06/18/2019

CMS-Medicare

Recent Oncology Related Articles

Medicare Billing: Form CMS-1450 and the 837 Institutional Web-Based Training Course — Reminder

With Continuing Education Credit

The Medicare Billing: Form CMS-1450 and the 837 Institutional Web-Based Training (WBT) course is available through the Medicare Learning Network Learning Management System. Learn:

• Billing requirements
• Claim completion information
• How to identify aspects of paper and electronic claims

Average Sales Price Files: July 2019

CMS posted the July 2019 Average Sales Price (ASP) and Not Otherwise Classified (NOC) pricing files and crosswalks on the 2019 ASP Drug Pricing Files webpage.

MLN Connects Special Edition - Thursday, June 6, 2019 

CMS Seeks Public Input on Patients over Paperwork Initiative to Further Reduce Administrative, Regulatory Burden to Lower Healthcare Costs
 
On June 6, CMS issued a Request for Information (RFI) seeking new ideas from the public on how to continue the progress of the Patients over Paperwork initiative. Since launching in fall 2017, Patients over Paperwork has streamlined regulations to significantly cut the "red tape" that weighs down our healthcare system and takes clinicians away from their primary mission-caring for patients. As of January 2019, we estimate that through regulatory reform alone, the healthcare system will save an estimated 40 million hours and $5.7 billion through 2021. These estimated savings come from both final and proposed rules.
 
This RFI provides an opportunity to share new ideas not conveyed during the first Patients over Paperwork RFI in 2017 and continue the national conversation on improving healthcare delivery. We are especially seeking innovative ideas that broaden perspectives on potential solutions to relieve burden and ways to improve:
 
Reporting and documentation requirements

• Coding and documentation requirements for Medicare or Medicaid payment
• Prior authorization procedures
• Policies and requirements for rural providers, clinicians, and beneficiaries
• Policies and requirements for dually enrolled (i.e., Medicare and Medicaid) beneficiaries
• Beneficiary enrollment and eligibility determination
• CMS processes for issuing regulations and policies 

Key Burden Reduction Milestones to Date:
 
We gathered feedback on burdensome requirements from medical and patient communities through other RFIs, listening sessions, and on-site meetings with frontline clinicians, healthcare staff, and patients and are working every day to reduce regulatory burden while safeguarding patient safety, quality, and program integrity.
Achievements so far:

• Simplified Documentation and Coding
• Improved Quality and Operational Efficiency
• Meaningful Measures
• Changing CMS Culture 

For More Information:

• RFI on Reducing Administrative Burden to Put Patients over Paperwork
• Patients over Paperwork webpage 

See the full text of this excerpted CMS Press Release (issued June 6). Submit comments by August 12.

NEW - Quality Payment Program: 2019 Resources

CMS posted new resources on the Quality Payment Program (QPP) Resource Library webpage for 2019 participation:

• Participating in QPP Infographic: Describes how to check your QPP participation status; basic
  requirements for participating in the Merit-based Incentive Payment System (MIPS), Advanced
  Alternative Payment Models (APMs), and MIPS APMs; and key dates
• MIPS Eligibility Decision Tree: Uses a series of questions to help you determine if you are eligible for MIPS
• Qualifying APM Participant (QP) Methodology Fact Sheet: Details how we determine which eligible clinicians are QPs and make predictive QP determinations
• MIPS Specialty Guides: Highlights specific MIPS measures and activities that may apply to clinical psychologists, physical therapists and occupational therapists, speech-language pathologists and audiologists, registered dietitian and nutrition professionals, anesthesiologists and certified nurse anesthetists, and primary care clinicians
• CAHPS for MIPS Approved Survey Vendors: Lists the survey vendors CMS approved to administer the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) for MIPS survey
• MIPS Quality User Guide: Details how to participate in the Quality performance category
• MIPS Cost User Guide: Details how to participate in the Cost performance category

For More Information:

• Check the QPP Participation Status Tool for initial eligibility information
• For questions, contact your local technical assistance organization, QPP@cms.hhs.gov, or 866-288-8292 (TTY: 877-715-6222)

Recent LearnResource & MedLearn Matters Articles

• Chimeric Antigen Receptor (CAR) T-Cell Therapy Revenue Code and
  HCPCS Setup Revisions
• Documentation of Medical Necessity of the Home Visit; and Physician Management Associated with Superficial Radiation Treatment
• July 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.2
• July 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS)