- MLN Connects for June 15, 2017
Thursday, June 15, 2017
- MIPS Group Reporting: Registration Period Ends June 30
- MIPS Performance Categories: Accepting Future Measures and Activities until June 30
- Chronic Care Management Services: New Connected Care Materials
- National Men’s Health Week 2017
- County by County Analysis of Current Projected Insurer Participation in Health Insurance Exchanges
- IMPACT Act Special Open Door Forum — June 20
- CLIA Certificate of Provider-performed Microscopy Webcast — June 28
- Diagnosis and Treatment of Parkinson’s Disease Webinar — June 28
- Improvements to the Medicare Claims Appeal Process and Statistical Sampling Call — June 29
- Guidance to Providers that Submit Outpatient Facility Claims and Those That Enter Claims Data via DDE Screens to Reduce Incidence of Claims Not Crossing Over MLN Matters® Article — New
Groups planning to use the CMS Web Interface or administer the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey to submit data for the Merit-based Incentive Payment System (MIPS) must register by June 30.
For More Information:
- Group Registration for CMS Web Interface and CAHPS for MIPS
- 2017 Registration Guide for the CMS Web Interface or CAHPS for MIPS Survey
- 2017 CAHPS for MIPS Fact Sheet
- 2017 MIPS: CMS Web Interface Fact Sheet
- 2017 CAHPS for MIPS Survey
- 2017 CAHPS for MIPS Conditionally-Approved Survey Vendor List
- MIPS Group Participation Webinar Recording
The CMS Annual Call for Measures and Activities for the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program is open until June 30. CMS encourages clinicians, measure stewards, organizations, and other stakeholders to identify and submit measures and activities to be considered for the Quality, Advancing Care Information, and Improvement Activities performance categories of MIPS in future years. Review the Annual Call for Measures and Activities fact sheet to learn more.
CMS has new resources to help you and your patients understand Chronic Care Management (CCM) services. Order these free materials from the CMS Product Ordering website:
- Postcard for Health Care Professionals (Pub # 909444): An overview of CCM, the four billing codes for payment, and how to learn more about implementation
- Postcard for Consumers (English and Spanish, Pub #909443): Helps you explain CCM and its benefits
- Poster (English and Spanish, Pub #909445): Display in office or waiting room to get your patient’s attention and help start the conversation
For More Information:
- Connected Care website
- Connected Care Health Care Professional Toolkit
- Partner Toolkit
- Email firstname.lastname@example.org
June is Men’s Health Month, and June 12 through 18 is National Men’s Health Week, which ends on Father’s Day. These observances heighten awareness of preventable health problems and encourage early detection and treatment of disease. Help your Medicare patients understand the steps they can take to improve their health and recommend appropriate preventive services.
For More Information:
- Medicare Preventive Services Educational Tool
- Centers for Disease Control and Prevention Men’s Health website
Visit the Preventive Services website to learn more about Medicare-covered services.
CMS released a county-level map of 2018 projected Health Insurance Exchanges participation based on the known issuer participation public announcements through June 9, 2017. This map shows that insurance options on the Exchanges continue to disappear. Plan options are down from last year and, in some areas, Americans will have no coverage options on the Exchanges, based on the current data.
The CMS map displays point in time data and is expected to fluctuate as issuers continue to make announcements on exiting or entering specific states and counties. It currently shows that nationwide 47 counties are projected to have no insurers, meaning that Americans in these counties could be without coverage on the Exchanges for 2018. It’s also projected that as many as 1,200 counties - nearly 40% of counties nationwide – could have only one issuer in 2018. Currently, for 2018 at least 35,000 active Exchange participants live in the counties projected to be without coverage in 2018, and roughly 2.4 million Exchange participants are projected to have one issuer. It’s expected that the number of consumers with no coverage choices will rise.
CMS continues to work with state departments of insurance and issuers to address bare counties, exploring all options available under current law to provide Americans with access to coverage. Qualified Health Plan submissions for the Federally-facilitated Exchanges will be accepted by states and CMS through June 21, 2017. You can learn more by visiting hhs.gov/relief.
See the full text of this excerpted CMS Press Release (issued June 13).
Insufficient documentation continues to be a leading cause of Medicare noncompliance for providers who bill for CT Scans. The CMS Provider Minute: CT Scans video includes pointers to help you properly submit claims with sufficient documentation. This is the fourth in a series of Medicare compliance videos to educate on areas identified with a high degree of noncompliance.
The 2018 ICD-10-CM code files are now available on the 2018 ICD-10 CM and GEMs webpage. This includes the 2018 tabular and index, as well as code descriptions and addendum files:
- 2018 General Equivalence Mappings (GEMs) will be posted in August
- 2018 ICD-10-CM guidelines, present on admission exempt codes, and conversion table will be posted later, once they are finalized and received from the Centers for Disease Control and Prevention
Tuesday, June 20 from 2 to 3 pm ET
This Special Open Door Forum (SODF) provides information and solicits feedback on the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). Learn about goals; RAND contract activities for item development, including the upcoming national testing; and opportunities for providers, consumers, stakeholders, researchers, and advocates to become involved over the next year. See the announcement for more information.
Wednesday, June 28 from 1:30 to 3 pm ET
Register for Medicare Learning Network events.
During this webcast, learn about the Clinical Laboratory Improvement Amendments (CLIA) requirements for Provider-performed Microscopy (PPM) testing. Participants should review PPM Procedures: A Focus on Quality prior to the webcast.
CLIA established quality standards to ensure accuracy and reliability of patients’ test results regardless of where the test is performed. The CLIA Certificate for PPM procedures is issued to laboratories where physicians, mid-level practitioners or dentists perform specific microscopic examinations during the course of the patients’ visit.
Target Audience: Physicians, mid-level practitioners, dentists, pathologists, laboratory directors, laboratories managers, point-of care testing coordinators, clinical laboratory scientists, and medical laboratories technicians.
Wednesday, June 28 from noon to 1:30 pm ET
Register for a webinar on the recognition of Parkinson’s disease, treatment options, importance of an interdisciplinary care team treatment, and impact of the illness on affected older adults, including Medicare-Medicaid enrollees and their caregivers. Continuing Medical Education (CME) and Continuing Education (CE) credit may be available at no additional cost to participants; see the registration page for more information.
Thursday, June 29 from 1 to 3 pm ET
Register for Medicare Learning Network events.
Are you aware of recent regulatory changes to the Medicare claims appeal process? During this call, CMS and the Office of Medicare Hearings and Appeals (OMHA) discuss the HHS Medicare Appeals Final Rule, published on January 17, 2017. Learn about changes intended to streamline the administrative appeal processes, reduce the backlog of pending appeals, and increase consistency in decision making across appeal levels. For an overview of the Final Rule, see the HHS fact sheet.
Did you know that certain appeals pending at OMHA may be eligible for more efficient adjudication through statistical sampling? Learn about the expansion of this program based on feedback from the pilot phase and how your participation may advance the adjudication of your appeals.
A question and answer session follows the presentation.
Target Audience: All Medicare Fee-For-Service providers.
Guidance to Providers that Submit Outpatient Facility Claims and Those That Enter Claims Data via DDE Screens to Reduce Incidence of Claims Not Crossing Over MLN Matters® Article — New
An MLN Matters Special Edition Article on Guidance to Providers that Submit Outpatient Facility Claims and Those That Enter Claims Data via Direct Data Entry Screens to Reduce Incidence of Claims Not Crossing Over is available. Learn about correctly submitting HIPAA ASC X12N 837 institutional claims and Direct Data Entry (DDE) claims.
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