Skip to Main Content

Physicians, Nurses and Allied Health Professionals Open Door Forum

Overview:

The Physicians, Nurses and Allied Health Professionals Open Door Forum (ODF) addresses the concerns and issues of Medicare and Medicaid physicians, non-physician practitioners, nurses, and other allied health care specialists. This diverse group of providers serves Medicare and Medicaid beneficiaries in almost all service settings, ranging from independent physician offices to specialized departments within larger facilities. The types of issues that come up during this forum are as varied as the providers who participate, but some frequent topics include the Physician Fee Schedule, Stark regulations, care plan oversight, payment and documentation rules, Provider Enrollment Chain Ownership System (PECOS), as well as the roles and responsibilities of different allied health professional staff under CMS regulations. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the forums.

******

**Updated: February 20, 2019 - Special Open Door Forum (SODF): Medicare Documentation Requirement Lookup Service, Thursday, February 28, 2019, from 2:00 – 3:00pm. Eastern Time. The purpose of this SODF to educate the public about a new initiative underway to develop a Medicare Fee for Service (FFS) Documentation Requirement Lookup Service prototype. Also, to allow physicians, suppliers, IT and Electronic Health Record (EHR) Developers and Vendors, and/or all other interested parties to provide feedback to CMS and inform how interested parties can get involved or track the progress of this initiative. CMS is collaborating with ongoing industry efforts to streamline workflow access to coverage requirements, starting with developing a prototype Medicare FFS Documentation Requirement Lookup Service and is participating in two workgroups to promote development of standards that will support the Lookup Service. One workgroup is a private sector initiative hosted by Health Level Seven (HL7), the Da Vinci project. The second workgroup is The Office of the National Coordinator for Health Information Technology (ONC) Payer + Provider (P2) Fast Healthcare Interoperability Resource (FHIR) Taskforce. By working with HL7, ONC, other payers, providers, and EHR vendors, CMS is helping define the requirements and architect the standards-based solutions. In parallel, CMS is preparing to support pilots testing the information exchanges for Medicare FFS programs and possibly coordinate pilots with volunteer participants to verify and test the new FHIR based solutions. The goals of the Documentation Requirement Lookup Service prototype are to reduce provider burden, reduce improper payments and appeals, and improve "provider to payer" information exchange. The prototype will be made accessible to pilot participants and will allow providers to be able to discover the following at the time of service and within their EHR or practice management system:

  1. If Medicare FFS requires prior authorization for a given item or service; and
  2. Documentation requirements for Oxygen and Continuous Positive Airway Pressure (CPAP) Devices.

For more information and to access the slide presentation for the SODF, please visit our website: go.cms.gov/MedicareRequirementsLookup. If you wish to participate, dial: 1-800 837-1935 & Conference ID: 8278138. We look forward to your participation. Please see the Downloads section below for the full call announcement. Thank you for your continued interest in the CMS Open Door Forums.

**Updated: January 18, 2019 - The proposed agenda for the next Physician Nurses & Allied Health Open Door Forum is scheduled for Wednesday, January 23, 2019 from 2:00pm-3:00pmET is as follows: Announcements & Updates; Policy changes related to opioids under Part D- Dr. Jeffrey Kelman, Michelle Ketcham, and Beckie Peyton. If you wish to participate, dial 1-800-779-4694. Conference ID: 4968517. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.

**Updated: November 6, 2018 - The proposed agenda for the next Physician Nurses & Allied Health Open Door Forum is scheduled for Thursday, November 8, 2018 from 2:00pm-3:00pmET is as follows: Announcements & Updates; Calendar Year 2019 Physicians Fee Schedule Final Rule. If you wish to participate, dial 1-800-779-4694. Conference ID: 34872372. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.

.