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  • Monday, December 09, 2019 12:07 PM | Jennifer Casasanta (Administrator)

    Self-Service Pulse: What You Need To Know This Week

    As your Medicare Administrative Contractor, National Government Services wants to provide you with a comprehensive source containing the most current information available for our self-service tools.

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      NGSMedicare.com


    The New Medicare Beneficiary Identifier (MBI)

    Effective 1/1/2020, the new Medicare Number, commonly referred to as the MBI, will be required for all Medicare inquiries and transactions. If you would like to learn more about the MBI, we have a section of our website with all the information you need to comply with the CMS initiative.

    1. Select “Claims & Appeals” then select “Medicare Beneficiary Identifier (MBI).”

    Or

    2. Click on the MBI scrolling banner on our home page.

    Or

    3. Select “Learn About MBI” on our home page.

    Avoid your claims being rejected. Use the MBI today.

    MBI_info

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      NGSConnex.com


    Final Countdown for the Medicare Beneficiary Identifier Transition Period

    There are less than 30 days left until the Medicare Beneficiary Identifier (MBI) transition period comes to an end. Effective, 1/1/2020 Medicare transactions can no longer contain Health Insurance Claim Numbers (HICNs). This includes transactions within the NGSConnex portal.

    Don't wait; MBIs can be used now. We encourage NGSConnex users to start using the MBI in all your portal transactions, including eligibility and claim status inquiries.

    Every person with Medicare has been assigned an MBI and beneficiaries can find this number on their new Medicare Card. If you are unable to obtain a copy of the beneficiary's new Medicare card, you can search for their MBI using the MBI Lookup Tool available in NGSConnex.

    Instructions for using the MBI Lookup Tool can be found in the NGSConnex User Guide:

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      MedicareUniversity.com


    Printing Your Transcript

    Do you need to show your manager the education you received for your end-of-year review? You can generate and print your Medicare University transcript. On the “My Courses” tab, click the “Transcript” tab, then click the “Print Report” button. Show your manager the quality education you have received from National Government Services.

    Medicare University Transcript screenshot


     

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      Interactive Voice Response

    Eligibility Submenus

    When you utilize the interactive voice response (IVR) system, you have the ability to access a Medicare beneficiary's eligibility information via submenus. These submenus allow you to choose the specific eligibility elements you want to hear.

    After the provider and beneficiary information is authenticated, you will hear the following upfront eligibility elements as applicable:

    • Entitlement dates
    • Qualified Medicare Beneficiary (QMB) status
    • Inactive dates
    • Corrected Medicare number
    • Date of death

    You can say "Repeat that" to hear the upfront eligibility elements again. You may then choose one of the submenu options to continue through the other eligibility elements as applicable.


    Part A Eligibility Submenu Options

    • Full Eligibility (Touchtone 1)
    • Basic Eligibility (Touchtone 2)
    • Hospital and SNF Billing (Touchtone 3)
    • Other Insurance (Touchtone 4)
    • ESRD (Touchtone 5)
    • Home Health and Hospice (Touchtone 6)
    • Special Services (Touchtone 7)

    Part B Eligibility Submenu Options

    • Full Eligibility (Touchtone 1)
    • Basic Eligibility (Touchtone 2)
    • Other Insurance (Touchtone 3)
    • ESRD (Touchtone 4)
    • Home Health and Hospice (Touchtone 5)
    • Special Services (Touchtone 6)

    After you select a submenu and listen to the elements available, you can say "Repeat that" to hear the specific submenu elements again. Or, you can say simply say another submenu option to listen to other elements.


    Refer to the IVR User Guide for all available features in the IVR:

    • Part A Provider Interactive Voice Response User Guide
    • Part B Provider Interactive Voice Response User Guide

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      YouTube

    MBI Lookup Tool in NGSConnex
     

    If you are currently registered with NGSConnex, our free, secure internet portal you will be able to login and use the MBI Lookup Tool to obtain your patient's MBI, if CMS has mailed them their new Medicare card. Watch this three-minute video to learn how to use the MBI LookUp Tool in our secure self-service portal, NGSConnex.

