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:
Do not wait. Protect your patients’ identities by using MBIs now for all Medicare transactions. Need an MBI?
For more information, see the MLN Matters Article.
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.
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.
A monthly bulletin about clinical quality measurement resources and opportunities
October 2019 [Volume 4, Edition 10]
Announcements: Stay Up to Date
Now Available: CMS is pleased to announce the publication of the updated Blueprint for the CMS Measures Management System (MMS). The updated version 15.0 of the MMS Blueprint is located on the MMS website. See Appendix A for a list of changes. Click here to access the MMS Blueprint v15.0
Now Available: Data Element Definitions for CMS eCQMs for 2020 Quality Reporting/Performance Period on the Collaborative Measure Development Workspace, Data Element Repository. Click here to access the full announcement
Now Available: 2020 Merit-based Incentive Payment System Performance Period Virtual Group Participation Overview Fact Sheet. Click here to access the fact sheet and toolkit
Now Available: 2019 Improvement Activities Performance Category Fact Sheet. The fact sheet provides an overview of the 2019 Merit-based Incentive Payment System (MIPS) Improvement Activities performance category. Click here to access the fact sheet
From CMS.gov: Ensuring Safety and Quality in Nursing Homes: Five Part Strategy Deep Dive. Click here to read the article
ICYMI: Medicare Plan Finder Gets an Upgrade for the First Time in a Decade. Click here to access the press release
Get Involved: Upcoming Events
Stakeholder Engagement Opportunities
Public Comment, Technical Expert Panels (TEP), and Federal Register Rule Comment
National Quality Forum (NQF) Event Calendar
Interested in providing feedback on measures under consideration for NQF endorsement? The NQF event calendar includes details about current and upcoming comment periods as well as information about upcoming meetings.
Stay in Touch
Have questions or suggestions? We're here to help!
Centers for Medicare & Medicaid Services (CMS) has sent this Measures Management System Update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.
Beneficiary Entitlement Date Errors Causing Incorrect Part A and Part B Claim Denials Date Reported: 10/9/2019 Status: Open Provider Type(s) Impacted: Part A, Part B, HH+H Reason Code(s): N/A Claim Coding Impact: N/A Description of Issue
National Government Services Action
NGS is actively pursuing a solution to this issue which will be shared with providers as soon as possible.
Provider Action
Please continue to check the Production Alerts section of our website and Email Updates for additional status information
Proposed Resolution/Fix Date
TBD
Registration is now open for the 2019 Healthcare Innovations Conference hosted by Pandion Healthcare: Education & Advocacy. This full-day educational event will be held on November 13 at the Rochester Riverside Hotel. Last year, more than 200 physicians, healthcare administrators and clinicians attended the conference, representing more than 70 organizations across New York.
Pandion has secured an award-winning speaker: Emmanuel Fombu, MD, MBA. Dr. Fombu is a physician, author, speaker, and healthcare executive turned Silicon Valley entrepreneur. He is the author of the book, “The Future of Healthcare: Human and Machines Partnering for Better Outcomes.”
Attendees will also be able to choose from six different educational tracks:
For more information and to register, please visit https://www.pandionalliance.com/healthcare-education-and-advocacy/2019-conference
Questions? Please contact Christine Pittman Ballard at cballard@pandionalliance.com or 585.214.2411.
The Workers Compensation Board is offering new resources to assist in the transition to Form CMS-1500, which will streamline medical billing and reduce the paperwork requirements currently in the workers compensation system.
To help you prepare, the Board has developed a training video to show health care providers, and all others who will be using Form CMS-1500, how to use the form and the required narrative reports to bill for their services to workers compensation patients.
Next week, the Board is also holding two follow-up Q&A webinars so that you can get answers to any questions you may have after viewing the training video and reading the CMS-1500 FAQ's on the Board s website.
With that in mind, we encourage you to view the training video before attending one of the webinars. As you view the training video, take note of questions that come up so that you ll be prepared for the Q&A webinar. This will enable you to take full advantage of both resources.
To view the training video, follow this link: CMS-1500 Training Video
The webinars will be held next week on:
September 17, 2019 8:30 a.m. - 9:30 a.m. Register Here September 18, 2019 4:00 p.m. - 5:00 p.m. Register Here
In the meantime, please see CMS-1500 Initiative and the CMS-1500 FAQ for information.
Please direct questions to CMS1500@wcb.ny.gov
The HBA Rochester affiliate has been founded to support the
Rochester healthcare community, fostering stronger relationships
and advancing women in healthcare. Join us at our first networking
event in Rochester,NY where we will learn the importance of
resilience in our careers from esteemed guest, Rebecca Leclair. Take
an opportunity to network with like-minded professionals in
healthcare and learn about what HBA can offer you.
HBA Rochester_ Launch Event 25 Sept.pdf
MM11437 2020 HPSAs.pdf
