Friday, November 19th, 2010
…. Discussions Continue on SGR Relief for all of 2011.
On November 18, Senate Majority Leader Harry Reid reached agreement with Senate Minority Leader Mitch McConnell on a unanimous consent request for a 31-day reprieve from the 23 percent Medicare physician payment cut scheduled to take effect on December 1. This move is a necessary first step to avoid a disruption in payments while Congressional leaders continue to seek funding offsets for legislation that will stabilize Medicare physician payments through 2011. Because the Congress is adjourning for a Thanksgiving recess, final action on the 31-day extension in the House cannot take place until Congress reconvenes the week of November 29.
Thank you: The success of the grassroots effort stems from all of our efforts working together! Delivering a strong, common message is the key to future success on all of medicine’s agenda. Don’t stop now! Keep up the pressure to secure a permanent fix for SGR relief. Physicians are again urged to contact Senators Schumer and Gillibrand as well as their respective House Representative to thank them for this temporary help AND ask them to work towards a permanent fix of the SGR. Physicians may contact their federal legislators through the AMA’s toll-free grassroots hotline at (800) 833-6354.
Moving Medicine Forward: A thirty day extension is not the final word. Physicians should not experience a repeat of 2010 with “patches” that last only a few months, creating uncertainty and disruption for physician practices. We will continue to press Congress to pass additional legislation before it adjourns next month to eliminate the threat of SGR cuts for all of 2011.
SGR is important, but the AMA is working hard to help physicians on several other fronts. Earlier this week, Dr. Ardis Hoven, AMA Chair, and Dr. Cecil Wilson were joined by colleagues from other physician organizations to meet with senior Obama Administration officials to improve opportunities for physician led organizations to participate and prosper in emerging new payment models. AMA staff in Chicago and Washington continue to advance AMA policy in regulations under development to implement the Affordable Care Act.
We are moving forward to help physicians and their patients!
Thursday, November 18th, 2010
National Government Services has launched an all-new Web application aimed at providers and offering access to a wide array of Medicare information.
Called Connex, the application will help answer questions, address Medicare issues, assist you in solving problems, and guide you to business forms.
Connex offers superior search capabilities that make it fast and easy for you to find the information you seek without having to place calls to the National Government Services Provider Contact Center. Centralized data housed within Connex ensures quick information retrieval and consistency.
Connex is available to you now at www.NGSConnex.com. As a provider selected to help test the system, you have full access to all of the site’s features. Registering to use Connex is simple and totally free. To begin, simply log on to the Connex site and click the “New User” link. You must designate a local security officer (LSO) for your organization (two is better) before anyone can access data for your provider accounts in Connex. You’ll find more information about LSOs and the registration process at the FAQ link on the Connex home page.
Questions or issues related to technical issues should be directed to the National Government Services Provider Contact Center by dialing (866) 837-0241 for Jurisdiction 13, Part B. Once you leave the CTI application, which has a male voice, you will hear a female voice announcement. During this female voice announcement, press 5. Do not wait until after the announcement is finished. Please do not respond to this e-mail.
A Rules of Behavior Document, Quick Steps Job Aid, and Connex training materials are available on the log-in screen of Connex. We recommend you review these documents prior to registering in the application.
NGSConnex.com is currently compatible with the following operating system/browser combinations:
|Client Operating System||Internet Explorer*
|Netscape 7.02||Firefox 2.0||Firefox 3.0–;
|Microsoft Windows 98||X||X||X||X||X|
|Microsoft Windows ME||X||X||X||X|
|Microsoft Windows NT 4.0||X||X||X||X||X|
|Microsoft Windows 2000||X||X||X||X||X|
|Microsoft Windows XP||X||X||X||X|
|Microsoft Windows Vista||X||X||X||X|
|Microsoft Windows 2003||X||X||X||X|
* Note to Internet Explorer (IE) Users: When accessing the www.NGSConnex.com application home page, if you receive a Page Cannot Be Displayed error, please follow these steps:
Friday, November 12th, 2010
*Classified Ad (Members)……………………………………………………$25.00 per 30 days
*Classified Ad (Non-members)………………………………………… $50.00 per 30 days
Fee must accompany advertisement. checks payable to Nassau County Medical Society
All advertising copy is subject to the approval of the publisher and acceptance of advertising does not imply endorsement and/or approval of a vendor’s products or services as a member benefit. Advertising which simulates editorial content must carry the word “advertisement”.
