Reimbursement E-News ISSUE: 17 May 2014 MISSION STATEMENT NJSOM is committed to keeping our members informed through quarterly educational conferences, networking, and continuous updates to our website. As part of our responsibility we strive to create an environment of constant learning and improvement in the Oncology/Hematology arena. NJSOM works hard to foster a network of growth, support and collaboration among our members. NJSOM is committed to the highest standards of ethics and integrity and strongly believes that we are responsible to our members, stakeholders, and to the community we serve. We believe that through education and commitment, NJSOM can improve the practice of Oncology in the State of New Jersey and subsequently improve the lives of cancer patients and their families. ADVERTISING OPPORTUNITIES!! We are looking for supporters of the NJSOM Reimbursement E-News. Interested parties contact one of our Board Members…CLICK HERE New Jersey Society of Oncology Managers PO Box 95 Florham Park, New Jersey 07932 Phone: Fax: E-mail: 800.658.5011 973.453.8133 info@njsom.org Front Page News Novitas Solutions Inc. Welcome to this Publication of the Monthly Newsletter!! The New Jersey Society of Oncology Managers Reimbursement E-News is a monthly publication focused on the latest reimbursement news for your Oncology Practice. You can scroll through the document a page at a time or you can use the links along the bottom to assist in quick navigation. Please feel free to submit any comments, suggestions, stories and/or questions to Michelle Weiss, editor, at njsombilling@gmail.com Community Oncologists and Administrators on Capitol Hill Talking Sequestration and Payment Reform May 2, 2014 – COA President Dr. Mark Thompson led a team meeting with members of Congress and staff in previewing the Virtual Hill Days May 7-8 to stop the sequester cut to cancer drugs. Kathleen Sebelius Resigns as HHS Secretary By JOANNE KENEN | 4/10/14 6:53 PM EDT Updated: 4/10/14 Health and Human Services Secretary Kathleen Sebelius is resigning six months after a disastrous rollout of President Barack Obama’s signature health law, according to administration sources. On Friday, Obama will nominate Sylvia Mathews Burwell, the director of the Office of Management and Budget, to replace her. READ MORE CMS Medicare Other Payer Updates READ MORE Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 2 Front Page News CMS Releases Trove of Medicare Physician Billing Data Apr 09, 2014 - The Centers for Medicare & Medicaid Services is making this information available for the first time in 35 years. Meanwhile, in their first run at the data, news outlets report that a small number of doctors account for a large share of Medicare costs. READ MORE Sliver of Medicare Doctors Get Big Share of Payouts By REED ABELSON and SARAH COHENAPRIL 9, 2014 - A tiny fraction of the 880,000 doctors and other health care providers who take Medicare accounted for nearly a quarter of the roughly $77 billion paid out to them under the federal program, receiving millions of dollars each in some cases in a single year, according to the most detailed data ever released in Medicare’s nearly 50-year history. READ MORE CMS Releases Tool to Search the Medicare Database by Provider Following CMS’ release of physician-specific raw Medicare data last week, the agency posted a tool to allow searches of the Medicare database by provider. This new look-up tool makes it easier to use the large data set about physician information that CMS released on April 9, 2014 to look up specific providers. CLICK HERE to access the tool. Are You Taking a Peek at Your Neighbor? ASCO Calls on CMS to Resolve Medicare Payment Data Issues (ASCO in Action) Apr 17, 2014 - The American Society of Clinical Oncology (ASCO) is urging the Centers for Medicare & Medicaid Services (CMS) to immediately correct inaccuracies in Medicare physician payment data released last week. READ ARTICLE Front Page News Novitas Solutions Inc. Written by Nancy J. Beckley, MB, MBA, CHC Do you know how much your healthcare “neighbors” charge? Can you believe the kind of fraud that is going on? The recent release by the Centers for Medicare & Medicaid Services (CMS) of the 2012 Medicare Physician Payment Data has generated a lot of buzz in the popular media as well as the trade media. The professional statisticians (think RACmonitor contributing columnist and mathematician Frank Cohen) have downloaded the massive data file, converted it into a robust database, and are busy running algorithms. The rest of us amateurs are left to peek at the data through one of the portals, such as the Wall Street Journal’s Medicare Payment to Providers 2012. Have you been there yet? Who did you look up? A colleague, a competitor, your primary care physician? Or perhaps your physical therapist or favorite ambulance company? Physicians and ancillary providers alike, if they billed Medicare in 2012, likely are all there. READ MORE CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 3 Front Page News ASCO Proposes Innovative Patient-Centered Payment System for Cancer Care May 4, 2014 - The American Society of Clinical Oncology (ASCO) today released a detailed proposal for a new approach to physician payment for cancer care services under Medicare. ASCO’s model would fundamentally restructure the way oncologists are reimbursed for cancer care in the United States by focusing payment on the full range of patient services that oncologists provide, while incentivizing high-quality, patient-centered care. READ MORE Avoiding EHR Note 'Cloning' While Maintaining Efficiency Copying-and-pasting in your electronic health record system can boost productivity, but use judgment In the wake of a recent government report that said the Centers for Medicare and Medicaid Services (CMS) is not doing enough to prevent electronic health record (EHR)enabled billing fraud, some physicians say they’re concerned that CMS might outlaw copying and pasting of previous visit notes into current notes in EHRs. Such a move, they say, would make practices less efficient and impede patient care. Calendar of Events "There comes a point where you can’t hamper the workflow of a doctor in the office if you want them to take good care of patients,” says Edward J. Gold, MD, an internist in Emerson, New Jersey. FULL ARTICLE Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 4 Novitas Solutions Inc. JL Top Claim Submission Errors The Top Claim Submission Errors and their resolution for March 2014 are now available. Please take some time to review these errors and avoid them on future claim submissions. 2014 Medicare Symposium "Understand the Basics of the Medicare Program" Session Handout Updated The 2014 Medicare Symposium session handout for "Understand the Basics of the Medicare Program" has been updated! If you have registered for this event, please take the time to review and print the updated handout. READ MORE READ MORE Informational Alert Common Working File (CWF) Hosts will be Conducting History Purges On Saturday, May 10, 2014, the CWF Southeast, South, and Pacific Hosts will be conducting a history purge. On Saturday, May 17, 2014, the CWF Northeast, Great Lakes, and Keystone Hosts will be conducting a history purge. Due to the anticipated duration of this activity and to ensure the completion of weekly processing and scheduled data center maintenance, there will be a CWF Dark Day at those Hosts only on the Saturday specified for the purge. This means there will be no access to the Health Insurance Master Record (HIMR) query, which is usually available until noon on Saturdays. All files received from satellites for each Fridays’ cycle will be completed prior to bringing CWF production down for those three weeks. If, for any reason, satellite files are received late Saturday morning, they will be processed by CWF after the history purge has been completed. The oldest claim history maintained at all nine of the CWF Hosts, after the purge process will be as follows: Oldest Inpatient claim Thru Date to be kept on file is January 1, 1966 Oldest Outpatient claim Thru Date to be kept on file is February 1, 2012 (27 months) Oldest Part B claim Thru Date to be kept on file is May 1, 2012 (24 months) Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Novitas Solutions e-News Electronic Billing Quarterly Newsletter MAY 2014 (Next edition to be released in May) Articles of note: Novitasphere Update Correct Usage of the EDI Fax Cover Sheet New Process for EDI Enrollment Forms And More…Available CLICK HERE Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 5 Novitas Solutions Inc. JL Part B Top Inquiries (January 2014 - March 2014) The monthly Part B FAQs have been updated. Please take some time to review these FAQs for answers to your questions. Local Contractor Pricing Information is now Available! A new information page specific to Local Contractor Pricing has been added to the Fee Schedule section of our web site. This new page includes an overview of the local pricing process, information on drug pricing, a section of frequently asked questions, pricing references, and pricing resources. READ MORE READ MORE New homepage for Clinical Trial and Device Information! Other Part B Frequently Asked Questions (FAQs) (January - March 2014) The Other Frequently Asked Questions (FAQs) have been updated. Please visit our FAQs for the answers to your questions. We are pleased to announce a new look and location for our Clinical Trial and Device information. Simply move your cursor to LCDs/Medical Policy located on the left menu and then click on Clinical Trials/Devices. You can find the most up-to-date information on Clinical Trials, Investigational Device Exceptions (IDEs), Humanitarian Device Exemptions (HDEs), Humanitarian Use Devices (HUDs), Pre-Market Approvals (PMAs), PMA Post-Approval Extension Studies, and Pre-Market Notification (PMN) (510(k)). READ MORE Medicare Part B- H O T L I N K S ! 2014 Medicare JL Part B Fee Schedule April 2014 Average Sales Price (ASP) Files 2014 Physician Fee Schedule Final Rule Current Active Part B LCD Policies Quarterly Update to CCI Edits Effective 4/1/2014 2014 CMS Physician Fee Schedule Final Rule Fact Sheet READ MORE Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 6 Novitas Solutions Inc. Self-Service Tools Did you know Novitas has many interactive apps to help answer your questions? We created these helpful tools to give you access to information you need, when you need it, without having to pick up the phone. Here are some of the great tools we offer to our providers: Appeals Status Tool Check to see if your appeal had a favorable outcome! This app shows details on the appeals you’ve submitted to Medicare. Enrollment Status Tool Have you filed an enrollment application or revalidation recently? Check to see where it’s at. Fee Schedule lookup App This app provides quick access to fee rates for CY 2012, 2013, and 2014! Secondary liability calculator Having trouble understanding the payment on Medicare Secondary claims? This tool helps you calculate what Medicare’s liability would be when there is another primary insurer. Also make sure to check out the Patient Responsibility Calculator afterwards to determine if there is a balance due from the patient Interactive Voice Response Unit (IVR) If you can’t find the information you’re looking for with these tools, make sure to review our IVR user guide. The IVR will give you comprehensive information on Claim Status and Patient Eligibility. You can also get check status, order a duplicate remittance, or get that patient account number you were looking for! IVR User Guide IVR Alphanumeric Conversion Tool IVR Name to Number Conversion Tool Front Page News Novitas Solutions Inc. CMS Medicare Enroll for Novitasphere Portal today! Novitas Solutions is pleased to announce open enrollment of its Novitasphere Portal! Novitasphere is a free, web-based portal that will allow you access to Eligibility, Claim Information and Remittance Advice, Claim Submission with File Status, Electronic Remittance Advice (ERA), Claim Correction, and a MailBox. Eliminate the need to call Novitas for this information, resulting in time savings for your office! Novitasphere is also a great alternative to using dial-up or Secure File Transfer Protocol (SFTP) for your EDI transactions. If you are a Medicare JL Part B Provider in the states of Pennsylvania, New Jersey, Maryland, Delaware and the District of Columbia/Metropolitan area, please visit our dedicated Novitasphere Portal center for information related to Novitasphere. This page will be your go-to resource for information on Novitasphere, technical requirements, the enrollment process, and contact information for Novitas as it relates to the portal. Please carefully review the information on this center before completing your Enrollment Form. It is important to note, customers must be running Internet Explorer Version 8 (or newer), Google Chrome, Apple Safari, or Mozilla Firefox in order to access Novitasphere. You can find the Novitasphere Portal center on the left side of the JL Part B center CLICK HERE or by visiting CLICK HERE. Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 7 Novitas Solutions Inc. Here are Upcoming Training Events You Won’t Want to Miss On-Demand Education DATE TIME EVENT LOCATION 05/13/14 10:00am-1100am Part B Incident To and Shared Split Billing 05/15/14 10:00am-11:00am Ask-the-Contractor Teleconference 05/16/14 10:00am-11:30am 05/20/14 11:00am-12:00pm Part B Understand the LCD and NCD Process New Patient Guidelines and Coding 05/20/14 2:00pm-3:30pm 05/23/14 10:00am-11:30am 05/27/14 10:00am-11:30pm 06/03/14 10:00am-1100am Via Webinar Via Teleconference Via Webinar Via Webinar Walking Through the CMS Regulations-A Journey of Compliance Part B Medicare Secondary Payer Basics Via Webinar Part B Established Patient Billing and Coding Office Visits Evaluation and Management Score Sheet: Part 1- Understanding the Key Components of Evaluation and Management Services Update-New Novitas Website Via Webinar Via Webinar Via Webinar 06/04/14 1:00pm-2:30pm Via Webinar 06/04/14 10:00am-1100am Using Place of Service Codes Correctly Via Webinar 06/05/14 10:00am-1100am Evaluation and Management Score Sheet: Part 2- Introduction to the Score Sheet Via Webinar NJSOM Members don’t miss this meeting! Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Weekly Audio Podcasts Training Modules Medicare Reference Manual Specialty Guides Acronyms & Abbreviations Frequently Asked Questions Quick Ref. Guides & Claims Errors/Issues Evaluation & Management (E/M) Center Comprehensive Error Rate Testing (CERT) Center CMS Education Open Payments (Physician Payments Sunshine Act) * Medicare Learning Network * National Provider Training Program * Internet-Only Manual * Provider Specialty Links Reducing Medicare and Medicaid Fraud and Abuse: Protecting Practices and Patients * How CMS Is Fighting Fraud: Major Program Integrity Initiatives * Safeguarding Your Medical Identity * Are You Ready for the National Physician Payment Transparency Program? * Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 8 CMS Medicare Performant Recovery can only audit issues approved by CMS and posted on their website. Be sure to monitor the Performant Recovery website frequently to stay up to date on audit issues. We will keep an eye on the Performant Recovery website and provide updates in future Reimbursement E-News. Visit https://www.dcsrac.com/PROVIDERPORTAL.aspx and click on the issues link to view approved issues. Important Provider Notice: May 01, 2014 - The following information is intended to notify providers of current Recovery Auditors' activities after June 1, 2014. As noted in previous updates, the last day that Recovery Auditors may send adjustment files to the Medicare Administrative Contractors (MAC) is June 1, 2014. As of June 2, 2014, only claim closure files may be sent to the MACs by the Recovery Auditor. Because no additional reviews will occur under the current contracts, current Recovery Auditors will not be required to update the "New Issue" (Approved Issue) portion of their websites as of June 2, 2014. However, Recovery Auditors shall continue to update the "Claim Status" portion of their provider portal, in a timely manner, until further notice. Recovery Auditors shall complete all Discussion Periods that are underway as of June 1, 2014. Recovery Auditors shall continue to accept new Discussion Period requests until June 30, 2014. All Discussion Periods initiated during June shall be completed. Recovery Auditors shall not accept new Discussion Period requests after July 1, 2014. Recovery Auditors shall continue to maintain their customer service areas (telephone lines and appropriately training staff) and process for escalating concerns, until further notice. Recovery Auditors shall continue to support the appeal process. Note: Medicare Administrative Contractor (MAC) processes will continue. Therefore, claims sent for adjustment, by a Recovery Auditor, on or before June 1, 2014 may complete the adjustment process on, or after, June 2, 2014. The Medicare Appeals process will also continue. Therefore, recoupments can occur, if a provider does not file a timely appeal (to the 1st or 2nd level of appeal), or receives an "unfavorable" decision at the 2nd level (QIC) of the appeals process. Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 9 CMS Medicare Holistic Collaborative Documentation Written by Sharon Easterling, MHA, RHIA, CCS, CDIP, CPHM Isn’t it great to imagine a health system in which the documentation shares a common thread and consistency across all payer types? One in which a patient with chronic systolic congestive heart failure has that diagnosis in their hospital medical record for Part A payment and within the physician record for Part B payment? Is it possible to have “Holistic” Documentation? This very well may be, as CMS continues to place providers on a path to meeting Meaningful Use, ICD-10, and ValueBased Purchasing/Pay for Performance/Accountable Care initiatives. Documentation has emerged into the need to document for payment and, ultimately, for survival. READ MORE Crowdsourcing Compliance: The Wrong Way to Do Things Written by Frank Cohen, MPA Created on Thursday, 01 May 2014 On April 9, the Centers for Medicare & Medicaid Services (CMS) made public a database that for years has been both highly coveted and highly protected. Prior attempts to get it released were stridently challenged in court, as it was believed that releasing the data, with all of its flaws and limitations would do more harm than good. Well, not much has changed, except now the data is freely available on the CMS website. The database contains utilization, billing, and payment data on pretty much every person and organization that billed Medicare in 2012. READ MORE New Data Spotlight Tracks Rising Enrollment in Medicare Advantage Plans A new brief from the Kaiser Family Foundation documents the continuing climb in Medicare Advantage plan enrollment, even at a time when payments to such plans are being reduced under the Affordable Care Act. Despite spending reductions enacted in the ACA to reduce historical overpayments to Medicare Advantage plans, from March 2013 to March 2014 enrollment in Medicare Advantage plans grew by 9 percent, or 1.4 million people, to reach a total of 15.7 million Medicare beneficiaries. READ MORE Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 10 CMS Medicare “HIPAA EDI Standards” Web-Based Training Course — Revised The “HIPAA EDI Standards” Web-Based Training (WBT) course was revised and is now available. This WBT is designed to provide education on electronic billing, transaction standards, and code sets. It includes an overview of the steps involved in the Medicare electronic data interchange process. Continuing education credits are available to learners who successfully complete this course. See course description for more information. New MLN Provider Compliance Fast Fact A new fast fact is now available on the MLN Provider Compliance web page. This web page provides the latest MLN Educational Products and MLN Matters® Articles designed to help Medicare health care professionals understand common billing errors and avoid improper payments. Please bookmark this page and check back often as a new fast fact is added each month. To access the WBT, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page. CMS Tipsheet for Multiple Locations Recent LearnResource & MedLearn Matters Articles CMS has created the new Multiple Locations Tipsheet for eligible professionals practicing at multiple locations. The Tipsheet provides information on how to successfully demonstrate meaningful use in the Medicare and Medicaid EHR Incentive Programs. The Tipsheet includes guidance on determining if a location is equipped with certified EHR technology, calculating patient encounters, and what to do when different menu objectives and clinical quality measures are chosen across locations. Visit the CMS EHR Incentive Programs website for more resources to help you successfully participate. Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Individualized Quality Control Plan for CLIA Laboratory Non-Waived Testing — Register Now Stage 2 Meaningful Use Requirements, Reporting Options, and Data Submission Processes for Eligible Professionals — Registration Now Open Notices of Intent to Apply for the Medicare Shared Savings Program 2015 Program Start Date Due by May 30 CMS is Accepting Suggestions for PQRS Measures Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 11 CMS Medicare New Fact Sheet Available on How to Avoid the 2016 PQRS Payment Adjustment Are you an eligible professional or part of a group practice participating in Physician Quality Reporting System (PQRS) this year? If so, you must satisfactorily report data on quality measures during 2014 to avoid the 2016 payment adjustment. Review the new fact sheet for guidance on how to avoid the 2016 PQRS Payment Adjustment. Avoid the 2016 Payment Adjustment You can avoid the 2016 payment adjustment by meeting one of the following criteria during the one-year 2014 reporting period (January 1–December 31): If Participating as an Individual Eligible Professional: Meet the criteria for satisfactory reporting adopted for the 2014 PQRS incentive. Or, participate in PQRS via qualified clinical data registry, qualified registry, or claims reporting and report at least three measures covering one National Quality Strategy (NQS) domain for at least 50 percent of your Medicare Part B Fee-For-Service (FFS) patients. If Participating as a Group Practice: Meet the Group Practice Reporting Option (GPRO) requirements for satisfactory reporting. Or, participate in PQRS via qualified registry reporting and report at least three measures covering one NQS domain for at least 50 percent of your group practice’s Medicare Part B FFS patients. Want more information about PQRS? Visit the PQRS website PQRS Participants: New Email Address for QualityNet Help Desk Do you have questions about participating in the Physician Quality Reporting System (PQRS)? The QualityNet Help Desk is available to assist you with your PQRS inquiries. The QualityNet Help Desk can provide guidance on: General PQRS program information Portal password issues Feedback report availability and access PQRS-IACS registration questions PQRS-IACS login issues Contact the Help Desk - Hours: 7am through 7pt CT; Monday-Friday - Phone: 866-288-8912; TTY: 1-877-715-6222 – Email: Qnetsupport@hcqis.org Other PQRS Resources - Additional resources are available on the Educational Resources web page to help you satisfactorily report your 2014 PQRS data. Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 12 CMS Medicare CMS NEWS FOR IMMEDIATE RELEASE - May 2, 2014 Administration announces proposal to clarify availability of Health Insurance Marketplace coverage to workers eligible for COBRA WASHINGTON – The Obama administration today announced updates to model notices informing workers of their eligibility to continue health-care coverage through the Consolidated Omnibus Budget Reconciliation Act. The updates make it clear to workers that if they are eligible for COBRA continuation coverage when leaving a job, they may choose to instead purchase coverage through the Health Insurance Marketplace. READ MORE New MLN Educational Web Guides Fast Fact A new fast fact is now available on the MLN Educational Web Guides web page. This web page provides information on Evaluation and Management services; Guided Pathways that contain resources and topics of interest; lists of health care management products; and easy-tounderstand billing and coding educational products. It is designed to provide educational and informational resources related to certain Medicare Fee-For-Service initiatives. Please bookmark this page and check back often as a new fast fact is added each month. http://www.dol.gov/opa/media/press/ebsa/ebsa20140750.htm "Part C & Part D: Organization Determinations, Appeals & Grievances” Web-Based Training Course — Released PART C The “Part C Appeals: Organization Determinations, Appeals & Grievances” Web-Based Training Course (WBT) was released and is now available. This WBT is designed to provide designed to provide education on Medicare Part C Appeals for health care and plan professionals. It includes information on basic definitions of terms related to Part C organization determinations, appeals & grievances; requirements for organization determinations; and common problems encountered by plans. Continuing education credits are available to learners who successfully complete this course. See course description for more information. PART D The “Part D Organization Determinations, Appeals & Grievances” Web-Based Training Course (WBT) was released and is now available. This WBT is designed to provide designed to provide education on Medicare Part D Appeals for health care and plan professionals. It includes information on basic definitions of terms related to Part D coverage determinations, appeals & grievances as well as, requirements for appeals, effectuation and grievances. Continuing education credits are available to learners who successfully complete this course. See course description for more information. To access the WBTs, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page. Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 13 CMS Medicare EHR Incentive Program: Hardship Exception Applications due July 1 for Eligible Professionals Are you a Medicare provider who was unable to successfully demonstrate meaningful use for 2013 due to circumstances beyond your control? CMS is accepting applications for hardship exceptions to avoid the upcoming Medicare payment adjustment for the 2013 reporting year. Payment adjustments for the Medicare Electronic Health Record (EHR) Incentive Program will begin on January 1, 2015 for eligible professionals. However, you can avoid the adjustment by completing a hardship exception application and providing supporting documentation that proves demonstrating meaningful use would be a significant hardship for you. CMS will review applications to determine whether or not you are granted a hardship exception. CMS has posted hardship exception applications on the EHR website for: Eligible professionals Eligible professionals submitting multiple National Provider Identifiers (NPIs) Applications for the 2015 payment adjustments are due July 1, 2014 for eligible professionals. If approved, the exception is valid for one year. New Hardship Exception Tipsheets You can also avoid payment adjustments by successfully demonstrating meaningful use prior to the payment adjustment. Tipsheets are available on the CMS website that outline when eligible professionals must demonstrate meaningful use in order to avoid the payment adjustments. Want more information about the EHR Incentive Programs? Make sure to visit the Medicare and Medicaid EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs. Front Page News Novitas Solutions Inc. CMS Medicare Learn About the Special EHR Reporting Periods for Eligible Professionals in 2014 If you are an eligible professional, make sure you are aware of the special Electronic Health Record (EHR) reporting periods for submitting meaningful use measures in 2014. Meaningful Use Reporting for Medicare and Medicaid Eligible Professionals You only need to demonstrate meaningful use for a three-month, or 90-day, reporting period, regardless if you are demonstrating Stage 1 or Stage 2 of meaningful use. Choose your reporting period based on your program and participation year: Medicare beyond first year of meaningful use: Select a three-month reporting period fixed to the quarter of the calendar year. Medicare in first year of meaningful use: Select any 90-day reporting period. To avoid the 2015 payment adjustment, begin your reporting period by July 1 and attest by October 1. Medicaid: Select any 90-day reporting period that falls within the 2014 calendar year. For More Information Make sure to visit the EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs. Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 14 CMS Medicare EHR Incentive Programs: Eligible Professionals Should Review Changes in Stage 1 Meaningful Use Criteria Are you a Medicare eligible professional who is participating or planning to participate in Stage 1 of the Medicare or Medicaid Electronic Health Record (EHR) Incentive Program this year? The Stage 2 rule for meaningful use included changes to Stage 1 requirements that took effect on January 1, 2014. These changes include: Record and Chart Changes in Vital Signs Change: The age limit increased for recording blood pressure in patients from age 2 to age 3; there is no age limit for height and weight. 2014 Measure: For more than 50 percent of all unique patients seen by the eligible professional during the EHR reporting period, blood pressure (for patients age 3 and over only) and height and weight (for all ages) should be recorded as structured data. Patient Electronic Access Change: Menu objective “Timely electronic access to health information” and core objective “Electronic copy of health information” are combined to become the new “View online, download, and transmit” core objective. 2014 Measure: More than 50 percent of all unique patients seen by the eligible professional during the EHR reporting period are provided timely (available to the patient within 4 business days after the information is available to the eligible professional) online access to their health information. Clinical Quality Measure (CQM) Reporting Change: Reporting CQMs is still required, but it has been removed as a separate objective. Stage 1 Resources: Resources to help you understand changes to Stage 1 of meaningful use are available on the EHR Incentive Programs website, including: Stage 1 Changes Tipsheet 2014 Stage 1 Changes Tipsheet New MLN Connects™ National Provider Call Transcripts and Audio Recordings Call materials for MLN Connects™ Calls are located on the Calls and Events web page. Audio recordings and written transcripts are now available for the following calls: April 8 —Medicare Shared Savings Program ACO: Preparing to Apply for 2015, audio, and transcript April 10 —How to Register for the PQRS Group Practice Reporting Option in 2014, audio and transcript Visit the Medicare and Medicaid EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs. Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 15 Other Payer Updates IMPORTANT!! Apr 30, 2014 May 2, 2014 A.I. duPont Hospital out of network as of May 1, 2014 Claim Editing Update: E&M Services and Modifier 25 Beginning August 1, our claim system will deny certain services when performed by the same provider on the same day as another service/procedure even if one of the codes in question is appended with Modifier 25. Horizon BCBSNJ's participation agreement with A.I. duPont Hospital is terminated as of May 1, 2014. LEARN MORE LEARN MORE Apr 29, 2014 Update: Conversion of Small Employer Group Coverage May 1, 2014 Claim Adjustment Notification: Medicare Advantage Institutional Claims Beginning June 1, 2014, certain claims will be adjusted to correct reimbursement that was calculated at the incorrect allowance. We continue to address challenges in the conversion of small