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Thursday, November 7, 2013
Hospitals Must Attest by November 30 to Receive Payment for 2013 EHR Incentive Program Participation
Streamlined Access to PECOS, EHR, and NPPES — Register Now
Friday, November 15; 2-3:30 ET
Target Audience: All Medicare Fee-For-Service providers, as well as Professionals and Hospitals eligible for the Medicaid Electronic Health Record (EHR) Incentive Program.
Changes have been made to simplify the way providers and suppliers access the Provider Enrollment Chain and Ownership System (PECOS), the Electronic Health Records (EHR) Incentive Program, and the National Plan and Provider Enumeration System (NPPES). These updates, available since October 7, improve the user experience when registering as an individual practitioner, authorized or delegated official of an organization, or someone working within PECOS on behalf of a provider or supplier (also known as a surrogate). This MLN Connects Call will provide detailed instructions on these changes.
The new process will:
Important Note: If you already have a user ID and password from NPPES, or currently access PECOS, NPPES, and/or EHR, your accounts will not be affected by this change. You can continue to use your established user ID and password to access the systems.
Agenda:
Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.
National Partnership to Improve Dementia Care in Nursing Homes — Register Now
Monday, November 25; 2-3:30pm ET
Target Audience: Consumer and advocacy groups, nursing home providers, surveyor community, prescribers, professional associations, and other interested stakeholders
CMS has developed a national partnership to improve the quality of care provided to individuals with dementia living in nursing homes. This partnership is focused on delivering health care that is person-centered, comprehensive, and interdisciplinary. By improving dementia care through the use of individualized, person-centered care approaches, CMS hopes to continue to reduce the use of unnecessary antipsychotic medications in nursing homes and eventually other care settings as well. The partnership promotes a systematic process to evaluate each person and identify approaches that are most likely to benefit that individual. While antipsychotic medications are the initial focus of the partnership, CMS recognizes that attention to other potentially harmful medications is also an important part of this initiative.
During this MLN Connects Call, CMS subject matter experts will provide a brief overview of the progress that has been made so far during the implementation of this national partnership. Additional speakers will be presenting on the CMS Hand in Hand training series. A question and answer session will follow the presentation.
Agenda:
Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.
Did You Miss These MLN Connects Calls?
Call materials for MLN Connects™ Calls are located on the Calls and Events web page. New materials are now available for the following calls:
Special Open Door Forum: Final Rule CMS-1599-F: Discussion of the Hospital Inpatient Admission Order and Certification; Two MidnightBenchmark for Inpatient Hospital Admissions
Tuesday, November 12; 1-2pm ET
CMS will host a third, follow-up Special Open Door Forum (ODF) call to allow hospitals, practitioners, and other interested parties to ask questions on the physician order and physician certification, inpatient hospital admission and medical review criteria that were released on August 2, 2013 in the FY 2014 Inpatient Prospective Payment System (IPPS)/Long-Term Care Hospital (LTCH) final rule (CMS-1599-F).
CMS also posted subregulatory instruction, relating to the claim selection process and preliminary review guidelines, for conducting patient status reviews of claims with Dates of Admission in October 2013 or later. These documents, as well as a document addressing some frequently asked questions are located on theInpatient Hospital Reviews web page.
Feedback and questions on the two midnight provision for admission and medical review can be sent to IPPSAdmissions@cms.hhs.gov. Questions on Part B inpatient billing and the clarifications regarding the physician order and certification should be sent to the subject matter staff listed in the final rule. CMS also recently released new guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions.
Additional information, including the conference call number and access information will be posted soon on the Special ODF website.
Special Open Door Forum: ACA Section 3004: Quality Reporting Program for Long Term Care Hospitals
Thursday, November 21; 1-2:30pm ET
The purpose of this Special Open Door Forum (ODF) is to provide updated data collection and submission information to Long Term Care Hospital (LTCH) providers for the FY 2016 and FY 2017 payment update determination. It will also cover time frames and submission deadlines for the FY 2015, FY 2016, and FY 2017 payment update determinations. The Special ODF will also present a select number of frequently asked questions and answers related to the quality measures, data collection and submission mechanisms and invite questions and comments from stakeholders.
CMS Innovation Center Special Open Door Forum: Discussion of the Medicare Intravenous Immune Globulin (IVIG) Demonstration
Friday, November 22; 1-2:30pm ET
CMS will host a Special Open Door Forum (ODF) call to allow providers, suppliers, beneficiary advocacy groups, and other interested parties to provide input into the design and implementation of the Intravenous Immune Globulin Demonstration (IVIG) Demonstration. Materials to be discussed during the call will be available for downloading from the demonstration website no later than November 15.