Although NCMS believes the classified advertisements in this section to be from reputable sources. The NCMS does not investigate the offers made and assumes no responsibility concerning them:
Mail all advertising orders to: NCMS Advertising
Nassau County Medical Society
1200 Stewart Ave.
Garden City, NY 11530
E-mail with attachment to: email@example.com
Questions: call 516-832-2300 xt 13
Thursday, November 11th, 2010
Dear Hospital Chief Executive Officer and President of the Medical Staff:
As you may know, The Joint Commission recently approved revisions to hospital accreditation Standard MS.01.01.01 (formerly MS.1.20), which will take effect April 1, 2011. The revisions were developed by an implementation task force convened by The Joint Commission that included representatives from the American College of Physicians, American College of Surgeons, American Dental Association, American Hospital Association (AHA), American Medical Association (AMA), Federation of American Hospitals and National Association of Medical Staff Services. All of the organizations involved support the new standard.
The purpose of this joint letter is to recognize that achieving compliance with the new standard will require that hospitals, their governing boards, and their medical staffs examine their current bylaws and related documents, determine if any changes need to be made, and work together to make those changes in a reasonable timeframe.
Feedback received from many hospitals and medical staffs during the public comment period preceding adoption of the new standard indicated that many believed that their current bylaws and related documents met the standard, while others found they would likely need to make modest modifications.
If your organization is among those that need to implement more substantive changes, it will be important for the medical staff to initiate the proposed changes soon so that they can be reviewed through the entire process and be in place the first time the hospital is surveyed by The Joint Commission after April 1, 2011. To help, The Joint Commission has made available through its website more information and a Frequently Asked Questions document to provide further detail.
The Joint Commission’s deadline is sufficiently close that it may put some pressure on both hospital and medical staff leadership to act expeditiously. Despite the need for quick action, this process and the quality and safety of care provided to our patients will benefit from clear expressions of mutual respect and an appreciation of the need for collaboration among your organization’s leadership groups.
Richard J. Umbdenstock Michael D. Maves, MD MBA
President and CEO Executive Vice President, CEO
American Hospital Association American Medical Association
Tuesday, November 9th, 2010
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that incentive payments for the 2009 Electronic Prescribing (eRx) Incentive Program were made to eligible professionals who met the criteria for successful reporting.
The 2009 eRx incentive payments are currently being processed and distributed by Carriers and Medicare Administrative Contractors (MACs). Distribution of the 2009 eRx incentive payments were completed by October 22, 2010.
E-prescribing incentives earned by individual participating physicians and other eligible professionals are paid as a lump-sum to the Taxpayer Identification Number (TIN) under which the EP’s claims were submitted. It is then up to the TIN to decide how to distribute the incentive within the practice.
Effective January 2010, CMS revised the manner in which incentive payment information is communicated to eligible professionals receiving electronic remittance advices. CMS has instructed Medicare contractors to use a new indicator of LE to indicate incentive payments instead of LS. LE will appear on the electronic remittance advice. Additionally the paper remittance advice will read “This is an eRx incentive payment.” It will not include the year and indicator LE in the paper remittance. In an effort to further clarify the type of incentive payment issued (either PQRI or eRx incentive), CMS created a 4-digit code to indicate the type of incentive and reporting year. For the 2009 eRx incentive payments, the 4-digit code is RX09. This code will be displayed on the electronic remittance advice along with the LE indicator. For example, eligible professionals will see LE to indicate an incentive payment, along with RX09 to identify that payment as the 2009 eRx incentive payment.
2009 Electronic Prescribing (eRx) Incentive Program Feedback Reports
The 2009 eRx feedback reports will be available on the Physician and Other Health Care Professionals Quality Reporting Portal at http://www.qualitynet.org/pqri on the internet, starting the second week of November. TIN-level reports on the Portal require an Individuals Authorized Access to CMS Computer Services (IACS) account. Participants may also contact their Carrier or MAC to request individual NPI-level reports via an alternate feedback report fulfillment process, please visit http://www.cms.gov/MLNMattersArticles/downloads/SE0922.pdf on the CMS website.
Who to Contact for Questions?
If you have questions about the status of your eRx incentive payment (during the distribution timeframe), please contact your Provider Contact Center. The Contact Center Directory is available at http://www.cms.gov/MLNProducts/Downloads/CallCenterTollNumDirectory.zip on the CMS website.
Feel free to contact the QualityNet Help Desk with any of the following:
<![if !supportLists]>· <![endif]>Physician Quality Reporting Initiative (PQRI) Portal password issues
<![if !supportLists]>· <![endif]>PQRI/eRx feedback report availability and access
<![if !supportLists]>· <![endif]>PQRI-IACS registration questions
<![if !supportLists]>· <![endif]>PQRI-IACS login issues
The QualityNet Help Desk is available Monday through Friday from 7:00 a.m. – 7:00 p.m. CST at 1-866-288-8912 or via firstname.lastname@example.org on the internet. The QualityNet Help Desk is also available to assist with PQRI and eRx measure-specific questions.
Monday, November 8th, 2010
Please Note: The following educational activity is jointly sponsored by National Government Services and the University of Kentucky (UK) HealthCare CECentral.
Do you order laboratory tests, radiology services, other types of diagnostic tests, diabetes self management training, medical nutrition therapy or durable medical equipment or supplies?
If the answer is yes, your National Provider Identifier (NPI) is entered on claims sent to Medicare as an ordering/referring physician. Beginning January 3, 2011 when those claims reach your Medicare contractor and the NPI entered as the ordering/referring is not in the Provider Enrollment, Chain and Ownership System (PECOS) those claims will reject and not be paid.
If you order or refer items or services for Medicare beneficiaries and you do not have an enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS), you need to submit an enrollment application to Medicare.
The fastest, easiest way to enroll is through the Internet-based PECOS. To learn more about the January 3, 2011 deadline review the Centers for Medicare & Medicaid Services Medicare Learning Network (MLN) Matters Special Edition article SE1011.
Please visit the UK CECentral Web site at http://www.cecentral.com/ and type PECOS in the search field to locate a 45-minute course that will help get you prepared for secure, online enrollment. This activity has been approved for AMA PRA Category 1 Credits™. Thank you,
National Government Services, Inc.
If you want to update your profile or unsubscribe from any of our lists, you will first need to set up a password for your account. To do this, click on the Login link from the Listserv page on the www.NGSMedicare.com Web site, then select one of the following:
Wednesday, November 3rd, 2010
|For Immediate Release:||Tuesday, November 02, 2010|
|Contact:||CMS Office of Public Affairs
FINAL 2011 POLICY, PAY CHANGES IN MEDICARE PHYSICIAN FEE SCHEDULE
The Centers for Medicare & Medicaid Services (CMS) issued a final rule with comment period on Nov. 2, 2010 that updates payment policies and Medicare payment rates under the Medicare Physician Fee Schedule (MPFS) for physicians’ services furnished in CY 2011. In addition to payment policy and payment rate updates, the MPFS addresses a number of provisions of the Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the “Affordable Care Act”). Although most of the provisions included in the final rule directly affect payments provided under the MPFS, the rule also addresses a number of policies that are not directly related to this payment system.
Since 1992, Medicare has paid for the services of physicians, NPPs, and certain other suppliers under the MPFS, a system that pays for covered physicians’ services furnished to a person enrolled under Medicare Part B. Under the MPFS, in general, a relative value is assigned to each of more than 7,000 services to capture the amount of work, the direct and indirect (overhead) practice expenses, and the malpractice insurance expenses typically involved in furnishing the service. The higher the number of relative value units (RVUs) assigned to a service, the higher the payment. The RVUs for a particular service are multiplied by a fixed-dollar conversion factor and a geographic adjustment factor to determine the payment amount for each service.
Affordable Care Act Provisions INCLUDED IN THE CY 2011 MPFS FINAL RULE
Primary Care & Prevention
CMS has developed two separate Level II HCPCS codes for the first annual wellness visit (G0438 – Annual wellness visit, including personalized prevention plan services, first visit), to be paid at the rate of a level 4 office visit for a new patient (similar to the IPPE), and for subsequent annual wellness visits (G0439 – Annual wellness visit, including personalized prevention plan services, subsequent visit), to be paid at the rate of a level 4 office visit for an established patient.
In the final rule with comment period, CMS excluded consideration of allowed charges for hospital inpatient care and emergency department visits in determining whether the 60 percent primary care threshold is met. These exclusions will make it easier for providers in rural areas to become eligible for the payment incentive program. The incentive payments will be made quarterly based on the primary care services furnished in CY 2011 by the primary care practitioner, in addition to any physician bonus payments for services furnished in Health Professional Shortage Areas (HPSAs).
