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Date
2017-09-07
Subject
MLN Connects for September 07,2017

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Thursday, September 7, 2017

News & Announcements

Provider Compliance

Claims, Pricers & Codes

Upcoming Events

Medicare Learning Network Publications & Multimedia

View this edition as a PDF [PDF, 219KB]  

 

 

News & Announcements 

 

Hospice Provider Preview Reports Available through September 28

Hospice Provider Preview Reports are now available through September 28. Preview your quality measure results, based on first to fourth quarter 2016 data, prior to the November 2017 Hospice Compare refresh.

For More Information:

 

IRF and LTCH Provider Preview Reports: Review by September 30

Inpatient Rehabilitation Facility (IRF) and Long-term Care Hospital (LTCH) Quality Reporting Program Provider Preview Reports are now available through September 30. Review your performance data on each quality measure, based on first to fourth quarter 2016 data, prior to public display on IRF Compare and LTCH Compare in December. Corrections to the underlying data will not be permitted during this preview period; however, you can request a CMS review if you believe your data is inaccurate. 

For more information:

 

IRF and LTCH Compare Quarterly Refresh

The September 2017 quarterly Inpatient Rehabilitation Facility (IRF) and Long-term Care Hospital (LTCH) Compare refresh is available, including quality measure results based on data submitted to CMS between the fourth quarter of 2015 and the third quarter of 2016. Visit IRF Compare and LTCH Compare to view the data. 

 

Mapping Medicare Disparities Tool: 2017 Enhancements Released

2017 enhancements to the CMS Mapping Medicare Disparities Tool focus on new data, measures, and functionality:

  • Data available for 2015, in addition to 2012 to 2014
  • Chronic diseases categorized as “Chronic or Potentially Disabling Conditions”
  • Usage rates for preventive services
  • “Trend view” provides charts for the selected measure
  • “County profile” displays socio-economic data

 

Visit the Office of Minority Health website for more information.

 

2015 Inpatient and Outpatient Hospital Utilization and Payment Data Available

CMS released the Hospital Inpatient and Outpatient Utilization and Payment Public Use Files (PUFs) with data for 2015:

  • The Inpatient PUF includes summarized information on inpatient discharges paid for under the Inpatient Prospective Payment System, including discharges, average Medicare payments, and average hospital charges organized by hospital provider and Medicare Severity Diagnosis Related Group. It provides data on more than 3,000 hospital providers, who collectively received $78.2 billion in Medicare payments.
  • The Outpatient PUF includes summarized information on select outpatient services and procedures paid for under the Outpatient Prospective Payment System, including services, average total payments, and average hospital charges organized by hospital provider and Ambulatory Payment Classification Groups. It provides data on more than 3,000 hospital providers, who collectively received $5.4 billion in total payments.

 

Healthy Aging® Month: Discuss Preventive Services with your Patients

Healthy Aging Month focuses national attention on all aspects of growing older. Talk with your patients about adopting a healthy lifestyle, including use of appropriate Medicare-covered preventive services; care coordination for chronic conditions; behavioral health integration; and cognitive assessment and care planning.

For More Information:

Visit the Preventive Services website to learn more about Medicare-covered services.

 

Provider Compliance

 

Lumbar Spinal Fusion CMS Provider Minute Video — Reminder

Improper Billing continues to be a leading cause of Medicare noncompliance for providers. The CMS Provider Minute: Lumbar Spinal Fusion video includes pointers to help you submit proper documentation for this procedure. Learn about:

  • Four elements needed in the medical record
  • How to obtain an attestation for an illegible signature

This video is part of a series to help providers of all types improve in areas identified with a high degree of noncompliance.

 

Claims, Pricers & Codes

 

October 2017 Average Sales Price Files Available

CMS posted the October 2017 Average Sales Price (ASP) and Not Otherwise Classified (NOC) pricing files and crosswalks on the 2017 ASP Drug Pricing Files webpage. 

 

Upcoming Events

 

Overview of MIPS for Small, Rural, and Underserved Practices Webinar — September 8

Friday, September 8 from 1 to 2:30 pm ET

Register for this event.

Join CMS and the National Rural Health Association for a webinar on the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program. Topics:

  • Brief overview of the Quality Payment Program
  • Overview of MIPS
  • Flexibilities and resources for small practices
  • A brief overview of Virtual Groups
  • Resources offered by Technical Assistance organizations

 

New Medicare Card Project: Clearinghouses and Vendors Special Open Door Forum — September 12

Tuesday, September 12 from 2 to 3 pm ET

This Special Open Door Forum is an opportunity for clearinghouses and vendors to learn more and ask questions about the CMS approach to change Social Security Number-based Health Insurance Claim Numbers (HICNs) to new Medicare Beneficiary Identifiers (MBIs). Learn about:

  • Background of the New Medicare Card Project
  • Implementation of new Medicare numbers
  • Format of the new number
  • Timeline and milestones
  • Transition period
  • Outreach and education
  • What you need to know to get ready for the new number

Participation Instructions:

  • Participant Dial-In Number: 800-837-1935
  • Conference ID #: 49250097
  • For TTY services dial 7-1-1 or 800-855-2880.

 

Qualified Medicare Beneficiary Program Billing Requirements Call — September 19

Tuesday, September 19 from 1:30 to 3 pm ET

Register for Medicare Learning Network events.

During this call, CMS experts discuss the Qualified Medicare Beneficiary (QMB) billing requirements and their implications. Find out about upcoming changes to the HIPAA Eligibility Transaction System (HETS) and remittance advice to identify the QMB status of your patients and exemption from cost-sharing. Also, learn key steps to promote compliance.

Medicare providers may not bill people in the QMB program for Medicare deductibles, coinsurance, or copays. Visit the QMB Program webpage for more information.

Target Audience: Medicare Part A and B providers, medical billing specialists, practice administrators, IT vendors, health care industry professionals, and other interested stakeholders.

 

Reporting Hospice Quality Data: Tips for Compliance Call — September 20

Wednesday, September 20 from 1:30 to 3 pm ET

Register for Medicare Learning Network events.

During this call, learn more about Hospice Quality Reporting Program requirements. Find out how to be compliant and successfully submit Hospice Item Set (HIS) data and the Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey in the next reporting year. A question and answer session follows the presentation.

Topics:

  • HIS and CAHPS® submission requirements
  • Reasons for noncompliance and how to address them
  • Timelines for data submission and compliance determinations
  • Resources for success, including how to access important websites and helpdesks 

Target Audience: Hospice providers.

 

PQRS: Feedback Reports and Informal Review Process for PY 2016 Results Call — September 26

Tuesday, September 26 from 1:30 to 3 pm ET

Register for Medicare Learning Network events.

 

Learn about Physician Quality Reporting System (PQRS) downward payment adjustments, PQRS feedback reports, and the informal review process for Program Year (PY) 2016 results and 2018 payment adjustment determinations. 

Note: 2016 was the last program year for PQRS. PQRS transitioned to the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program. The final data submission timeframe for reporting 2016 PQRS quality data to avoid the 2018 PQRS downward payment adjustment was January through March 2017. The first MIPS performance period is January through December 2017. For more information, visit the Quality Payment Program website.

This event is being evaluated by CMS for CME and CEU continuing education credit (CE). Check the event webpage for CE Activity Information & Instructions.

Target Audience: Physicians; individual eligible professionals; group practices; Comprehensive Primary Care practice sites; Accountable Care Organizations; therapists; practice managers; medical and specialty societies; payers; and insurers.

 

Physician Compare Call — September 28

Thursday, September 28 from 1:30 to 3 pm ET

Register for Medicare Learning Network events.

Are you interested in learning more about Physician Compare? Find out about the:

  • Upcoming 30-day preview period for the 2016 performance data targeted for release in December
  • Future of public reporting and what is coming in the next year

Learn how to review your performance information before it is published. A question and answer session follows the presentation.

This event is being evaluated by CMS for CME and CEU continuing education credit (CE). Check the event webpage for CE Activity Information & Instructions.

Target audience: Physicians and other clinicians; medical groups; practice managers; medical and specialty societies; and other interested stakeholders.

 

Medicare Learning Network Publications & Multimedia

 

Medicare Diabetes Prevention Program: Audio Recording and Transcript — New

An audio recording, transcript, and clarification are available for the August 16 listening session on the Medicare Diabetes Prevention Program Model Expansion. The CY 2018 Medicare Physician Fee Schedule (PFS) proposed rule makes additional proposals to implement the expanded model starting in 2018.

 

 


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