- MLN Connects Provider eNews for May 19, 2016
- Part C Appeals: Organization Determinations, Appeals, and Grievances WBT — Revised
- Part D Coverage Determinations, Appeals, and Grievances WBT — Revised
- Resources for Medicare Beneficiaries Booklet — Revised
- How to Use the Searchable Medicare Physician Fee Schedule Booklet — Revised
- Updated MLN Matters® Search Indices
- 2017 Medicare Shared Savings Program: Notice of Intent to Apply Period Closes May 31
- SNF Value-Based Purchasing Program: Specifications for New Measure
- 2014 PQRS Experience Report Available
- How to Use ICD-10 and Maintain Your Progress
- Talk to Your Patients about Mental Health
Audio recordings and transcripts are available for the following events:
- April 28 — National Partnership to Improve Dementia Care and QAPI Call: audio recording and transcript. This call focuses on infection control, highlighting Antibiotic Stewardship and community-wide efforts. CMS subject matter experts share information about the upcoming Infection Control Pilot Project, as well as updates on the progress of the National Partnership and Quality Assurance and Performance Improvement (QAPI).
- May 4 — How to Register for the 2016 PQRS Group Practice Reporting Option Call: audio recording and transcript. This call gives a walkthrough of the Physician Value - Physician Quality Reporting System (PV-PQRS) Registration System. Learn how to meet the satisfactory reporting criteria through the PQRS Group Reporting Option and avoid the CY 2018 PQRS payment adjustment and Value Modifier automatic downward payment adjustment.
Wednesday, June 8 from 3 to 4:30 pm ET
Join CMS for an informative discussion of the comparative billing report on Psychotherapy and Evaluation and Management (E/M) Services (CBR201607), an educational tool for psychiatry providers who bill psychotherapy Current Procedural Terminology (CPT) codes with and without a corresponding E/M code. During the webinar, providers will interact directly with content specialists and submit questions about the report. See the announcement for more information and find out how to participate.
With Continuing Education Credit
A revised Part C Appeals: Organization Determinations, Appeals, and Grievances Web-Based Training (WBT) course is available through the Learning Management and Product Ordering System. Learn about:
- Medicare Part C Appeals
- Basic definitions of terms related to Part C organization determinations, appeals, and grievances
- Requirements for organization determinations
- Common problems encountered by plans
With Continuing Education Credit
A revised Part D Coverage Determinations, Appeals, and Grievances Web-Based Training (WBT) course is available through the Learning Management and Product Ordering System. Learn about:
- Medicare Part D Appeals
- Basic definitions of terms related to Part D coverage determinations, appeals, and grievances
- Requirements for appeals, effectuation, and grievances
A revised Resources for Medicare Beneficiaries Booklet is available. Learn about resources providers can use to answer beneficiaries' questions on:
- Medicare, Medicare supplements, and other insurance
- Medical expenses and basic needs
- Long-term care
- Informed decisions, rights and protections, notices, and forms
- Fraud, waste, and abuse
A revised How to Use the Searchable Medicare Physician Fee Schedule Booklet is available. Learn about:
- Navigating the Medicare Physician Fee Schedule
- Searching for payment information
- Pricing, Relative Value Units
- Payment policies
Updated MLN Matters Articles search indices are available in the “Downloads” section of the MLN Matters Articles webpage. Search the lists by specific keywords and topics. You can also search the MLN Matters archive by year on the left side of the webpage. Subscribe to the electronic mailing list to find out when new and revised MLN Matters articles are released.
The Medicare Shared Savings Program Notice of Intent to Apply (NOIA) period is open for the January 1, 2017, program start date. The NOIA is available for:
- Accountable Care Organizations (ACOs) not currently participating in the program (initial applicants)
- Currently participating ACOs with a 2014 start date intending to renew their agreement (renewing applicants)
- Currently participating ACOs in or applying to the program under Track 3 (two-sided risk model) that intend to apply for the Skilled Nursing Facility (SNF) 3-Day Waiver
The NOIA period closes at 5 pm ET on May 31. If you intend to apply to the Medicare Shared Savings Program and/or the SNF 3-Day Waiver for 2017, you must submit an NOIA. An NOIA submission does not bind your organization to submit an application.
Plan to apply?
Submit form CMS-20037 (Application for Access to CMS Computer Systems) to obtain your CMS User ID as soon as possible using the link and instructions provided in your NOIA confirmation email. The final deadline is Friday, June 3. Mail your completed form to CMS via tracked mail (FedEx, UPS, etc.) to: Attention: HPMS Access, Centers for Medicare & Medicaid Services, 7500 Security Blvd, Mailstop C4-18-13, Baltimore, MD 21244.
For information on the NOIA submission and application process, visit the How to Apply webpage and see Step 1.
Specifications for the proposed Skilled Nursing Facility (SNF) 30-Day Potentially Preventable Readmission Measure from the FY 2017 SNF PPS proposed rule are available. CMS will accept comments on the proposed rule until June 20. For more information, visit the SNF Value-Based Purchasing webpage.
CMS released the 2014 Physician Quality Reporting System (PQRS) Experience Report. This annual report provides data and trends on participation, incentive eligibility, incentive payments, and payment adjustments. Report highlights include:
- 1.32 million professionals were eligible to participate in PQRS in 2014
- Participation increased by 11 percent in 2014 from 2013
- Participation via electronic health record more than doubled in number since 2013
- 558,885 eligible professionals are currently subject to the 2016 PQRS negative payment adjustment
- Participation in PQRS Group Practice Reporting Option had a large increase in 2014 compared to 2013
- The 2014 PQRS incentive payments paid equaled $224,088,411
Visit the Analysis and Payment webpage for more information.
CMS developed two infographics to help you continue to use ICD-10 successfully:
- Use ICD-10 Now: Offers useful information about coding in ICD-10 and gives a quick reference to helpful ICD-10 resources.
- Next Steps: Based on the Next Steps Toolkit, it can help you analyze ICD-10 progress. Track and compare key performance indicators to assess progress, address findings, and maintain progress.
Visit the ICD-10 website and Roadto10.org for the latest news and official resources, including the Quick Start Guide and a contact list for provider Medicare and Medicaid questions.
Mental Health Month raises awareness about mental health conditions and the importance of good mental health for everyone. Medicare covers several preventive services to help monitor your patients’ mental health, including the Initial Preventive Physical Examination, Annual Wellness Visit, and depression screening.
For More Information:
- Medicare Preventive Services Educational Tool
- Initial Preventive Physical Examination Educational Tool
- Annual Wellness Visit Educational Tool
- Centers for Disease Control and Prevention Mental Health and Aging website
- Mental Health America website
Visit the Preventive Services website to learn more about Medicare-covered services.