Inpatient Hospital Payment Rate Impacted by the Consolidated Appropriations Act, 2016

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, January 14, 2016 Inpatient Hospital Payment Rate Impacted by the Consolidated Appropriations Act, 2016 On Friday, December 18, 2015, President Obama signed into law the Consolidated Appropriations Act, 2016.  Section 601, Modification of Medicare Inpatient Hospital Payment Rate for Puerto Rico Hospitals modifies the payment calculation with respect to operating costs of inpatient hospital services of a subsection (d) Puerto Rico hospital for discharges on or after January 1, 2016. CMS is currently revising the Inpatient Prospective Payment System (IPPS) FY 2016 Pricer to reflect the new payment calculation requirement.  The amount of the payment with respect to the operating costs of inpatient hospital services of a subsection (d) Puerto Rico hospital for inpatient hospital discharges on or after January 1, 2016, will be based on 0 percent of the applicable Puerto Rico percentage and 100 percent of the applicable Federal percentage. In addition, the IPPS FY 2016 Pricer will include conforming changes to certain FY 2016 IPPS operating rates and factors that result from the application of the new Puerto Rico hospital payment calculation requirement, which are applicable to all IPPS hospital discharges on or after January 1, 2016. We will also incorporate the revised IPPS rates into the Long-Term Care Hospital (LTCH) Pricer, as they are used for certain LTCH claims payments. To allow sufficient time to develop and test, we will implement the IPPS and LTCH Pricers on April 4, 2016. Medicare Administrative Contractors (MACs) will reprocess IPPS inpatient claims from Puerto Rico and all other IPPS hospitals with a discharge date on or after January 1, 2016. The MACs will also reprocess LTCH claims with a discharge date on or after January 1, 2016, due to the impact of this change.  Puerto Rico hospitals (as well as all other IPPS and LTCH hospitals) do not need to take any action. We expect to reprocess claims no later than June 30, 2016. Like the eNews? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).

Continuing Patient-Centered Care with New ACO Initiatives

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, January 14, 2016 Can't view the image? Read the eNews! View this edition as a PDF In This Edition: MLN Connects® Events ESRD QIP: Payment Year 2019 Final Rule Call — Last Chance to Register Collecting Data on Global Surgery as Required by MACRA Listening Session — Last Chance to Register IMPACT Act: Connecting Post-Acute Care across the Care Continuum Call — Register Now Medicare Learning Network® Publications and Multimedia Introduction to the IMPACT Act of 2014 Video — New Preventive Services Poster — New Drug Diversion: Schemes, Auditing, and Referrals Web-Based Training — New Medicare Parts C and D General Compliance Training Web-Based Training — New Combatting Medicare Parts C and D Fraud, Waste, and Abuse Web-Based Training — New Medicare Quarterly Provider Compliance Newsletter Educational Tool — New Hospice Payment System Fact Sheet — Revised ICD-10 Post-Implementation: Coding Basics Revisited Video — Reminder Announcements Accountable Care Organization Initiatives Announced to Improve Health System Care Delivery Home Health Compare: Deadline to have Data Suppressed is January 25 CMS to Release a Comparative Billing Report on Electrodiagnostic Testing in February Revised Two-Midnight Rule Guidelines PQRS Web-Based Measure Search Tool January is Cervical Health Awareness Month Like the eNews? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).

Stay Informed About Medicare Program Changes in 2016

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, January 7, 2016 Can't view the image? Read the eNews! View this edition as a PDF In This Edition MLN Connects® Events ESRD QIP: Payment Year 2019 Final Rule Call — Register Now Collecting Data on Global Surgery as Required by MACRA Listening Session — Register Now IMPACT Act: Connecting Post-Acute Care across the Care Continuum Call — Register Now New Audio Recordings and Transcripts Available Stay Informed about Medicare Program Changes Other CMS Events Comparative Billing Report on Home E/M Services Webinar Medicare Learning Network® Publications and Multimedia FY 2017 and After Payments to Hospice Agencies That Do Not Submit Required Quality Data MLN Matters® Article — Released Remittance Advice Resources and FAQs Fact Sheet — New Medicare Overpayments Fact Sheet — Revised Medicare Vision Services Fact Sheet — Revised Screening, Brief Intervention, and Referral to Treatment Services Fact Sheet — Revised Medicare Enrollment Guidelines for Ordering/Referring Providers Fact Sheet — Revised Certificate of Medical Necessity Web-Based Training Course — Revised New Educational Web Guides Fast Fact Announcements Medicare FFS Utilization and Payment Data Available for HHAs CMS Finalizes Rule Creating Prior Authorization Process for Certain DMEPOS Items CMS Quality Measure Development Plan Improving the Submission of Quality Data to CMS Quality Reporting Programs Pilot Project to Test Improving Patients’ Health by Addressing Their Social Needs EHR Incentive Programs: 2015 Program Year Attestation Begins January 4 PQRS: Submission Timeframes for 2015 Data PQRS: Self-Nomination for 2016 Qualified Registries and QCDRs Open through January 31 IRF Data Submission Deadline Extended to February 15 LTCH Data Submission Deadline Extended to February 15 LTCH QRP: FAQs and Provider Training Materials Available Hospice Item Set Timeliness Compliance Threshold Fact Sheet Available Improving the Documentation of Chiropractic Services Video Reporting the Diabetes: Hemoglobin A1c Measure for Program Year 2015 CMS to Release a Comparative Billing Report on Domiciliary E/M Services in January January Quarterly Provider Update Available Get Your Patients Off to a Healthy Start in 2016 Continue Seasonal Influenza Vaccination through January and Beyond Claims, Pricers, and Codes Holding of 2016 Date-of-Service Claims for Services Paid Under the 2016 MPFS Provider Enrollment Application Fee Amount for CY 2016 Clarification for Coding Relating to Cologuard January 2016 OPPS Pricer File Available January 2016 FQHC Pricer Files Available Transcatheter Mitral Valve Repair Claims Editing Incorrectly Pharmacogenomic Testing for Warfarin Responsiveness Claims Editing Incorrectly Adjustments to Correct Home Health Claim Payments Like the eNews? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).

ICD-10: A Look Back at 2015

ICD-10. COMPLIANCE DATE OCTOBER 1, 2015

News Updates | December 23, 2015

ICD-10: A Look Back at 2015 While there were many things to celebrate during 2015, we at the Centers of Medicare & Medicaid Services (CMS) National Standards Group (NSG) see the transition to ICD-10 as one of the year’s big accomplishments. Although many in the industry are still adjusting to ICD-10, we think everyone will agree that the unprecedented cooperation within the health care community is something we can all celebrate. Everyone, from providers and hospitals, to clearinghouses, payers, and vendors, are working together to ensure that the switch to ICD-10 is going as smoothly as possible.  Here at NSG, we look forward to continued cooperation and collaboration in 2016. Happy holidays! Keep Up to Date on ICD-10 Visit the CMS ICD-10 website and Roadto10.org for the latest news and official resources, including the ICD-10 Quick Start Guide and a contact list for provider Medicare and Medicaid questions. Sign up for CMS ICD-10 Email Updates andfollow us on Twitter.

More Quality Measures Now Available on Physician Compare!

2014 Quality Measures Released on Physician Compare The Centers for Medicare & Medicaid Services (CMS) is committed to providing useful and current quality performance data. CMS recently released newly available data on the quality of care provided by individual health care professionals, group practices, and Accountable Care Organizations (ACOs). These data are available onPhysician Compare. The Physician Compare website empowers consumers with information to make more informed health care decisions, encourages health care professionals to strive for higher levels of quality, and drives overall health system improvement. The 2014 data released include:  Additional performance scores on preventive care, diabetes, cardiovascular care, and patient safety by some physician group practices and ACOs. New performance scores on patients’ experiences with some physician group practices and ACOs. First set of individual health care professional performance scores on preventive care, cardiovascular care, and patient safety measures. If you have any questions about Physician Compare or the 2014 quality measure release, please contact us atPhysicianCompare@Westat.com. ______________________________________________________________________________________ SAVE THE DATE The Centers for Medicare and Medicaid Services (CMS) will host a series of one-hour webinars to discuss recent updates and the future of Physician Compare, including a publicly reported benchmark. Registration details will be sent at a later date. Webinars will be conducted via WebEx at the following times: Tuesday, February 23, 2016 at 12:00 pm ET/ 9:00 am PT Wednesday, February 24, 2016 at 4:00 pm ET/ 1:00 pm PT Thursday, February 25, 2016 at 11:00 am ET/8:00 am PT All sessions will present the same information. Multiple times are offered to help best accommodate your busy schedule.

Centers for Medicare & Medicaid Services (CMS) has sent this Medicare.gov- Physician Compare Update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.