09/18/2018

CMS-Medicare

Recent Oncology Related Articles

Open Payments: Key Thresholds for Program Year 2019 Reporting

Open Payments key (de minimis) thresholds for reporting are adjusted based on the consumer price index. Small payments or transfers of value of less than $10.79 do not need to be reported, except when the total annual value of payments or other transfers of value to a covered recipient exceeds $107.91 for Program Year 2019 (data collected from January 1 through December 31, 2019).

For More Information:

• Open Payments website
• For questions, contact the Help Desk at openpayments@cms.hhs.gov or 855-326-8366, (TTY 844-649-2766)

Open Payments: Program Year 2019 Teaching Hospital List

The Open Payments Program Year 2019 teaching hospital list is available in PDF or Excel formats. The list identifies which teaching hospitals are eligible for reporting in Program Year 2019 (data collected from January 1 through December 31, 2019).

For More Information:

• Open Payments website
• For questions, contact the Help Desk at openpayments@cms.hhs.gov or 855-326-8366, (TTY 844-649-2766)

Physician Compare: Public Reporting Webinar Materials

A recording and transcript of the Public Reporting on Physician Compare: What you Need to Know webinar is available on the Physician Compare Initiative website. Contact PhysicianCompare@Westat.com if you have questions.

Annual Clotting Factor Furnishing Fee: 2019 Update MLN Matters Article — New

A new MLN Matters Article MM10918 on Annual Clotting Factor Furnishing Fee Update 2019 is available. Learn about the furnishing fee paid for items and services associated with clotting factor.

Influenza Vaccine Payment Allowances: Annual Update MLN Matters Article — New

A new MLN Matters Article MM10914 on Influenza Vaccine Payment Allowances - Annual Update for 2018-2019 Season is available. Learn about payment allowances for influenza virus vaccines updated on August 1.

Influenza Virus Vaccine Code: January 2019 Update MLN Matters Article — Revised

A revised MLN Matters Article MM10871 on Quarterly Influenza Virus Vaccine Code Update - January 2019 is available. Learn about new influenza virus vaccine code 90689.

Complying with Documentation Requirements for Laboratory Services Fact Sheet — Revised

A revised Complying with Documentation Requirements for Laboratory Services Fact Sheet is available. Learn about:

• Tips for signature requirements
• Services to help avoid errors in claims submission

MIPS Targeted Review Request: Deadline October 1 

If you participated in the Merit-based Incentive Payment System (MIPS) in 2017, your MIPS final score and performance feedback are available on the Quality Payment Program website. The payment adjustment you receive in 2019 is based on this final score. If you believe there is an error in your 2019 MIPS payment adjustment calculation, request a targeted review until October 1 at 8 pm.

For More Information:

• How to Request a Targeted Review Video
• Targeted Review of 2019 MIPS Payment Adjustment User Guide
• Targeted Review of 2019 MIPS Payment Adjustment Fact Sheet
• Contact the Quality Payment Program at 866-288-8292 (TTY: 877-715-6222) or QPP@cms.hhs.gov

2019 eCQM Flows for EPs

CMS posted 2019 performance period electronic Clinical Quality Measure (eCQM) flows for eligible clinicians and Eligible Professionals (EPs) on the eCQI Resource Center for the following programs:

• Quality Payment Program: Merit-based Incentive Payment System and Advanced Alternative Payment Models
• Comprehensive Primary Care Plus
• Promoting Interoperability Program

CMS plans to publish flows for eligible hospital and critical access hospital eCQMs in September. Send
questions to the ONC eCQM Issue Tracker.

2016 PQRS and 2018 Value Modifier Experience Reports

Find data from the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier Programs. 2018 payment adjustments are based on 2016 data.

• 2018 Value-Based Payment Modifier Program Experience Report (2015 – 2018) and 2018 Results Fact Sheet
• 2016 PQRS Reporting Experience Including Trends (2007-2016) and Appendix

 Claims for Biosimilar Drug Code Q5108

Medicare will pay for a new biosimilar drug (code Q5108) provided on or after July 12. You may submit claims for this drug starting October 1. See the HCPCS Drug/Biological Code Changes MLN Matters® Article for more information. 

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

With Continuing Education Credit

A revised Diagnosis Coding: Using the ICD-10-CM Web-Based Training course is available through the
Learning Management System. Learn about:

• Structure, format, and features
• How to find correct codes
• ICD-10-CM/PCS coding tips, information, and resources

 Medicare Enrollment for Physicians, NPPs, and Other Part B Suppliers Booklet — Reminder

The Medicare Enrollment for Physicians, Non-Physician Practitioners (NPPs), and Other Part B Suppliers Booklet is available. Learn about:

• Who are Part B suppliers
• Enrolling in the Medicare Program
• Determining if you want to be a participating provider

Recent LearnResource & MedLearn Matters Articles

• Intensity-Modulated Radiation Therapy (IMRT) Planning Services Editing (SE 18013)
• International Classification of Diseases, Tenth Revision (ICD10) and Other Coding Revisions to National Coverage Determinations (NCDs) (Revised MM 10859)
• Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - October 2018 Update (Revised MM 10834)