    YouTube: How to Use the MBI Lookup Tool in NGSConnex

    Fun Fact

    National Cocoa Day

    A cold winter day is the perfect time to make yourself a cup of hot cocoa and enjoy National Cocoa Day. Each year on December 13, people across the country celebrate their favorite cold weather comfort drink.

    Hot cocoa is a warm beverage made with cocoa powder, heated milk or water and sugar. The terms hot chocolate and hot cocoa are often used interchangeably by Americans. To make hot chocolate, we use ground chocolate which contains cocoa butter. It’s mixed with hot milk and is also called drinking chocolate.


    Did You Know?

    Did you know you can search for a participating physician on our website by using the Medicare Participating Physicians Directory?


  • Wednesday, December 04, 2019 10:06 AM | Jennifer Casasanta (Administrator)

    MLN Connects® Special Edition for Tuesday, December 3, 2019

    MBI Transition Ends This Month: Will You Be Paid On January 1?

    The 21 month transition period will end on December 31; use Medicare Beneficiary identifiers (MBIs) now.

    • You are currently submitting 86% of claims with MBIs.
    • Get MBIs from your patients and through the MAC portals (sign up) now and after the transition period. You can also find the MBI on the remittance advice.
    • Protect your patients from identity theft - use MBIs.

    Starting January 1, if you do not use the MBI (regardless of the date of service) for Medicare transactions

    • We will reject your claims with a few exceptions
    • We will reject all eligibility transactions

    See the MLN Matters Article for more information on getting and using MBIs.

    Also from NGS

    Link to NGSConnex.com

    Link to Medicare University

    Link to NGS YouTube Channel

    Link to the NGS Twitter

    Copyright 2019 - National Government Services


  • Tuesday, November 26, 2019 3:57 PM | Jennifer Casasanta (Administrator)

    Quality Payment Program

    Additional QP APM Incentive Payment Details Now Available on QPP.CMS.GOV

    The Quality Payment Program website (qpp.cms.gov) has been updated to include 2019 Alternative Payment Model (APM) Incentive Payment details. Clinicians and surrogates can log in to the QPP website using their HARP credentials to see their APM Incentive Payment details.

    In November, CMS announced that the second round of payments are being disbursed to eligible clinicians who were Qualifying APM Participants (QPs) based on their 2017 performance for their 2019 5% APM Incentive Payments. For additional information on the APM Incentive Payment, please review the 2019 APM Incentive Payment Fact Sheet to explain:

    • Who is eligible to receive an APM incentive payment in 2019
    • How CMS determines your 2019 APM Incentive Payment
    • Answers to frequently asked questions

    APM Incentive Payment Details Available on QPP Website

    CMS has taken time to ensure correct payments and information are available during the 2019 payment year. CMS’ process includes verifying eligible clinicians’ Advanced APM participation and the calculation of the APM Incentive Payment.

    You can now log in to the QPP website and see the amount and the organization paid.

    For More Information

    • Visit the QPP website for more information on APMs and lists of current APM participants

    ·        Contact the Quality Payment Program at 1-866-288-8292 (TTY 1-877-715-6222), Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at QPP@cms.hhs.gov.

    Reminder: Applications for the 2019 Promoting Interoperability Hardship and Extreme and Uncontrollable Circumstances Exceptions are Due December 31

    If you are interested in applying for a Promoting Interoperability Hardship Exception or Extreme and Uncontrollable Circumstances Exception for the 2019 Performance Year of MIPS, you must submit your application to CMS by Tuesday, December 31, 2019.

    Who is Eligible for a Promoting Interoperability Hardship Exception?

    MIPS eligible clinicians, groups, and virtual groups may qualify for a re-weighting of the Promoting Interoperability performance category to 0% if they:

    • Are a small practice;
    • Have decertified EHR technology;
    • Have insufficient Internet connectivity;
    • Face extreme and uncontrollable circumstances such as disaster, practice closure, severe financial distress, or vendor issues; or
    • Lack control over the availability of CEHRT

    Note: If you’re already exempt from reporting Promoting Interoperability data, you don’t need to apply.

