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Date
2018-10-25
Subject
MLN Connects for October 25,2018

 MLN Connects logo

Thursday, October 25, 2018

News & Announcements

Provider Compliance

Upcoming Events

Medicare Learning Network® Publications & Multimedia

View this edition as a PDF [PDF, 252KB]  

 

 

News & Announcements

 

New Medicare Card: Handouts and Videos for Patients

CMS offers New Medicare Card English & Spanish Beneficiary Resources you can use to educate your patients.

Have we finished mailing new Medicare cards in your state? Register and order (or print):

Mailing in your state not complete?

Fraud resources for all states:

Remember:

To ensure people with Medicare continue to get health care services, you can continue to use the Health Insurance Claim Number through December 31, 2019, or until your patient brings in their new card with the new number.

Visit the Provider webpage for the latest information.

 

DME: Formal Telephone Discussion Demonstration Expansion

The CMS Qualified Independent Contractor (QIC) Durable Medical Equipment (DME) Formal Telephone Discussion Demonstration is expanding into Medicare Administrative Contractor (MAC) Jurisdictions A and B, effective November 1; supplier participation remains voluntary. All DME claim types are eligible for the demonstration, except:

  • Claims or suppliers involved in another CMS initiative (i.e., Settlement Conference Facilitation, Prior Authorization for Power Mobility Devices) excluded in all jurisdictions.
  • Claims for glucose/diabetic testing strip supplies excluded in Jurisdictions A and B only.

We plan to expand the demonstration into the Part A East QIC Jurisdiction in the future. Visit the Original Medicare Appeals webpage for more information.

 

Emergency Preparedness: Hospital-based Incident Command System, Earthquakes, Medical Surge

The most recent Express - Opens in a new window  - External Link Policy - Opens in a new window   from the Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) highlights:

  • Webinar on hospital-based incident command system experiences and applications
  • New resources, including major earthquakes and medical surge
  • Upcoming events
  • Domain updates

HHS offers a comprehensive national knowledge center about emergency preparedness for health care, public health, and disaster clinical practitioners. Sign up to receive the monthly Express and quarterly Exchange that highlight new and trending emergency preparedness resources.

For More Information:

 

Provider Compliance

 

Coding for Specimen Validity Testing Billed in Combination with Urine Drug Testing — Reminder

In a February 2018 report, the Office of the Inspector General (OIG) determined that Medicare payments to clinical laboratories and providers for specimen validity tests did not comply with Medicare billing requirements. A recent MLN Matters® Special Edition Article reminds laboratories and other providers about proper billing for specimen validity testing done in conjunction with drug testing; this article contains no policy changes.

Current coding for testing for drugs of abuse relies on a structure of presumptive and definitive testing that identifies the specific drug and quantity in the patient. This article includes descriptors for:

  • Presumptive drug testing codes
  • Definitive drug testing codes

Use the following resources to bill correctly and avoid overpayment recoveries:

 

Upcoming Events

 

Physician Compare: Preview Period and Public Reporting Webcast — October 30

Tuesday, October 30 from 1:30 to 3 pm ET

Register - Opens in a new window  - External Link Policy - Opens in a new window   for Medicare Learning Network events.

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

  • 2017 Quality Payment Program performance information targeted for public reporting
  • Upcoming 30-day preview period

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

CMS will use webcast technology for this event with audio streamed through your computer. If you are unable to stream audio, phone lines are available.

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

 

Meeting the Needs of Dually Eligible Older Adults with Schizophrenia Webinar — November 6

Tuesday, November 6 from 2:30 to 4 pm ET

Register - Opens in a new window  - External Link Policy - Opens in a new window   for this webinar.

This interactive webinar discusses how to identify common symptoms of schizophrenia among older adults, identify promising practices related to treatment options and care coordination, and demonstrate practical strategies for meeting beneficiary needs. Continuing Medical Education (CME) and Continuing Education (CE) credits may be available.

 

IRF Payment and Coverage Policies: FY 2019 Final Rule Call — November 15

Thursday, November 15 from 1:30 to 3 pm ET

Register - Opens in a new window  - External Link Policy - Opens in a new window  for Medicare Learning Network events.

During this call, learn about changes finalized in the FY 2019 Inpatient Rehabilitation Facility (IRF) Prospective Payment System final rule, including:

  • Revisions to coverage criteria
  • Removal of the Functional Independence Measure (FIM) and Associated Function Modifiers from the IRF - Patient Assessment Instrument
  • Refinements to the case mix classification

Prior to the call, participants are encouraged to review the Medicare Benefit Policy Manual, Chapter 1, Section 110. A question and answer session follows the presentation; however, attendees may email questions in advance to irfcoverage@cms.hhs.gov with “November 15 Call” in the subject line. These questions may be addressed during the call or used for other materials following the call.

Target Audience: IRF providers.

 

Medicare Learning Network® Publications & Multimedia

 

Order Requirements When Prescribing Practitioner is DMEPOS Supplier MLN Matters Article — New

A new MLN Matters Article MM10984 on Order Requirements When Prescribing Practitioner is also the Supplier and is Permitted to Furnish Specific Items of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) is available. Learn about requirements for a written order.

 

Updating CY 2019 MDPP Payment Rates MLN Matters Article — New

A new MLN Matters Article MM10970 on Updating Calendar Year (CY) 2019 Medicare Diabetes Prevention Program (MDPP) Payment Rates is available. Learn about updated payment rates for CY 2019.

 

Quality Payment Program 2018 MIPS Cost Performance Category Web-Based Training Course — New

With Continuing Education Credit

A new Quality Payment Program in 2018: Merit-based Incentive Payment System (MIPS) Cost Performance Category Web-Based Training Course is available through the Learning Management System - Opens in a new window  - External Link Policy - Opens in a new window   . Learn about:

  • Data sources used to calculate scores
  • Cost score calculation methods
  • Beneficiary attribution

 

Quality Payment Program 2018 MIPS Improvement Activities Performance Category Web-Based Training Course — Revised

With Continuing Education Credit

A revised Quality Payment Program in 2018: Merit-based Incentive Payment System (MIPS) Improvement Activities Performance Category Web-Based Training Course is available through the Learning Management System - Opens in a new window  - External Link Policy - Opens in a new window    . Learn about:

    • Requirements
    • How the category fits in the Quality Payment Program
    • Steps to report data
  • Basics of scoring

 

Quality Payment Program 2018 MIPS APMs Web-Based Training Course — Revised

With Continuing Education Credit

A revised Quality Payment Program in 2018: Merit-based Incentive Payment System (MIPS) Alternative Payment Models (APMs) Web-Based Training Course is available through the Learning Management System - Opens in a new window  - External Link Policy - Opens in a new window   . Learn:

  • How to recognize if you are a part of a MIPS APM
  • Benefits of the special APM scoring standard
  • Criteria for reporting on performance

 

Quality Payment Program 2018 Advanced APMs Web-Based Training Course — Revised

With Continuing Education Credit

A revised Quality Payment Program in 2018: Advanced Alternative Payment Models (APMs) Web-Based Training Course is available through the Learning Management System - Opens in a new window  - External Link Policy - Opens in a new window   . Learn:

  • How to identify Advanced APMs
  • How to participate in QPP via an Advanced APM

 

Items and Services Not Covered under Medicare Booklet — Revised

A revised Items and Services Not Covered under Medicare Booklet is available. Learn about:

  • Four categories not covered under Medicare
  • Applicable exceptions

 

 


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