04/02/2019

CMS-Medicare

Recent Oncology Related Articles

CMS to Revisit National Coverage Determination on NGS Tumor Testing

Mar 27, 2019 - The Centers for Medicare & Medicaid Services will reopen a national coverage determination on next-generation sequencing panels to address the healthcare community's concerns about the negative impact the current policy would have on patients' ability to access genetic testing to learn their risk for cancer. READ ARTICLE (free registration required)

Medicare Enrollment for Physicians and Other Part B Suppliers — Revised

A revised Medicare Enrollment for Physicians, NPPs, and Other Part B Suppliers Medicare Learning Network Booklet is available. Learn:

• Who are part B suppliers
• What it means to be a participating provider

Medicare Secondary Payer — Revised

A revised Medicare Secondary Payer Medicare Learning Network Booklet is available. Learn:

• When Medicare pays first
• How to gather accurate data from the beneficiary
• What happens if you fail to file correct and accurate claims

Medicare Secondary Payer Provisions Web-Based Training Course — Revised

With Continuing Education Credit

A revised Medicare Secondary Payer Provisions Web-Based Training (WBT) course is available through the Medicare Learning Network Learning Management System. Learn about:

• Identifying provisions
• Recognizing when Medicare is primary and secondary
• Responsibilities to comply

8 things physicians need to know about MACRA in 2019

The Medicare Quality Payment Program, enacted under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), will affect participating physicians’ payment in 2021. 
View the slideshow 

PECOS FAQs — Revised

A revised PECOS FAQs Medicare Learning Network Booklet is available. Learn:

• How to get started
• How to submit an enrollment application
• If you need to pay an application fee
• If you need to submit supporting documentation

PECOS Technical Assistance Contact Information — Revised

A revised PECOS Technical Assistance Contact Information Medicare Learning Network Fact Sheet is
available. Learn who to contact about common problems.

Comparing Hospital Quality: CMS Updates Consumer Resources

On February 28, CMS updated hospital performance data on the Hospital Compare website and on
data.medicare.gov to empower patients, families, and stakeholders with important information they need to compare hospitals and make informed health care decisions. This data includes specific measures of hospitals’ quality of care, many of which are updated quarterly, and the Overall Hospital Star Ratings, which were last updated in December 2017. The data are collected through CMS Hospital Quality Initiative programs.

We also posted potential changes to the Hospital Star Ratings for public comment. These changes under consideration intend to respond to stakeholder feedback, seek to enhance the Star Ratings methodology by making hospital comparisons more precise and consistent, and allow more direct, “like-to-like” comparisons. We look forward to your comments on the potential changes by March 29.

See the full text of this excerpted CMS Press Release (issued February 28). 

Diagnosis Coding: Using the ICD-10-CM Web-Based Training Course — Reminder

With Continuing Education Credit

The Diagnosis Coding: Using the ICD-10-CM Web-Based Training (WBT) course is available through the Learning Management System. Learn:

• How to recognize features
• Find correct codes
• Identify structure and format

Dual Eligible Beneficiaries under Medicare and Medicaid Booklet — Reminder

The Dual Eligible Beneficiaries under Medicare and Medicaid Booklet is available. Learn about:

• Assistance with Medicare premiums or cost sharing through a Medicare Savings Program, including the Qualified Medicare Beneficiary Program
• Benefits and qualifications

Quality Payment Program: Payment Adjustment Resource

CMS posted a new Merit-based Incentive Payment System (MIPS) resource, addressing frequently asked questions about the application of payment adjustments, which began January 1, 2019. Topics include: 

• Services subject to the 2019 MIPS payment adjustment
• Changes made to remittance advice documents
• Impact of claim assignments on payment adjustments
• Correction of the inclusion of Medicare Part B drugs and certain items and services
• Links to additional resources

For More Information:

• Resource Library webpage
• For questions, reach out to your local technical assistance organization or contact the Quality Payment Program at QPP@cms.hhs.gov or 866-288-8292 (TTY: 877-715-6222)

QPP Videos: MIPS Data Submission

Learn how to manage and submit your 2018 Merit-based Incentive Payment System (MIPS) data through the Quality Payment Program (QPP) website by April 2 by viewing these brief videos:

• Uploading Files for Data Submission
• Reviewing Overview Data
• Reviewing Quality Category Data
• Reviewing Promoting Interoperability Category Data
• Reviewing Improvement Activities Category Data
• Manual Attestation of the Promoting Interoperability Category
• Manual Attestation of the Improvement Activities Category
• Deleting Submitted Data in the System
• Reviewing and Submitting Data as a Registry
• Navigation to Individual and Group Submission

For More Information:

• Resource Library webpage
• 2018 Data Submission FAQs
• QPP Access User Guide

Quality Payment Program: 2019 Resources

CMS posted new resources to help you prepare for the 2019 performance year of the Merit-based Incentive Payment System (MIPS):

• Medicare Part B Claims Measure Specifications and Supporting Documents: Descriptions of the claims measures for the Quality performance category
• Clinical Quality Measure Specifications and Supporting Documents: Descriptions of the clinical quality measures for the Quality performance category
• CMS Web Interface Measure Specifications and Supporting Documents: Descriptions of the CMS Web Interface measures for the Quality performance category
• Cross-Cutting Quality Measures: List of cross-cutting Quality measures that are broadly applicable to all clinicians regardless of their specialty
• Quality Measure Benchmarks: Lists and explains benchmarks used to assess performance in the
  Quality performance category
• Promoting Interoperability Measure Specifications: Overview of the requirements for the Promoting Interoperability performance category objectives and measures
• Cost Measure Code Lists: Details the cost measure code lists for each of the 8 episode-based cost measures that are new for the Cost performance category
• Cost Measure Information Forms: Details the measure methodology for each episode-based measure for the Cost performance category
• MIPS: Summary of Cost Measures: Summary of cost measures
• Improvement Activities Inventory: List of the improvement activities and descriptions
• Qualified Clinical Data Registries (QCDRs) and Qualified Registries Qualified Postings: List of CMSapproved QCDRs and Qualified Registries and the performance categories and measures they support
• MIPS Participation and Eligibility Fact Sheet: Overview of the eligibility criteria
• Quality Performance Category Fact Sheet: Includes an overview of quality measures and how to collect and submit quality data
• Cost Performance Category Fact Sheet: Includes details on the episode-based measures

For More Information:

• Resource Library webpage
• Quality Payment Program website
• Reach out to your local technical assistance organization
• Contact QPP@cms.hhs.gov or 866-288-8292 (TTY: 877-715-6222)

Quality Payment Program: Webinar Library

CMS moved Quality Payment Program (QPP) webinar resources to the newly redesigned QPP Webinar Library webpage. Search for the webinars and accompanying recordings, transcripts, and presentation slides by performance year, reporting track, performance category, and webinar type. For questions, contact QPP@cms.hhs.gov or 866-288-8292 (TTY: 877-715-6222). 

Recent LearnResource & MedLearn Matters Articles

• Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2019
• April 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS)
• Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2019 Update
• April 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.1
• Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update
• National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS)