All Fee-For-Service Providers

Spotlights

• National Provider Call: Getting Started with PQRS Reporting: Implications for the Value-based Payment Modifier- — Registration Now Open 

  Target Audience: Physicians, physician group practices, practitioners, therapists, practice managers, medical and specialty societies, payers, insurers.

  Date: Wednesday June 5; 1:30-2:30pm ET

  This National Provider Call will cover how to obtain an Individuals Authorized Access to the CMS Computer Services (IACS) account in order for (1) physician group practices to select their CY 2013 Physician Quality Reporting System (PQRS) Group Reporting Mechanism, and if applicable, elect quality tiering to calculate their CY 2015 Value-based Payment Modifier; and (2) individual eligible professionals to select the Administrative Claims reporting mechanism for CY 2013.  A question and answer session will follow the presentation.

  Registration Information: In order to receive call-in information, you must register for the call on the CMS Upcoming National Provider Calls registration website.

• Learn about the Medicare Shared Savings Program application process for the January 1, 2014 program start date. Register for upcoming National Provider Calls on June 20 and July 18.

• National Provider Call: National Physician Payment Transparency Program (Open Payments) - What You Need To Know — Registration Now Open - Target Audience:  Physicians & Teaching Hospitals

  Date: Wednesday, May 22; 2:30-4pm ET

  The National Physician Payment Transparency Program (Open Payments) requires manufacturers of pharmaceuticals or medical devices to publically report payments made to physicians and teaching hospitals, creating greater transparency around the financial relationships that occur among them.

  Registration Information:  In order to receive call-in information, you must register for the call on the CMS Upcoming National Provider Calls registration website. 

• Revised Fact Sheet for Referral Agents - Where are the Round 2 areas?  What if a beneficiary travels? What do you need to know before prescribing a DMEPOS item or referring the beneficiary to a DMEPOS supplier? Want more information on the national mail-order program for diabetic testing supplies?

  For answers to these questions and more, see the revised “Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program: Referral Agents” Fact Sheet (ICN 900927), which is now available in downloadable format. 

• Information for people who refer Medicare beneficiaries for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). The DMEPOS Competitive Bidding Program is how some Medicare patients get covered supplies. Be sure to give your Medicare patients the correct information.
  
  

• Temporary Delay in Implementing Ordering and Referring Denial Edits 
  Due to technical issues, implementation of the Phase 2 ordering and referring denial edits is being delayed. These edits would have checked the following claims for an approved or validly opted-out physician or non-physician who is an eligible specialty type with a valid individual National Provider Identifier (NPI). If either of these were missing or incorrect, claims would deny.  

  • Medicare Part B claims from laboratories, imaging centers and Durable Medical Equipment, Orthotics, and Supplies (DMEPOS) that have an ordering or referring physician/non-physician provider; and  
  • Part A Home Health Agency (HHA) claims that require an attending physician provider. 

  CMS will advise you of the new implementation date in the near future. In the interim, informational messages will continue to be sent for those claims that would have been denied had the edits been in place.  For more information, see the revised article SE1305 – Full Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DME, and Part A Home Health Agency (HHA) Claims.

• Follow us on Twitter!  CMS has added the social media site Twitter to our communication and outreach program. Our main goal is to reach providers, suppliers, health professionals, and others interested in current and up-to-date information on the Medicare Fee-For-Service program. Messages on Twitter will include updates to rules & regulations, MLN products, notices of upcoming National Provider Calls, new web postings, and more.

• Follow us at http://twitter.com/cmsgov and search the following hash tags:

  • #CMSMLN for all MLN tweets,
  • #CMSNPC for all National Provider Call tweets, or
  • #MLNProducts for all tweets related to MLN products.
    
•  The Provider Call Center Toll Free Number Directory information can now be found in the Provider Compliance Interactive Map at: http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/provider-compliance-interactive-map/index.html.
  

Medicare FFS e-News Spotlights

• • Subscribe now to receive the weekly CMS Medicare FFS Provider e-News for the latest Fee-For-Service program information, event announcements (including National Provider Call announcements), claims and pricer information, and MLN educational product updates.