CMS will determine a practitioner’s eligibility for incentive payments in CY 2011 using claims data and the provider’s specialty designation from CY 2009 for practitioners enrolled in CY 2009. For newly enrolled practitioners, CMS will use claims data from CY 2010 to make an eligibility determination regarding CY 2011 incentive payments. For subsequent years, CMS will revise the list of primary care practitioners on a yearly basis, based on updated data regarding an individual’s specialty designation and percentage of allowed charges for primary care services.
The Affordable Care Act establishes a permanent 1.0 floor for the PE GPCI for frontier states (currently, Montana , Wyoming , Nevada , North Dakota , and South Dakota ). The Affordable Care Act limits recognition of local differences in employee wages and office rents in the PE GPCIs for CYs 2011 and 2012 as compared to the national average. Localities are held harmless for any decrease in CYs 2011 and 2012 in their PE GPCIs that would result from the limited recognition of cost differences. CMS will continue to review the GPCIs in CY 2011, in accordance with the Affordable Care Act provision that requires the Secretary of Health and Human Services to analyze current methods of establishing PE GPCIs in order to make adjustments that fairly and reliably distinguish the costs of operating a medical practice in the different fee schedule areas.
Improving Payment Accuracy
In addition, the Affordable Care Act eliminates the lump sum (up-front) purchase payment option for standard power-driven wheelchairs. CMS has revised the regulations to conform to this new requirement, which permits payment only on a monthly rental basis for standard power-driven wheelchairs effective for items furnished on or after Jan. 1, 2011. For complex rehabilitative power-driven wheelchairs, the regulations continue to permit payment to be made on either a lump sum purchase method or a monthly rental method.
The Affordable Care Act also specifies that these changes do not apply to payments made for power-driven wheelchairs furnished pursuant to contracts entered into prior to Jan. 1, 2011 as part of the Medicare DMEPOS competitive bidding program.
The final rule with comment period will appear in the Nov. 29, 2010, Federal Register. CMS will accept comments on certain aspects of the final rule with comment period until Jan. 3, 2011, and will respond to them in a final rule to be issued on or about Nov. 1, 2011 that sets forth the policies and payment rates effective for services furnished to Medicare beneficiaries on or after Jan. 1, 2012.
For more information, see: www.federalregister.gov/inspection.aspx#special
# # #
Tuesday, November 2nd, 2010
Call this number for your enrollment status, for assistance with the CMS-855 form, or with other enrollment-related questions.
Please be prepared with all of your information when you call so we can help answer your questions and solve your problems. We look forward to hearing from you.
James D. Bavoso
Provider Outreach & Education
National Government Services
50 Broadway, Suite 103
Hawthorne, NY 10532
PROVIDERS did you know that you can now get eligibility and claims status from our Connex website free of charge? Log onto NGSConnex.com today and sign up to access your information on line.
Have your voice heard—complete the survey when it is presented on the www.NGSMedicare.com Web site so we can make your job easier!
PECOS Web – your ticket to fast, secure, online enrollment: https://pecos.cms.hhs.gov
Monday, November 1st, 2010
National Government Services is enhancing the NGSMedicare.com Web site with an all-new look, improved usability, and greater flexibility.
Users will find visual changes in the site’s navigation platform and will have new options to help guide their site experience, including:
Breadcrumb Navigation: The breadcrumb navigation is located above the Quick Links and tracks the path you follow as you navigate our site. (Refer to figure, item 1)
Primary Top Global Navigation: The primary top navigation menu appears next to the breadcrumb navigation and is available on almost all pages of the Web site. The top navigation offers immediate access to frequently used and requested site tools, resources, and information. The top navigation menu for all lines of business includes: Home, Resources, Enrollment, and FAQs. (Refer to figure, item 2)
Expandable/Collapsible Primary Left Global Navigation: The left navigation is located below the Quick Links area and is available on almost all pages of the Web site. The primary navigation serves two purposes (refer to figure, item 3):
It operates as the site’s primary global navigation menu, and it illustrates where the page is located, in context with other pages, on a continuous basis
Secondary Navigation: The secondary navigation for all lines of business is located under the primary navigation and is available on almost all pages of the Web site. To access the site’s secondary navigation simply click on the name of the secondary navigation link. (Refer to figure, item 4)
Footer Navigation: The site’s global footer navigation consists of two lines and includes access to (refer to figure, item 5):
Line 2: People with Medicare and Congressional Offices
Watch for additional communications on these exciting enhancements to the NGSMedicare.com site.
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