November is National Diabetes Month and Diabetic Eye Disease Month: November 14 is World Diabetes Day
Diabetes is the leading cause of kidney failure, non-traumatic lower-limb amputation, and new cases of blindness among adults in the United States. People with diabetes are also two to four times more likely than people without diabetes to develop heart disease. Please join CMS this November in raising awareness about diabetes and diabetic eye disease.
Help protect the health of your patients by educating them about their risk factors and lifestyle changes they can make that can help reduce their risk of developing diabetes. Encourage them to take advantage of diabetes-related preventive services covered by Medicare that focus on early disease detection and disease management, including:
For more information:
Diabetes and Seasonal Influenza Vaccination
November is National Diabetes Month and also a time when flu activity usually increases. Even if diabetes is well managed, flu illness can cause serious complications for someone with diabetes. The Centers for Disease Control and Prevention (CDC) advises that this is an opportune time to take action to combat the flu. Health care providers are encouraged to get a flu vaccine to help protect themselves from the influenza and to keep from spreading it to their family, co-workers, and patients. In addition, now is the perfect time for providers to vaccinate Medicare beneficiaries, as it can take 2 weeks after vaccination to develop antibodies that protect against seasonal influenza. Influenza vaccination is especially important for Medicare beneficiaries who suffer from diabetes, due to a weakened immune system and increased susceptibility to respiratory infections such as influenza and pneumonia.
As a health care provider, you play an important role in setting an example by getting yourself vaccinated and recommending and promoting influenza vaccination. The CDC recommends that you assess vaccination status with each patient visit, encourage seasonal influenza vaccination, and vaccinate or refer to a vaccine provider when appropriate.
Generally, Medicare Part B covers one influenza vaccination and its administration per influenza season for Medicare beneficiaries without co-pay or deductible. Note: The influenza vaccine is not a Part D-covered drug.
For more information on coverage and billing of the influenza vaccine and its administration, please visit:
2014 eRx Payment Adjustment Informal Review is Now Available
Are You Subject to the 2014 eRx Payment Adjustment?
Eligible professionals (EPs) and group practices (who self-nominated for the 2012 and/or 2013 Electronic Prescribing (eRx) group practice reporting option (GPRO)) who were not successful electronic prescribers under the eRx Incentive Program will be subject to a payment adjustment in 2014 as mandated by section 1848 (a)(5) of the Social Security Act.
All EPs and group practices had the opportunity to avoid the 2014 eRx payment adjustment through the following options:
Complete information about the eRx payment adjustment is available on the eRx Payment Adjustment Information web page.
CMS will notify those EPs and group practices who will be subject to the 2014 eRx payment adjustment. Providers receiving the 2014 eRx payment adjustment will see the indicator “LE” on their Remittance Advice for all Medicare Part B services rendered from January 1 through December 31, 2014. The remittance advice will also contain the following Claim Adjustment Reason Code (CARC) and Remittance Advice Remark Code (RARC):
Need to Request an Informal Review?
CMS has implemented an informal review process for the 2014 eRx payment adjustment. This means that EPs and group practices can request to have their applicable eRx Incentive Program reporting performance reviewed. Informal review requests will be accepted November 1, 2013 through February 28, 2014. EPs and group practices should submit their eRx informal review request via email to the informal review mailbox ateRxInformalReview@cms.hhs.gov. Complete instructions on how to request an informal review are available in the 2014 eRx Payment Adjustment Informal Review Made Simple educational document.
Need More Information?
The following CMS resources are available to help EPs and group practices access and understand their 2014 eRx payment adjustment and request an informal review:
Questions?
For all other questions related to the eRx Incentive Program, please contact the QualityNet Help Desk at 866-288-8912 (TTY 1-877-715-6222) or viaqnetsupport@sdps.org. They are available Monday through Friday from 7am-7pm CT.
Access Your 2012 PQRS Feedback Report Today
Feedback reports are now available for providers who submitted Physician Quality Reporting System (PQRS) data from Medicare Part B Physician Fee Schedule claims received with dates of service between January 1 and December 31, 2012. Access instructions for individual eligible professionals (EPs) and groups who participated in 2012 PQRS Group Practice Reporting Option (GPRO) are listed below. For more information on locating and interpreting data provided in the feedback report, review the 2012 PQRS Feedback Report User Guide.
Eligible ProfessionalsIndividual EPs who submitted 2012 PQRS data can retrieve their 2012 PQRS Feedback Reports using the following options:
Group Practice Reporting Option
Groups who participated in 2012 PQRS GPRO can access PQRS feedback through the 2012 Quality and Resource Use Reports (QRURs). Authorized representatives of practices with 25 or more EPs can access the QRURs at https://portal.cms.gov using an IACS account with one of the following group-specific PV-PQRS Registration System roles:
Information about QRURs and the required IACS roles is available on the CMS Physician Feedback Program website under the QRUR Templates and Methodologies web page.
PQRS Resources
For more information about participating in PQRS, visit the PQRS website. You can also learn about other eHealth initiatives at CMS by visiting the CMS eHealth website. How to Avoid the 2015 Payment Adjustments for PQRS
Providers considered eligible and able to participate in the Physician Quality Reporting System (PQRS) may be subject to payment adjustments beginning in 2015. Eligible professionals (EPs) and group practices that fail to satisfactorily report data on quality measures during the 2013 program year will be subject to a 1.5% payment adjustment of their Physician Fee Schedule (PFS) charges beginning in 2015. Individuals and group practices participating in PQRS must meet one of the following criteria to avoid payment adjustments in 2015.
Criteria for Individual EPsEPs can avoid the 2015 payment adjustment if one of the following criteria is met during the 2013 PQRS program year:
Criteria for Registered Groups (ACO)/PQRS GPRO)Group practices participating in the Group Practice Reporting Option (GPRO) can avoid 2015 payment adjustments if one of the following criteria is met during the 2013 PQRS program year:
Note: Administrative claims-based reporting is not available to Accountable Care Organization (ACO) GPROs
ResourcesView the PQRS Payment Adjustments Tip Sheet for more information on how to avoid the 2015 payment adjustment.
For more information or support on the PQRS program, please visit the PQRS Incentive Program website or the Help Desk.
Reporting Period for EPs Participating in EHR Incentive Programs Ends December 31
December 31, 2013, is an important deadline for eligible professionals (EPs) participating in the EHR Incentive Programs. It marks the end of the calendar year and the last day of the 2013 meaningful use program year.
Attestation DeadlineIf you are an EP participating in the Medicare EHR Incentive Program, you have until February 28, 2014, to attest to demonstrating meaningful use of the data collected during the reporting period for the 2013 calendar year. You must attest by 12:00 am (midnight) Eastern Standard Time on February 28 to demonstrate meaningful use. If you are participating in the Medicaid EHR Incentive Program, please refer to your state’s deadlines for attestation information. You must attest to demonstrating meaningful use every year to receive an incentive and avoid a payment adjustment.
Payment AdjustmentsPayment adjustments will be applied beginning January 1, 2015, if you have not successfully demonstrated meaningful use. The adjustment is determined by the reporting period in a prior year. For more information, visit the payment adjustment tipsheet. If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you must demonstrate meaningful use to avoid the payment adjustments. You may demonstrate meaningful use under either Medicare or Medicaid. If you are only eligible to participate in the Medicaid EHR Incentive Program, you are not subject to these payment adjustments.
EPs in 2014January 1, 2014 marks many important milestones for EPs participating in the EHR Incentive Programs, including:
Resources
Want more information about the EHR Incentive Programs?Make sure to visit the Medicare and Medicaid EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.
Hospitals Must Attest by November 30 to Receive Payment for 2013 EHR Incentive Program Participation
The last day that eligible hospitals and critical access hospitals (CAHs) can register and submit attestation in FY 2013 for the Medicare EHR Incentive Program is November 30, 2013. Eligible hospitals and CAHs must successfully attest to demonstrating meaningful use by November 30 to receive a 2013 incentive payment. Hospitals must attest to demonstrating meaningful use every year to receive an incentive and avoid a payment adjustment.
Medicaid Eligible HospitalsHospitals participating in the Medicaid EHR Incentive Program need to refer to their state deadlines for attestation.
Payment AdjustmentsPayment adjustments will be applied beginning FY 2015 (October 1, 2014) to Medicare eligible hospitals that have not successfully demonstrated meaningful use. The adjustment is determined by the hospital’s reporting period in a prior year. Read the eligible hospital payment adjustment tipsheet to learn more.
Resources
Plan Ahead
Review all of the important dates for the EHR Incentive Programs on the Health Information Technology Timeline.
New and Updated FAQs for the EHR Incentive Programs Now Available
To keep you updated with information on the Medicare and Medicaid EHR Incentive Programs, CMS has recently added two new and two updated FAQs to the CMS FAQ system. We encourage you to stay informed by taking a few minutes to review the new information below.
New FAQs:
Updated FAQs:
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Saturday, November 9, 2013
MLN Connects Provider eNews for Thursday November 7, 2013
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