    Who is Eligible for an Extreme and Uncontrollable Circumstances Exception?

    MIPS eligible clinicians, groups, and virtual groups may qualify for a re-weighting of any or all MIPS performance categories to 0% if they are affected by extreme and uncontrollable circumstances extending beyond the Promoting Interoperability performance category. These circumstances must render them unable to:

    • Collect information necessary to submit for a performance category; or
    • Submit information that would be used to score a performance category for an extended period of time.

    Note: Individual MIPS eligible clinicians (not groups or virtual groups) will receive the exception automatically if they are located in a CMS-designated region that has been affected by an extreme and uncontrollable event during the 2019 MIPS Performance Year. These clinicians will not need to apply for the exception.

    How do I Know if I’m Approved?

    If you submit an application for either of the exceptions, you will be notified by email if your request was approved or denied. If approved, this will also be added to your eligibility profile on the QPP Participation Status Tool, but may not appear in the tool until the submission window is open in 2020.

    For More Information

    • Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222). To receive assistance more quickly, consider calling during non-peak hours—before 10 AM and after 2 PM ET.

    If you are interested in applying for a Promoting Interoperability Hardship Exception or Extreme and Uncontrollable Circumstances Exception for the 2019 Performance Year of MIPS, you must submit your application to CMS by Tuesday, December 31, 2019.

    Who is Eligible for a Promoting Interoperability Hardship Exception?

    MIPS eligible clinicians, groups, and virtual groups may qualify for a re-weighting of the Promoting Interoperability performance category to 0% if they:

    • Are a small practice;
    • Have decertified EHR technology;
    • Have insufficient Internet connectivity;
    • Face extreme and uncontrollable circumstances such as disaster, practice closure, severe financial distress, or vendor issues; or
    • Lack control over the availability of CEHRT

    Note: If you’re already exempt from reporting Promoting Interoperability data, you don’t need to apply.

    Who is Eligible for an Extreme and Uncontrollable Circumstances Exception?

    MIPS eligible clinicians, groups, and virtual groups may qualify for a re-weighting of any or all MIPS performance categories to 0% if they are affected by extreme and uncontrollable circumstances extending beyond the Promoting Interoperability performance category. These circumstances must render them unable to:

    • Collect information necessary to submit for a performance category; or
    • Submit information that would be used to score a performance category for an extended period of time.

    Note: Individual MIPS eligible clinicians (not groups or virtual groups) will receive the exception automatically if they are located in a CMS-designated region that has been affected by an extreme and uncontrollable event during the 2019 MIPS Performance Year. These clinicians will not need to apply for the exception.

    How do I Know if I’m Approved?

    If you submit an application for either of the exceptions, you will be notified by email if your request was approved or denied. If approved, this will also be added to your eligibility profile on the QPP Participation Status Tool, but may not appear in the tool until the submission window is open in 2020.

    For More Information

    • Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222). To receive assistance more quickly, consider calling during non-peak hours—before 10 AM and after 2 PM ET.

    TEP Nominations Open for Physician Cost Measures and Patient Relationship Codes Project

    CMS has contracted with Acumen, LLC to develop episode based-cost measures to meet the requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). As part of the measure development process, CMS asks contractors to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during cost measure development and maintenance.

    Acumen, LLC is seeking nominations to a Technical Expert Panel (TEP) that will provide guidance for activities under the “Physician Cost Measures and Patient Relationship Codes (PCMP)” contract. This contract continues the measure development activities performed under the previous “MACRA Episode Groups and Resource Use Measures” contract, and adds the maintenance of the MSPB Hospital measure. This TEP nomination is separate from the nomination to Clinical Subcommittees, which Acumen convenes to gather detailed clinical input on measures in specific clinical areas.

    The first meeting is a two-day, in-person meeting in Washington, D.C. on February 6-7, 2020. Subsequent meetings may be held in-person or via webinar.

