- MLN Connects for May 4, 2017
- DMEPOS Revised Blended Fee Schedule Amounts
- TEP on SNF QRP Development and Maintenance of Quality Measures: Nominations due May 12
- 2018 Medicare Shared Savings Program: Submit Notice of Intent to Apply by May 31
- MIPS: Submit Measures for the Advancing Care Information Performance Category by June 30
- Hospice Item Set V2.00.0 Receives OMB Approval
- EHR Incentive Programs: Review 2017 Program Requirements
- Hand Hygiene Day is May 5
- Medicare Shared Savings Program Call: Audio Recording and Transcript — New
- Medicare Fraud & Abuse: Prevention, Detection, and Reporting Web-Based Training Course — Revised
- Medicare Ambulance Transports Booklet — Revised
- Looking for the Latest National Medicare Policy Information?
Section 16007(a) of the 21st Century Cures Act
Information on the revised blended fee schedule payment amounts and adjustments for July through December 2016 required by Section 16007(a) of the 21st Century Cures Act is available on the Durable Medical Equipment, Prosthetics/Orthotics & Supplies (DMEPOS) Fee Schedule webpage.
Nominations are due May 12 for a Technical Expert Panel (TEP) to obtain input on currently implemented Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) measures and areas for future measure development in support of CMS quality missions. Visit the Technical Expert Panels webpage for more information.
CMS is accepting Notices of Intent to Apply (NOIA) for the January 1, 2018 start date. You must submit a NOIA if you intend to apply to the Medicare Shared Savings Program, Skilled Nursing Facility 3-Day Rule Waiver, and/or Medicare Accountable Care Organization Track 1+ Model. NOIA submissions are due no later than May 31, 2017, at noon ET.
A NOIA submission does not bind an organization to submit an application; however, you must submit a NOIA to be eligible to apply. See the NOIA Guidance Document and How to Apply webpage for eligibility requirements and detailed instructions on the submission process.
CMS encourages providers to identify and submit measures for the Advancing Care Information performance category of the Merit-based Incentive Payment System (MIPS):
- The CMS Annual Call for Measures and Activities ends June 30
- To submit, send the Advancing Care Information Submission Form to CMSCallforMeasuresACI@ketchum.com
- To learn more about the process, visit the Call for Measures webpage, and review the Call for Measures and Activities fact sheet
The Office of Management and Budget (OMB) approved the Hospice Item Set (HIS) V2.00.0, effective April 1, 2017. The HIS Manual V2.00 and the HIS V2.00.0 forms are now final and posted in the downloads section of the HIS webpage. No changes were made to the HIS or the HIS Manual as part of OMB approval.
CMS encourages eligible hospitals, critical access hospitals, and dual-eligible hospitals to review 2017 program requirements for the Electronic Health Record (EHR) Incentive Programs, including:
- Modified Stage 2 and Stage 3 Attestation Worksheets
- Overview of the OPPS/ASC Final Rule Changes
- EHR Incentive Programs website
“Save Lives: Clean Your Hands.” Hand Hygiene Day is the World Health Organization’s annual call to action for health workers. Clean your hands at the right times and stop the spread of antibiotic resistance.
Take a web-based training course on Infection Control: Hand Hygiene from the Medicare Learning Network:
- Learn about hand hygiene in patient care zones and nearby administrative areas, including appropriate methods for maintaining good hand hygiene
- Physician and non-physician practitioners may receive continuing education credit for successful completion
- Available on the Learning Management System
In November 2016, the Office of the Inspector General (OIG) reported that hospitals did not always comply with Medicare requirements for reporting cochlear devices replaced without cost to the hospital or beneficiary. In 116 of 149 claims reviewed, hospitals did not report the appropriate modifiers and charges or a combination of the appropriate value code and condition codes. Medicare Administrative Contractors use this information to adjust payment; incorrect billing led to Medicare overpayments of $2.7 million.
- Services furnished on or after January 1, 2014: outpatient hospitals should report value code “FD” along with condition code 49 or 50
- Services furnished prior to January 1, 2014: outpatient hospitals should report the modifier “FB” on the same line as the procedure code (not the Cochlear Device code)
Use the following resources to bill correctly and avoid overpayment recoveries:
- Nationwide Medicare Compliance Review of Cochlear Devices Replaced Without Cost OIG Report
- List of CMS resources
Thursday, May 11 from 1 to 2:30 pm ET
Visit the event webpage to register.
During the webinar, CMS provides an overview of group reporting under the Merit-based Incentive Payment System (MIPS) and highlights requirements for participation, including:
- Individual vs. group reporting
- Group reporting requirements
- Performance category measures
- Data submission mechanisms
- Post-data submission
- Participation milestones
An audio recording and transcript are available for the April 19 call on the Medicare Shared Savings Program. During this call, learn helpful tips to complete a successful application for the 2018 Medicare Shared Savings Program, the Medicare Accountable Care Organization Track 1+ Model, and/or Skilled Nursing Facility 3-Day Rule Waiver.
With Continuing Education Credit
A revised Medicare Fraud & Abuse: Prevention, Detection, and Reporting Web-Based Training (WBT) course is available through the MLN LMS. Learn about:
- Fraud and abuse in health care
- Laws governing fraud and abuse activities
- Government partnerships fighting fraud and abuse
- Where to report suspected fraud and abuse
A revised Medicare Ambulance Transports Booklet is available. Learn about:
- Ambulance transport benefit
- Types of transports
- Ground and air ambulance providers and suppliers; vehicles; and personnel requirements
- Documentation requirements
- Coverage, billing, and payments
- Advance Beneficiary Notice of Noncoverage
Visit the MLN Matters® Articles webpage. Learn about coverage, billing, and payment rules for specific provider types.
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