• Thursday, February 06, 2020 12:21 PM | Jennifer Casasanta (Administrator)

    Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging – Educational and Operations Testing Period - Claims Processing Requirements

    Click Here


  • Monday, February 03, 2020 12:10 PM | Jennifer Casasanta (Administrator)

    Quality Payment Program

    Register for the February 12 MIPS Value Pathways Webinar

    The Centers for Medicare & Medicaid Services (CMS) is hosting a webinar on Wednesday, February 12 at 2:30 p.m. ET to provide an overview of the MIPS Value Pathways (also referred to as MVPs) participation framework, which was outlined in the 2020 Quality Payment Program Final Rule. CMS is committed to co-developing the MIPS Value Pathways with stakeholders and the public, and will be using this webinar to answer questions from organizations interested in providing input on MVPs.

    During the webinar, CMS subject matter experts will:

    • Recap the MIPS Value Pathways framework
    • Discuss the goals of the MVPs and benefits for clinicians
    • Obtain feedback and answer questions as time allows

    Please note that this webinar will only cover existing information about the MIPS Value Pathways, as found within the 2020 Final Rule, MVPs webpage, and accompanying materials such as the MVPs fact sheet and illustrative diagrams. No new information about the MVPs will be presented during this time.

    Webinar Details

    Title: MIPS Value Pathways Webinar

    Date: Wednesday, February 12, 2020

    Time: 2:30 – 3:30 p.m. ET

    Registration Link: https://register.gotowebinar.com/register/7531766105167712011

    Please note: The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. CMS will open the phone line for the feedback portion. If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com.

    Quality Payment Program


  • Wednesday, January 22, 2020 9:02 AM | Jennifer Casasanta (Administrator)

    Centers for Medicare & Medicaid Services

    Quality Payment Program

    New 2019 Data Submission Resources Now Available on the QPP Resource Library

    CMS has posted the following new Quality Payment Program (QPP) resources to the QPP Resource Library to help eligible clinicians submit their 2019 Merit-based Incentive Payment System (MIPS) data until the submission period closes at 8:00 p.m. EDT on March 31, 2020. 

    • 2019 Opt-In Demonstration Videos:
      • Opt in as a QPP Eligible Clinician – Explains how to report MIPS data for the 2019 performance period as an opt-in eligible clinician.
      • Opt in as a Registry – Provides an overview on how a Qualified Registry can report MIPS data and make an election for an opt-in eligible participant through the Registry Dashboard on the QPP website.
    • 2019 Web Interface Demonstration Videos – A series of videos, which describe how to use the CMS Web Interface for reporting 2019 performance period data. Video topics include an Excel template introduction, data irregularities, planning the work, PREV-10, resolving errors, 2019 data submission, and tracking progress. Web Interface Support Call webinar recordings will also be added to this video playlist.

    For More Information

    • Contact the Quality Payment Program at 1-866-288-8292 or by e-mail at: QPP@cms.hhs.gov. To receive assistance more quickly, consider calling during non-peak hours---before 10 AM and after 2 PM ET. We also encourage you to contact us earlier in the year, as response times often increase with heavier demand as the March 31 data submission deadline approaches.
      • Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

    Quality Payment Program


  • Tuesday, January 21, 2020 10:11 AM | Jennifer Casasanta (Administrator)

    Centers for Medicare & Medicaid Services

    CMS Updates Open Payments Data

    Today, January 17, 2020, the Centers for Medicare & Medicaid Services (CMS) updated the Open Payments dataset to reflect changes to the data that took place since the last publication in June 2019. The updated dataset is now available for viewing at https://openpaymentsdata.cms.gov/.

    CMS updates the Open Payments data at least once annually to include updates from disputes and other data corrections made since the initial publication of the data. The refreshed Open Payments Data Set includes:

    • Record Updates: Changes to non-disputed records that were made on or before November 15, 2019, are published.
    • Disputed Records: Dispute resolutions completed on or before December 31, 2019 are displayed with the updated information. Records with active disputes that remained unresolved as of December 31, 2019 are displayed as disputed.
    • Record Deletions: Records deleted before December 31, 2019 were removed from the Open Payments database. Records deleted after December 31, 2019, remained in the database, but will be removed during the next data publication in June 2020.

    The following is not included in the data refresh:

    • Any records submitted to the Open Payments system for the first time after the close of the Program Year 2018 submission window (March 31, 2019). 
    • Any records that were disputed and for which dispute resolution resulted in a change to the covered recipient.

    Note: Updates not included in the refresh are due to the requirement that covered recipients must be provided an opportunity to review data attributed to them for accuracy. For more information about the Open Payments Program timeline, visit www.cms.gov/openpayments

    This financial data was submitted by applicable manufacturers and group purchasing organizations (GPOs).

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    Open Payments Website Updates

    CMS is pleased to announce that the Open Payments search tool (https://openpaymentsdata.cms.gov/) was updated with the following features:

    Entity Profile Updates

    • The profile pages for companies, physicians and teaching hospitals were redesigned to present the payment data in a dashboard format.
    • Users can apply filters to sort the data by year, payment type, entity making or receiving payment, and nature of payment which updates the data sections.

    Query Builder Renamed “Advanced Search”

    • The Query Builder has been renamed to “Advanced Search” and remains located on the Open Payments search tool homepage.
    • The advanced search features and autocomplete for entity lookup and an improved searching experience.

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    Questions – Contact Live Help Desk

    Submit questions to the Help Desk via email at openpayments@cms.hhs.gov or by calling 1-855-326-8366 (TTY Line: 1-844-649-2766), Monday through Friday, from 9:00 a.m. to 5:00 p.m. (ET), excluding Federal holidays.

    The Help Desk refers media inquiries to CMS’ Press Office for response. 

    Visit the Resources page on the Open Payments website for many of the above resources.

    (Back to top)

    Creating Public Transparency of Industry-Physician Financial Relationships. Learn More.

    Centers for Medicare & Medicaid Services (CMS) has sent this update.

    To contact CMS go to our Contact Us page.


  • Monday, January 13, 2020 2:08 PM | Jennifer Casasanta (Administrator)

    Quality Payment Program

    Upcoming QPP Service Center Hold Times

    Due to the opening of the 2019 MIPS data submission period, the Quality Payment Program (QPP) Service Center is projecting an increase in volume of calls and emails between January and March 2020, resulting in longer wait times.

    CMS recommends the following to minimize wait times and ensure successful 2019 submission:

    • Use One Method to Report Issues— Due to the increase in volume at the QPP Service Center and to minimize backlog, please use only one method of reporting for the same issue (email or phone). Note: Cases are processed in the order which they are received regardless of the manner in which the Service Center was contacted. Please allow time for processing.
    • Submit Your Data Early— We encourage you to submit your 2019 MIPS performance period data early during the submission period. Early submission will allow you plenty of time for Service Center assistance if needed.
    • Call the Service Center at Off-Peak Hours— We strongly recommend calling the Service Center during off-peak hours (8:00 AM-10:00 AM ET OR 2:00 PM-8:00 PM ET).

    For More Information

    • Visit the QPP Resource Library to review new and existing QPP resources.
    • Contact the Quality Payment Program at 1-866-288-8292, Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at: QPP@cms.hhs.gov. Reminder: to receive assistance more quickly, consider calling during non-peak hours—before 10:00 AM and after 2:00 PM ET.
      • Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

     

    Quality Payment Program


  • 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.

    twitter

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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.


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