    Nominations can be submitted through this web-based nomination form and the nomination period will close on December 20, 2019 at 11:59PM ET. For more information, please visit the CMS Technical Expert Panel webpage.


  • Friday, November 15, 2019 9:54 AM | Jennifer Casasanta (Administrator)


    Select this link to view email as a web page, go here.

     

    The CY 2020 MPFS Is Now Available
     
    The CY 2020 Medicare Physician Fee Schedule (MPFS) is now available. You can view the new fees using the Fee Schedule Lookup tool page on the NGSMedicare.com website.
     

     

    Also from NGS

    Link to NGSConnex.com

    Link to Medicare University

    Link to NGS YouTube Channel

    Link to the NGS Twitter

     

    Copyright 2019 - National Government Services

     

     


  • Wednesday, November 13, 2019 4:01 PM | Jennifer Casasanta (Administrator)

    Marc D. Brown, M.D., professor of Dermatology and Oncology at the University of Rochester Medical Center, was elected president of the American Society for Dermatologic Surgery (ADSD) at the organization’s annual meeting in October. Brown is director of the department’s Division of Mohs Surgery and Cutaneous Oncology.

    An active ASDS member since residency, Brown previously served on its Board of Directors and on numerous work groups, and has chaired its Audit Committee and Educational Exchange Work Group.

    “I’m passionate about making sure that ADSD members can continue to provide appropriate quality care for their patients by working with policy makers and insurance payers at the local, state, and national levels,” Brown said. “I also believe educating the public through the media is imperative to continue the message of the safe and effective surgical treatments that dermatologic surgeons provide.”

    ASDS is the second largest professional medical specialty society for dermatology in North America.


  • Monday, November 11, 2019 8:43 AM | Jennifer Casasanta (Administrator)

    The CDC opioid prescribing guidelines do not endorse mandated or abrupt discontinuation of opioid prescriptions. The guidelines recommend tapering only when patient harm outweighs the benefit of opioid therapy. Nonetheless, there are reports of patients being abruptly dropped from their longstanding prescriptions without appropriate tapering or MAT referral.

    Please join CMS and the NYHPA for a webinar on November 13th at 1pm on the importance of appropriate tapering of opioids and the role played by MAT.

    On the webinar we'll discuss the efforts of payors to support appropriate tapering and MAT, the role of MAT, and how patients can be more effectively linked to treatment services when necessary.

    Speakers will include a representative from the CMS Regional Office, Dr. Sandy Koyfman and Dr. Cynthia Miller of Wellcare and Leah Kauffman and her colleague Samantha Arsenault of Shatterproof, a leading nonprofit organization dedicated to ending the devastation addiction causes families.  Participants will have ample time to raise concerns and questions during this important conversation.

    Register here.  Dial-in and login information will be sent in advance of the call.  Please share with prescribers, clinicians, and partners who may be interested in logging on or dialing in.


  • Tuesday, November 05, 2019 8:30 AM | Jennifer Casasanta (Administrator)

    CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS)

    MLN Connects Header Graphic

    Special Edition – Monday, November 4, 2019

     

    Physician Fee Schedule and OPPS/ASC Final Rules Call — November 6

    Wednesday, November 6 from 2:15 to 3:45 pm ET

     Register for Medicare Learning Network events.

     During this call, learn about the provisions in two CMS CY 2020 final rules:

     Changes to the Physician Fee Schedule are aimed at reducing burden, recognizing clinicians for the time they spend taking care of patients, removing unnecessary measures, and making it easier for clinicians to be on the path towards value-based care. Topics include:

    • Payment and supervision policy updates
    • Merit-based Incentive Payment System Value Pathways:  Streamlining the Quality Payment Program to reduce clinician burden
    • Creating the new Opioid Treatment Program benefit in response to the opioid epidemic

    In addition, updates and policy changes under the Medicare OPPS and ASC payment systems lay the foundation for a patient-driven health care system.

    A question and answer session follows the presentation. We encourage you to review the final rules prior to the call.

    Target Audience: Medicare Part B fee-for-service clinicians; office managers and administrators; state and national associations that represent health care providers; all hospitals operating in the United States; and other stakeholders.

