MEDICARE PROVIDER FEEDBACK TOWN HALL MEETING

October 29, 2009
2:00 - 4:00 PM ET

The Centers for Medicare & Medicaid Services (CMS) requests your participation in a Town Hall meeting on October 29, 2009, from 2:00 PM to 4:00 PM (Eastern Time). The meeting will be held via conference call as well as in the auditorium at the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244.

The purpose of the meeting is to capture individual provider feedback on relevant Fee-for-Service (FFS) Medicare policy and operational issues. By doing so, we advance CMS’ efforts to enhance our relationship with providers and suppliers. This Town Hall meeting also provides a venue to allow CMS staff to engage individual providers and suppliers through the following year. This meeting is open to all Medicare FFS providers and suppliers that participate in the Medicare program.

The agenda topics include: 5010, ICD-10, Medicare Contracting Reform: Lessons Learned from Medicare Administrative Contractor (MAC) Implementations, Recovery Audit Contractors (RACs), Provider Communications, and Program Integrity as noted in the September 25, 2009 Federal Register Notice. Meeting agenda and discussion materials will be available to download at http://www.cms.hhs.gov/center/provider.asp by October 23, 2009. CMS will conduct a discussion session at the meeting that offers meeting participants an opportunity to provide feedback on agenda topics.

Please note: Due to time constraints not all participants will have an opportunity to speak, but written submissions will be accepted at MFG@cms.hhs.gov through November 6, 2009. CMS will give consideration to feedback received, but written responses will not be provided.

Meeting Registration Details

All participants must pre-register for the meeting through on-line registration located at http://registration.intercall.com/go/cms2. Registration will open on September 28, 2009 and will close on October 23, 2009. Registered participants may be contacted for follow-up meetings to solicit additional individual opinions and clarify any issues that may arise during the October 29th Town Hall meeting.

Upon registering, you will receive a confirmation page to indicate the completion of your registration. Please print this page as your registration receipt. We encourage you to complete your registration as soon as possible. Registration after 5:00 p.m. on October 23, 2009 will not be accepted.

Meeting Participation Details

All persons attending the meeting in person will be required to show a photographic identification (a valid driver's license or passport). Further details can be found in the September 25, 2009 Federal Register Notice. All persons participating via conference call will receive dial-in information with their confirmation email.

Additional Questions/Information

For questions or additional information about the Medicare Provider Feedback Town Hall Meeting, please send an email to MFG@cms.hhs.gov

The Centers for Medicare & Medicaid Services (CMS) Updates Physician Payment Information for Value-Driven Health Care

To support the delivery of high-quality, efficient health care and enable consumers to make more informed health care decisions, the U.S. Department of Health and Human Services is making cost and quality data available to all Americans. As part of this initiative, Medicare posted information in 2007 and 2008 about the payments it made during the previous year for common and elective procedures and services provided by Hospitals, Ambulatory Surgery Centers (ASCs), Hospital Outpatient Departments, and Physicians.

The Hospital information is posted on the Hospital Compare Website where it can be viewed along with hospital quality information. The Hospital compare website may be found at www.medicare.gov.

On August 28, 2009, Medicare posted an update to the Ambulatory Surgery Center data. The Physician payment data was posted on September 25, 2009. Hospital Outpatient Department data will be updated later this year. The information is being displayed in the same format as in previous years, updated with calendar year (CY) 2008 data. The posting updates may be found at: www.cms.hhs.gov/HealthCareConInit/.

What’s New with 2009 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Incentive Programs

1. New Medicare Learning Network Education Product


2. New and Revised MLN Articles on the Physician Quality Reporting Initiative


3. Three Physician Quality Reporting Initiative Help Desk Resources Now Available for Eligible Professionals

Medicare Learning Network Announces Availability of the 2009 PQRI and E-Prescribing Program Web-based Training Course

The Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network (MLN) is pleased to announce that the Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Incentive Program (E-Prescribing) Web-based Training Course is now available.

The course provides information to physicians, health care professionals, and medical administrative staff on the completion, submission and maintenance of the documentation required to successfully participate in Physician Quality Reporting Initiative (PQRI) and Electronic Prescription Incentive (E-Prescribing) programs. The course offers continuing education credits; please see the course description page for the details.

The course can be accessed by going to http://www.cms.hhs.gov/MLNGenInfo on the CMS website and scrolling down to the “Related Links Inside CMS” section and selecting Web Based Training (WBT) Modules. Once on the web-based training module page, select the Physician Quality Reporting Initiative and Electronic Prescribing Incentive Program WBT from the list provided.

Medicare Learning Network Announces New and Revised MLN Articles on the 2009 PQRI

~New-MM6514- Coding and Reporting Principles for the Physician Quality Reporting Initiative (PQRI) and the Electronic Prescribing (E-Prescribing) Incentive Programs
http://www.cms.hhs.gov/mlnmattersarticles/downloads/MM6514.pdf

~Revised-SE0830- Steps for Individual Eligible Professionals to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports Personally
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0830.pdf

~Revised-SE0831- Steps for Organizations to Access Their 2007 Physician Quality Reporting Initiative (PQRI) Feedback Reports
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf

These new and revised articles are intended to assist eligible professionals and group practices who report PQRI quality measures data to Medicare.

