed September 1, 2008 – Payment cycle changes
Riverbend Government Benefits Administrator will be closed on September 1, 2008 in recognition of Labor Day. As a result, there will be some changes to our normal payment cycle.
For the week ending September 5, there will be 2 payment runs: September 3 and September 5, 2008.Remittance advices will be mailed on Friday September 5, 2008. For the week ending September 12, we will resume with our normal payment cycle with a payment run on September 8, 2008.
New:
MM6109 Remittance Advice Remark Code and Claim Adjustment Reason Code update http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6109.pdf
M6158 Part B Drug Competitive Acquisition Program (CAP) Quarterly Drug Update
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6158.pdf
MM6125 Reporting Withholding Due to IRS Federal Payment Levy Program (FPLP) on the Remittance Advice http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6125.pdf
MM6131 Implementation of a New Claim Adjustment Reason Code (CARC) No.213. "Non-compliance with the physician self-referral prohibition legislation or payer policy"
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6131.pdf
MM6124 Revisions to the Competitive Acquisition Program (CAP) for Part B Drugs and Biologicals http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6124.pdf
MM6121 2008 Reminder for Roster Billing and Centralized Billing for Influenza and Pneumococcal Vaccinations
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6121.pdf
End of Listserv Message.
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