    Like our newsletter? Have suggestions? Please let us know!

    The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered
    trademarks of the U.S. Department of Health and Human Services (HHS).

    Centers for Medicare & Medicaid Services and The Medicare Learning Network


  • Tuesday, November 05, 2019 8:18 AM | Jennifer Casasanta (Administrator)

    The CDC opioid prescribing guidelines do not endorse mandated or abrupt discontinuation of opioid prescriptions. The guidelines recommend tapering only when patient harm outweighs the benefit of opioid therapy. Nonetheless, there are reports of patients being abruptly dropped from their longstanding prescriptions without appropriate tapering or MAT referral.

    Please join CMS and the NYHPA for a webinar on November 13th at 1pm on the importance of appropriate tapering of opioids and the role played by MAT.

    On the webinar we'll discuss the efforts of payors to support appropriate tapering and MAT, the role of MAT, and how patients can be more effectively linked to treatment services when necessary.

    Speakers will include a representative from the CMS Regional Office, Dr. Sandy Koyfman and Dr. Cynthia Miller of Wellcare and Leah Kauffman and her colleague Samantha Arsenault of Shatterproof, a leading nonprofit organization dedicated to ending the devastation addiction causes families.  Participants will have ample time to raise concerns and questions during this important conversation.

    Register here.  Dial-in and login information will be sent in advance of the call. 


  • Thursday, October 24, 2019 12:33 PM | Jennifer Casasanta (Administrator)

    New Medicare Card:

    Claim Reject Codes After January 1

    Starting January 1, 2020, you must use Medicare Beneficiary Identifiers (MBIs) when billing Medicare regardless of the date of service:

    ·         Medicare will reject claims submitted with Health Insurance Claim Numbers (HICNs) with a few exceptions

    ·         Medicare will reject all eligibility transactions submitted with HICNs

    If you do not use MBIs on claims after January 1, you will get:

    • Electronic claims reject codes: Claims Status Category Code of A7 (acknowledgment rejected for invalid information), a Claims Status Code of 164 (entity’s contract/member number), and an Entity Code of IL (subscriber)
    • Paper claims notices: Claim Adjustment Reason Code (CARC) 16 “Claim/service lacks information or has submission/billing error(s)” and Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier”

    Do not wait. Protect your patients’ identities by using MBIs now for all Medicare transactions. Need an MBI?

    • Ask your patients for their cards. If they did not get a new card, give them the Get Your New Medicare Card flyer in English or Spanish.
    • Use your Medicare Administrative Contractor’s look-up tool. Sign up for the Portal to use the tool.
    • Check the remittance advice. Medicare return the MBI on the remittance advice for every claim with a valid and active HICN.

    For more information, see the MLN Matters Article.


  • Thursday, October 24, 2019 12:27 PM | Jennifer Casasanta (Administrator)

    Centers for Medicare & Medicaid Services

    Primary Care First Model Options Request for Applications (RFA) & Webinars Announced

     

    The Centers for Medicare and Medicaid Services (CMS) is excited to announce that the Primary Care First Request for Applications (RFA) and Practice Application are now live!

    Review the RFA on the Primary Care First website for full details on the model, including information on model participation options, practice eligibility, and payment.

    Primary Care First is currently accepting Practice Applications. The deadline to apply is January 22, 2020.

    The application is now open!

    In the coming week, CMS will also release a Primary Care First Statement of Interest form from prospective payer partners through December 6, 2019. This process will be followed by a formal Solicitation of Payer Partnership beginning on December 9, 2019 through March 13, 2020.

     

    Upcoming Primary Care First Webinars

    The Primary Care First team will be hosting two webinars to help you learn more and apply: an Application Webinar on October 30th and the Seriously Ill Population (SIP) Part II Webinar on October 31st.

    Please feel free to forward this bulletin to colleagues who will be involved in submitting your organization’s Practice Application for Primary Care First or that may be interested in attending these events.

    For additional information, please visit the Primary Care First Model Options web page.

     

    Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.

     

     


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