Thursday, December 9, 2021
- PECOS: Multi-Factor Authentication Requirement Delayed
- HHS Seeks Public Comments to Advance Equity & Reduce Disparities in Organ Transplantation, Improve Life-Saving Donations, and Dialysis Facility Quality of Care
- Orthoses Referring Providers: Comparative Billing Report in December
- Reduced Payment for Physical Therapy and Occupational Therapy Services Furnished in Whole or in Part by a Physical Therapist Assistant or an Occupational Therapy Assistant
- Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2022
CMS delayed implementing Multi-Factor Authentication (MFA) for the Provider Enrollment, Chain, and Ownership System (PECOS) until January 10, 2022. PECOS will use the same MFA methods as the Identity & Access Management System (I&A). Users who have set up MFA in I&A won’t need to do additional setup for MFA in PECOS.
There’s a 60-day grace period to set up MFA. The grace period countdown starts with a user’s first log in after January 10. By April 21, all users must access these systems using MFA. To prepare and set up an MFA account, log in to the Identity & Access Management System. View this MFA Presentation for more information.
If you work on behalf of other providers, be sure to enable the appropriate surrogacy connections. Learn how with the I&A Quick Reference Guide.
HHS Seeks Public Comments to Advance Equity & Reduce Disparities in Organ Transplantation, Improve Life-Saving Donations, and Dialysis Facility Quality of Care
On December 1, the U.S. Department of Health and Human Services, through CMS issued a Request for Information to solicit stakeholder and public feedback that will be used to inform potential changes and future rulemaking to improve the organ transplantation system and seek to enhance the quality of life of those living with organ failure. This is part of the Biden-Harris Administration’s ongoing efforts to improve the health outcomes of the more than 106,000 people who are waiting to receive a life-saving or life-enhancing organ transplant. CMS is focused on identifying potential system-wide improvements that would increase organ donations, improve transplants, enhance the quality of care in dialysis facilities, increase access to dialysis services, and advance equity in organ donation and transplantation.
Read the full Press Release.
In December, CMS will issue a third educational letter in the Special Edition Comparative Billing Report (CBR) series on Part B claims for orthoses referring providers. Use the data-driven tables to compare your billing and payment patterns with peers in your state and across the nation.
The public can’t view CBRs. Look for an email from email@example.com to access your report. Update your email address in the Provider Enrollment, Chain, and Ownership System to ensure delivery.
For More Information:
- View a webinar recording
- Visit the CBR website
- Register for a live webinar on December 29 from 3 – 4 pm ET
In a recent report, the Office of Inspector General found that Medicare improperly paid claims for implanted spinal neurostimulators when providers didn’t provide sufficient documentation supporting medical necessity. For dates of service on or after July 1, 2021, you must ask your Medicare Administrative Contractor (MAC) to authorize these services before performing the procedure in the hospital outpatient department.
Learn what you need to include in patient medical records to support Medicare coverage:
- Hospital Outpatient Department (OPD) Services webpage
- Hospital Outpatient Prospective Payment System Final Rule Section XVII
- Implanted Spinal Neurostimulators: OPD Guide (PDF) Section 126.96.36.199
- 2021 Final List of Outpatient Department Services That Require Prior Authorization (PDF)
Reduced Payment for Physical Therapy and Occupational Therapy Services Furnished in Whole or in Part by a Physical Therapist Assistant or an Occupational Therapy Assistant
- Payment changes due to Section 53107 of the Bipartisan Budget Act of 2018
- Payment reduction for services provided by Physical Therapist Assistants (PTAs) and Occupational Therapy Assistants (OTAs)
- Modifiers CQ and CO needed on claims for PTA and OTA services
CMS deleted incorrect information (PDF) that didn’t apply to supervising diagnostic tests performed by IDTFs. The COVID-19 public health emergency supervision flexibility (PDF) only applies to certain nonphysician practitioners; it didn’t change the diagnostic tests supervision requirements under the IDTF regulations.
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