2021-04-01-MLNC

Date
2021-04-01
Subject
Repayment of COVID-19 Accelerated and Advance Payments
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Thursday, April 1, 2021

 

News

Compliance

Claims, Pricers, & Codes

Events

MLN Matters® Articles

Multimedia

View this edition as PDF (PDF)

 

News

 

Repayment of COVID-19 Accelerated and Advance Payments Began on March 30, 2021

CMS issued information about repayment of COVID-19 accelerated and advance payments. If you requested these payments, learn how and when we’ll recoup them:

  • Identify payments we recovered
  • Prepare your billing staff

More Information:

 

COVID-19 Vaccine Administration – No Out-of-Pocket Cost to Patients

If you participate in the CDC COVID-19 Vaccination Program, you must:

  • Administer the vaccine with no out-of-pocket cost to your patients for the vaccine or administration of the vaccine
  • Vaccinate everyone, including the uninsured, regardless of coverage or network status

You also can’t:

  • Balance bill for COVID-19 vaccinations
  • Charge your patients for an office visit or other fee if COVID-19 vaccination is the only medical service given
  • Require additional medical or other services during the visit as a condition for getting a COVID-19 vaccination

Report any potential violations of these requirements to the HHS Office of the Inspector General:

Submit claims for administering COVID-19 vaccines to:

 

Alcohol Misuse: Medicare Covers Screening & Counseling

Medicare covers alcohol misuse screening and counseling, and your patients pay nothing if you accept assignment. During Alcohol Awareness Month, perform a brief screening and intervention, if appropriate.

More Information:

 

Compliance

 

DMEPOS: Bill Correctly for Items Provided During Inpatient Stays

In a recent report, the Office of Inspector General (OIG) determined that Medicare improperly paid suppliers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items provided during inpatient stays. Review the Medicare DMEPOS Improper Inpatient Payments (PDF) fact sheet to help you bill correctly. Additional resources:

 

Claims, Pricers, & Codes

 

COVID-19: RHC & FQHC Lump Sum Payments

Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS will pay you for COVID-19 vaccines and administration at 100% reasonable cost like influenza and pneumonia vaccines. Contact your Medicare Administrative Contractor for more information.

 

Events

 

Medicare Part A Cost Report: Easier File Uploads for e-Filing in MCReF Webcast — April 29

Thursday, April 29 from 1 - 2:30 pm ET

Register for our Medicare Learning Network webcast.

Medicare Part A providers: Learn about the new user-friendly upload feature for the Medicare Cost Report e-Filing (MCReF) system. The new feature allows you to:

  • Submit documents without turning them into ZIP files
  • Tag documents
  • Get alerts about missing documents

Also during this webcast:

  • Get an overview of the system
  • Attend a Q&A session

Use MCReF to:

  • Submit cost reports (Individually or in bulk) for fiscal years ending on or after December 31, 2017.
  • Track the status of cost reports with fiscal years ending after December 31, 2009.
  • You have the option to electronically transmit your cost report through MCReF or mail or hand deliver it to your Medicare Administrative Contractor. You must use MCReF if you choose to submit electronically.

You may send questions in advance to OFMDPAOQuestions@cms.hhs.gov with “MCReF Webcast” in the subject line. We’ll answer your questions during the webcast or use them to develop educational materials. For more information, see the MLN Matters Article (PDF) and webpage.

If you can’t stream audio through your computer for this webcast, you can call in.

Target Audience: 

  • Medicare Part A providers
  • Entities that file cost reports for providers

 

MLN Matters® Articles

 

New Provider Enrollment Administrative Action Authorities

CMS issued a new MLN Matters Special Edition Article SE21003 on New Provider Enrollment Administrative Action Authorities (PDF). Learn about new revocation, denial, and supporting authorities to stop fraud, waste, and abuse.

 

April 2021 Quarterly Update to HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement

CMS issued a new MLN Matters Article MM12212 on April 2021 Quarterly Update to HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement (PDF). Learn about file revisions for 2021, 2020, 2019, and 2017.

 

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2021

CMS issued a new MLN Matters Article MM12171 on Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2021 (PDF). Learn about software changes for clinical diagnostic laboratory services.

 

Claims Processing Instructions for National Coverage Determination (NCD) 20.4 Implantable Cardiac Defibrillators (ICDs)

CMS issued a new MLN Matters Article MM12104 on Claims Processing Instructions for National Coverage Determination (NCD) 20.4 Implantable Cardiac Defibrillators (ICDs) (PDF). Learn about changes for services provided on or after February 15, 2018.

 

Update to the Manual for Telephone Services, Physician Assistant (PA) Supervision, and Medical Record Documentation for Part B Services

CMS issued a new MLN Matters Article MM11862 on Update to the Manual for Telephone Services, Physician Assistant (PA) Supervision, and Medical Record Documentation for Part B Services (PDF). Learn how CMS clarified the manual to bring it in line with payment policy.

 

Multimedia

 

Medicare Part A Cost Report Appeals Listening Session: Audio Recording & Transcript

An audio recording (ZIP) and transcript (PDF) are available for the March 16 Medicare Learning Network listening session. Through the Medicare Part A appeals process, you can ask for administrative review of your CMS or Medicare Administrative Contractor final determinations.

 


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