Three Physician Quality Reporting Initiative Help Desk Resources are Available for Eligible Professionals

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce three PQRI Help Desk Resources to assist eligible professionals with their questions on the Physician Quality Reporting Initiative.

1. Provider Call Center Directory




• Remittance Advice Notices


• Incentive payment distribution status


• Adjustments made to incentive payment due to sanctions/overpayments

For contact information, see the “Provider Center Toll-free Numbers Directory” by clicking the link under the “Related Links Inside CMS” section below and scrolling down to the “Downloads” section.



2. External User Services (EUS) – 7:00 AM – 7:00 PM EST




• Registering/creating an IACS account


• Accessing an IACS account


• Changing an IACS account


• Approving users into an organization

Phone: 1-866-484-8049
TTY: 1-866-523-4759



3. QualityNet Help Desk – 7:00 AM – 7:00 PM CST




• General CMS PQRI & ERX Information


• PQRI Portal Password Issues


• PQRI feedback report availability and access

Phone: 1-866-288-8912

All publicly available information on the CMS Physician Quality Reporting Initiative can be found at http://www.cms.hhs.gov/PQRI, on the CMS website.

All publicly available information on the CMS Electronic Prescribing Incentive Program can be found at http://www.cms.hhs.gov/ERxIncentive on the CMS website.

Tennesssee Medicare Part B Providers

Ask Cahaba B

The Open Door Forums offered by the Centers for Medicare and Medicaid Services (CMS) have opened communication channels with providers on a national basis. Cahaba GBA, LLC, Medicare Part B contractor has adopted a similar approach to communicating with our enrolled providers by organizing toll-free Ask the Contractor Teleconferences (ACT), which will focus on specific topics.

Initially, we will present providers with the most common reasons why Medicare Part B claims are “returned as unprocessable” to providers who bill Cahaba GBA Medicare Part B. We will also discuss a few current Medicare updates. Subsequently, we will go over pre-solicited questions specific to the topic of claim submission errors. If time permits, the call will be opened to providers to ask questions. A wrap-up session will conclude the call.

Topic
Claim Submission Errors

Date & Time
September 25, 2009
10:30 am -12:00 pm CST, 11:30 am -1:00 pm EST

Registration is limited to the first 250 providers. Please use one telephone line per practice. Participants may submit questions in advance for discussion during this teleconference. For additional details regarding this event, visit our web site at https://www.cahabagba.com/apps/course_registration/al/course_summary.jsp?EID=212

Thank you,

Provider Outreach and Education (POE)
Cahaba GBA- J10 A/B MAC

Free CME Performance Improvement Opportunity - From The Consortium for Southeastern Hypertension Control (COSEHC)

Linked below is a communication we received from The Consortium for Southeastern Hypertension Control (COSEHC) regarding an opportunity for primary care providers to participate in a study which could potentially reduce morbidity and mortality from hypertensive related conditions for our patient population. The provider will be offered free of charge a 16 hour CME program and may earn an additional 5 CME credits for participating in a full year of the project. COSEHC will provide $2,000 compensation to the practice at the end of the project year once all data is collected.

Once you review the linked material, if you are interested in participating please contact Debra Simmons, Executive Director of COSEHC directly at 336-716-1130 or dwirth@wfubmc.edu HPI is merely disseminating the information to our membership. HPI is not involved in the enrollment or administration of this project.

Please click here to view the material.

UPDATES FROM MEDICARE INTERMEDIARY CAHABA

Effective August 29, 2009, the Tennessee Medicare intermediary changed from Cigna to Cahaba GBA. This change is called the “J10 Transition”. Two important announcements from Cahaba follow. Please be sure you have enrolled in Cahaba GBA’s List Serve to receive regular updates & notices. You can enroll by going to http://www.cahabagba.com/J10

Help For Questions/Problems With the Change to Cahaba GBA
Cahaba GBAs’ Provider Outreach and Education department will be hosting a J10 A/B MAC Post Transition teleconference on Wednesday, September 23, 2009 at 10:00 a.m. - 11:30 a.m. CST; 11:00 a.m. - 12:30 p.m. EST. This teleconference will focus on any post transition concerns or issues related to our Tennessee Part B providers. Participants are encouraged to submit questions they would like addressed during the teleconference by 5:00 p.m. (CT) on Thursday, September 17, 2009. Questions submitted should relate to the topic being presented.

Registration deadline is Friday, September 18, 2009. For more details on how to register, please visit our Web site at https://www.cahabagba.com/apps/course_registration/al/calendar.jsp.

Hurry since registration fills up quickly!

Instructions for Providers Receiving Payment by Electronic Funds Transfer (EFT): Tennessee Medicare Part B providers accustomed to receiving Medicare payments via Electronic File Transfer (EFT), who have not submitted a new CMS-588 form to Cahaba GBA, MUST submit a CMS-588/EFT form (http://www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf), “Authorization Agreement for Electronic Funds Transfer”, immediately.

Providers that have not submitted the CMS-588 EFT form will not receive Medicare payments until the new CMS-588 is received by Cahaba GBA. If you have already submitted the EFT form, please do not send in another one. As long as you have sent it to the appropriate Cahaba address or fax below, we have your form.

To ensure we receive your CMS-588/EFT form quickly, please fax to (912) 921-4993 or (912) 927-6946 and mail the hardcopy original to one of the addresses referenced below.

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

Overnight:
Cahaba GBA, LLC
Provider Enrollment TN Part B
300 Corporate Parkway
Birmingham, AL 35242

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

URGENT MESSAGE TO ALL PROVIDERS WHO RECEIVE MEDICARE PAYMENTS VIA ELECTRONIC FUNDS TRANSFER (EFT)

Tennessee Medicare Part B providers accustomed to receiving Medicare payments via Electronic File Transfer (EFT), who have not submitted a new CMS-588 form to Cahaba GBA, MUST submit a CMS-588/EFT form (http://www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf), Authorization Agreement for Electronic Funds Transfer, IMMEDIATELY.

PROVIDERS THAT HAVE NOT SUBMITTED THE CMS-588 EFT FORM WILL NOT RECEIVE MEDICARE PAYMENTS UNTIL THE NEW CMS-588 IS RECEIVED BY CAHABA GBA. IF YOU HAVE ALREADY SUBMITTED THE EFT FORM, PLEASE DO NOT SEND IN ANOTHER ONE. AS LONG AS YOU HAVE SENT IT TO THE APPROPRIATE CAHABA ADDRESS OR FAX BELOW, WE HAVE YOUR FORM.

To ensure we receive your CMS-588/EFT form quickly, please fax to (912) 921-4993 or (912) 927-6946 and mail the hardcopy original to one of the addresses referenced below.

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

Overnight:
Cahaba GBA, LLC
Provider Enrollment TN Part B
300 Corporate Parkway
Birmingham, AL 35242

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

Thank you,
Provider Enrollment(PE)
Cahaba GBA- J10 A/B MAC

CMS releases H1N1 vaccine and administration codes

In anticipation of the vaccine for H1N1 influenza, the Centers for Medicare & Medicaid Services (CMS) has created two new codes for medical providers. G9142 (Influenza A [H1N1] vaccine, any route of administration) describes the vaccine, while G9141 (Influenza A [H1N1] immunization administration, including physician counseling the patient/family) describes the administration of the vaccine. Both codes become effective on Oct. 1.

CMS anticipates the H1N1 vaccine will be supplied to providers at no cost, although Medicare will pay for its administration. From the CMS adult immunizations Website, “Medicare will cover immunizations for H1N1 influenza, also called the "swine flu." There will be no coinsurance or copayment applied to this benefit, and beneficiaries will not have to meet their deductible. H1N1 influenza vaccine is currently under production and will be available in the Fall of 2009.”

Read details in the CMS MLN education article MM6617.

Read the 2008-2009 Immunizers’ Question & Answer Guide to Medicare Coverage of Influenza and Pneumococcal Vaccinations.

Review the Centers for Disease Control & Prevention Novel H1N1 Influenza: Resources for Clinicians Web page.

Important Information for Tennessee Medicare Part B Providers on Corrected Claims from Cahaba GBA

An analysis done by the Cahaba Government Benefit Administrators®, LLC Process Control area reveals a large number of paper claims being submitted with the wording “Corrected Claim” written on the form; however, there is no cover letter attached indicating what has changed from the original claim and no instructions of what action the provider is expecting Cahaba GBA to take.

Cahaba GBA will begin returning these claims to providers on September 7, 2009. Cahaba asks that providers follow the instructions below that pertain to your situation:

• If you file paper claims and need to make a simple correction to your claim, please call our telephone Clerical Error Reopening (CER) line. Calling our toll free lines to make simple claim corrections is the fastest, most efficient and cost effective way to correct your claim.

Examples of simple corrections and the applicable telephone numbers can be found on our website at https://www.cahabagba.com/part_B/claims/clerical_error_reopen.htm

• If you file electronically and your claim was denied, you may refile the claim electronically with the necessary corrections.

• If you file electronically and your claim was paid; however, you still need to make a simple correction, please call our telephone CER line.

Please remember that CMS requires all claims to be filed electronically unless your office meets certain specific exception criteria. For more information, please visit our website at http://www.cahabagba.com/part_b/edi/hipaa_electronic_submission_medicare_claims.htm

Cahaba GBA sincerely appreciates your assistance in our effort to reduce the number of “corrected claims” received.