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.
CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS)
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:
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.
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
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.
Please continue to check the Production Alerts section of our website and Email Updates for additional status information
Proposed Resolution/Fix Date
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 email@example.com or 585.214.2411.