04/16/2019

CMS-Medicare

Recent Oncology Related Articles

Provider Minute Video: The Importance of Proper Documentation

Why is proper documentation important to you and your patients? Find out how it affects items/services, claim payment, and medical review in the Provider Minute: The Importance of Proper Documentation video. Learn about:

• Top five documentation errors
• How to submit documentation for a Comprehensive Error Rate Testing review
• How your Medicare Administrative Contractor can help

A revised Telehealth Services Medicare Learning Network Booklet is available.

Learn about:

• Requirements
• Distant site practitioners
• Billing and payment for the originating site facility 

Quality Payment Program Merit-based Incentive Payment System (MIPS): Quality Performance Category in 2019 Web-Based Training Course — Revised

With Continuing Medical Education Credit

A revised Quality Payment Program Merit-based Incentive Payment System (MIPS): Quality Performance Category in 2019 Web-Based Training Course is available through the Medicare Learning Network Learning Management System. Learn about:

• Reporting requirements
• Identifying data submission and collection types
• Scoring and benchmark methodology, and helpful resources

Quality Payment Program CMS Web Interface and CAHPS for MIPS Survey: Register by July 1

Registration is required for groups and virtual groups that intend to use the CMS Web Interface and/or
administer the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for Merit-based
Incentive Payment System (MIPS) Survey for 2019. The registration period closes on July 1 at 5 pm ET.

For More Information:

• How to Register for CMS Web Interface and the CAHPS for MIPS Survey webpage
• Registration Guide
• Access User Guide
• How to Create a Quality Payment Program Account video
• Resource Library webpage
• Individual or Group Participation webpage
• CMS Web Interface Fact Sheet
• CAHPS for MIPS Survey Vendor List
• Participation Status Tool

Patients Over Paperwork April Newsletter

Read the CMS Patients Over Paperwork April newsletter for updates about our work to reduce administrative burden and improve the customer experience for hospitals:

• Human centered design to incorporate hospital perspective
• Local Coverage Determination (LCD) process
• Recent policies and proposed rules

Physician Compare: Supplemental Preview Period Open until April 27

CMS is offering a supplemental Physician Compare preview period through April 27 with the latest 2017 performance information. Eligible clinicians and groups: Check your information by logging into the Quality Payment Program website.

For More Information:

• Preview Period User Guide
• Materials from the October Medicare Learning Network webcast
• Physician Compare Initiative website
• Clinician Information: Performance Year 2017 Preview Period
• Group Information: Performance Year 2017 Preview Period
• For assistance accessing the Quality Payment Program website or obtaining your user role, contact QPP@cms.hhs.gov
• For questions about Physician Compare, public reporting, or the preview period, contact
  PhysicianCompare@Westat.com 

Open Payments: Review and Dispute Data by May 15

Pre-publication review and dispute for program year 2018 Open Payments data is available through May 15. CMS will publish program year 2018 data and updates to the previous program years’ data in June. Physician and teaching hospital review of the data is voluntary, but strongly encouraged:

• Records eligible for review and dispute: All records submitted during the submission period of the
  current calendar year, including newly edited, submitted, and re-attested records from previous
  calendar years; See the Physician and Teaching Hospital Review and Dispute Tutorial
• Disputes must be initiated by May 15: See the Review and Dispute Timing and Data Publication Quick Reference Guide
• CMS does not meditate or facilitate disputes: Work directly with reporting entities to resolve disputes
• Registration in the Open Payments system is required: Visit the Registration for Physicians & Teaching Hospitals webpage for instructions

If you are already registered, log in to review your data:

• If you have not accessed your account in 60 days or more, you will need to unlock your account in the CMS Portal
• If you have not accessed your account in 180 days or more, your account has been deactivated, and you will need to contact the Open Payments Help Desk to reinstate your account

For More Information:

• Open Payments website
• Materials from March 13 Medicare Learning Network call
• Contact the Open Payments Help Desk at openpayments@cms.hhs.gov or 855-326-8366; TTY 844-649-2766

Comparative Billing Report on Subsequent Hospital Visits

In late March, CMS issued a Comparative Billing Report (CBR) on Subsequent Hospital Visits. The CBR, produced by RELI Group, focuses on rendering providers who submit Medicare Part B claims. These reports contain data-driven tables with an explanation of findings that compare your billing and payment patterns to those of your peers in your state and across the nation.

CBRs are not publicly available. Look for an email from cbrpepper.noreply@religroupinc.com with your report. Update your contact email address in the National Plan and Provider Enumeration System to ensure accurate delivery.

For More Information:

• Visit the CBR website

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

• July 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
• Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.2 Effective July 1, 2019
• Evaluation and Management (E/M) When Performed with Superficial Radiation Treatment