TENNESSEE MEDICARE PART B CUTOVER DATE IS AUGUST 29, 2009

On January 07, 2009, the Centers for Medicare & Medicaid Services announced Cahaba Government Benefit Administrators®, LLC is the Medicare Administrative Contractor (MAC) for Jurisdiction 10 comprised of Alabama, Georgia, and Tennessee. As the J10 MAC, Cahaba GBA will be responsible for the administration of all Medicare Part A and Part B claims in Alabama, Georgia and Tennessee.

The Centers for Medicare and Medicaid Services (CMS) needs to change the contractor workload numbers for the Part A and Part B workloads in the states of Alabama, Georgia and Tennessee when workload is transitioned to the J10 A/B MAC.

Part B Tennessee
J10 MAC Workload No.: 10302
Effective Date: 08/29/2009
Current Contractor No.: 05440

Tennessee Part B claims submitted to the J10 A/B MAC, Cahaba GBA, after 4:00 p.m. CT (5:00 p.m. ET) on Friday, August 28, 2009 MUST have the new workload/receiver ID, 10302, in segments ISA08 and GS03 as well as in loop 1000B, segment NM109. Also, electronic claim status inquiries (276/277) must have the new workload/receiver ID, 10302, in segments ISA08 and GS03 as well as in loop 2100A, segment NM109. Claims and claim status inquiries sent without the new workload ID WILL REJECT. Please contact your vendor to insure your system is updated. Failure to submit the correct workload/receiver ID will cause your claims to reject during the front-end editing process.

Electronic Funds Transfer (EFT)
All providers currently receiving payments from CIGNA Government Services via EFT, MUST submit a new CMS-588/EFT form (http://www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf), Authorization Agreement for Electronic Funds Transfer, IMMEDIATELY to avoid an interruption in EFT payment. This is required even if Cahaba GBA’s financial institution is the same as that of CIGNA Government Services. Providers that do not complete and submit the CMS-588/EFT form prior to cutover will not receive Medicare payments.

Please Note: If you are a group practice and have multiple physicians within your organization, only one CMS-588/EFT for the group is needed. A separate CMS-588/EFT for each provider within the group is not required. Additionally, group practices with multiple locations that are all under the same Tax ID number and have their Medicare payments deposited to one bank account are only required to send in one CMS-588/EFT Agreement. However, if the Medicare payments for each location are deposited to different bank accounts, a separate CMS-588/EFT form is needed for each location and/or bank account payable to the group practice.

If you have not already done so, you MUST submit the CMS-588/EFT form to Cahaba GBA IMMEDIATELY even if you recently updated your information with CIGNA Government Services.

Completed CMS-588/EFT forms should be sent to:

Cahaba GBA Provider Enrollment-TN-Part B P.O. Box 830170 Birmingham, AL 35283-0170

EFT Resources:

• Form CMS-588: http://www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf
• EFT Instructions: http://www.cms.hhs.gov/ElectronicBillingEDITrans/13_EFT.asp
• Tips On Completing the CMS-588: http://www.cahabagba.com/j10/CMS588_tips.pdf

Further Communication
Providers may subscribe to our listserv by visiting the Cahaba GBA website at http://www.cahabagba.com/j10/email_service.htm. Listserv messages will be sent to the providers that will further explain the upcoming EDI changes and what they need to do to prepare for the upcoming transitions.

2009 Segal Health Plan Cost Trend Survey

The 2009 Segal Health Plan Cost Trend Survey reports projections obtained from a survey of major insurance carriers, Managed Care Organizations – including preferred provider organizations, point of service plans, health maintenance organizations – pharmacy benefits managers and third party administrators. To access the survey highlights:
click here

CDC information on the H1N1 influenza

The Centers for Disease Control and Prevention (CDC) recently established the Novel H1N1 Influenza: Resources for Clinicians Web page. Designed to give providers "access to the latest guidelines and information on the evolving novel H1N1 influenza investigation," it contains several links to guidance regarding patient management, place of setting specific information (including 10 Actions Steps for Medical Offices and Outpatient Facilities), directions for specific patient populations overall treatment recommendations, and patient education information.

To access the Resources for Clinicians webpage:
http://www.cdc.gov/h1n1flu/clinicians/?s_cid=ccu081709_NovelH1N12_e

To access the 10 Actions Steps for Medical Offices and Outpatient Facilities:
http://www.cdc.gov/h1n1flu/10steps.htm

Medicare Test Pays for Hospital Performance

"WASHINGTON - A pilot project by Medicare that links hospital payments to the quality of care has helped prevent infections in pneumonia patients and cut death rates in heart-attack patients, according to data to be released Monday." To read the full Wall Street Journal article by Jane Zhang click here.

H1N1 Information for Virginia Providers

The Commonwealth of Virginia has released information on how providers can pre-register for H1N1 vaccine. Vaccine, ancillary supplies (needles, syringes, sharps containers and alcohol swabs) and shipping will be provided at no cost to the vaccine providers. Vaccine will be free to patients but an administration fee may be allowed for those with health insurance. Vaccinators will be asked to report doses given through the Virginia Immunization Information System (VIIS), the state's immunization registry.



For additional information please click here.

ICD-10-CM/PCS Publications

The following ICD-10-CM/PCS publications are now available from the Centers for Medicare & Medicaid Services Medicare Learning Network:

• 
  ICD-10-CM/PCS Myths & Facts (June 2009), which presents correct information in response to some myths regarding the ICD-10-Clinical Modification/Procedure Coding System, is now available in print format. To place your order, visit http://www.cms.hhs.gov/MLNGenInfo/, scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”


• 
  ICD-10-CM-PCS Bookmark (revised August 2009), which provides information about the ICD-10-Clinical Modification/Procedure Coding System including the benefits of adopting the coding system, recommended steps to be taken in order to plan and prepare for implementation of the coding system, and where additional information about the coding system can be found, is now available in downloadable format at http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10ClinModBookmrk.pdf.

MEDICARE PROVIDER ENROLLMENT REMINDER

For Physicians, Non-Physician Practitioners and Group Practices

The Centers for Medicare & Medicaid Services reminds physicians and non-physician practitioners, and group practices that they are required to notify their designated Medicare contractor regarding (a) a change in ownership, (2) a change in practice location, including a change in reassignment of benefits, or (3) any final adverse action (e.g., license suspension/revocation or felony conviction) within 30 days of the reportable event. By reporting changes as soon as possible, but within 30 days of the reportable event, physicians, non-physician practitioners, and group practices will help to ensure that their claims are processed correctly.

Physicians, non-physician practitioners, and group practices are also encouraged to update their Medicare enrollment information on file with the Medicare contractor if the physician, non-physician practitioner, or group practice has not done so since November 2003.

Physicians, non-physicians practitioners, and group practices can use CMS’ electronic enrollment process, known as Internet-based Provider Enrollment, Chain and Ownership System (PECOS), to enroll or make a change in an existing enrollment record.

Information regarding physician, non-physician practitioner, and group practice reporting responsibility and other informational material regarding provider enrollment can be found on the Medicare Provider/Supplier Enrollment web site, www.cms.hhs.gov/MedicareProviderSupEnroll, and in the documents available for downloading in the Downloads section of each web page.