employer group health insurance plans to 2014 ACA-compliant plans. LEARN MORE LEARN MORE Apr 25, 2014 NaviNet End User Agreement Update Apr 25, 2014 Modifier SU Reimbursement Policy NaviNet will be deploying an updated End User Agreement to help maintain the highest levels of patient privacy and security. Services appended with modifier SU are not eligible for reimbursement. LEARN MORE Front Page News Novitas Solutions Inc. CMS Medicare LEARN MORE Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 16 Other Payer Updates Office Manager Seminars Join us for an Office Manager Seminar. We make doing business with us easier. Topics include: 2014 Products, Polices & Procedures, Healthcare Effectiveness Data Information Set (HEDIS®) and Medicare Star, ICD-10 Readiness, Patient-Centered Programs, Risk Adjustment, Stage 2 Meaningful Use. If you have questions about the seminar, please call 1-973-466-5573 or e-mail Physician_seminars@HorizonBlue.com. To register, email Physician_Seminars@HorizonBlue.com with your name, practice name, Tax ID number and preferred date and location. You can also fax the registration form to 1-973-274-4049. Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 17 Other Payer Updates Apr 15, 2014 Horizon Advance EPO: Participation and Reimbursement Our new Horizon Advance EPO plan includes unique benefit designs regarding physician and facility participation and reimbursement. QUICKLINK Horizon Medical Policy Manual LEARN MORE For details….CLICK HERE Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 18 Other Payer Updates A Few Articles You Won’t Want to Miss: A Few Articles You Won’t Want to Miss: Optum Cloud Features…pg 20 UnitedHealthcare Medical Policy, Drug Policy, Coverage Determination Guideline and Utilization Review Guideline Updates…pg 25 Changes in Advance Notification and Prior Authorization Requirements…pg 57 Changes to July 1, 2014 National Precert List (Includes Gazyda)…pg 1 Questions about Health Insurance Exchanges?…pg 1 Submit preauthorizatons for certain services…pg 3 Aetna 2014 HEDIS data collection is underway…pg 6 Coverage determinations and utilization management…pg 7 Check out our new and improved Education Site…pg 8 Reminder: PPACA Medicaid PCP Enhancement Payments…pg 58 United for Reform Resource Center – Helping Providers Stay And Much More…. MARCH 2014 Qtly Issue Available HERE Abreast on the Latest Reform Updates…pg 61 Learn About Advance Notification and Prior Authorization on UnitedHealthcareOnline.com…pg 63 Change in HCPCS Code J3489 Pricing…pg 80 Information for Providers: Contracts, Legal Notices Oxford® & River Valley Medical and Administrative Policy Updates…pg 82 to pg 95 NEW! Front Page News Provider Resources Medicaid Managed Care Contract Dual Eligible Special Needs Plan Contract Accountable Care Organizations Public Notices New Jersey Medicaid State Plan And Much More… MAY 2014 Bi-Monthly Issue Available HERE Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 19 Other News DRUG SHORTAGES – If you are looking for a complete list of Drug Shortages from the FDA CLICK HERE. Another good resource which provides detailed information about the various drug shortages can be found HERE. Facing Dire Shortage of IV Saline, FDA Again Turns to Enforcement Discretion Approach Latest News | Posted: 30 April 2014 - by Alexander Gaffney, RAC In the face of mounting concerns about a shortage of intravenous saline solutions, the US Food and Drug Administration (FDA) announced it is once again utilizing an uncommon regulatory mechanism to ease the shortage—a mechanism no longer on the strongest of legal footings. READ MORE RECENT FDA APPROVALS/CHANGES FDA Approves Zykadia for Late-Stage Lung Cancer 04/29/2014 03:08 PM EDT The U.S. Food and Drug Administration today granted accelerated approval to Zykadia (ceritinib) for patients with a certain type of late-stage (metastatic) non-small cell lung cancer (NSCLC). READ MORE **************** FDA Approved Ofatumumab FDA approved ofatumumab (Arzerra Injection, for intravenous infusion; GlaxoSmithKline) in combination with chlorambucil, for the treatment of previously untreated patients with chronic lymphocytic leukemia (CLL), for whom fludarabine-based therapy is considered inappropriate. Diplomat has access to dispense Arzerra. April 17, 2014 – MORE INFORMATION. Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 20 Other News **************** FDA Approves Cyramza for Stomach Cancer 04/21/2014 04:09 PM EDT The U.S. Food and Drug Administration today approved Cyramza (ramucirumab) to treat patients with advanced stomach cancer or gastroesophageal junction adenocarcinoma, a form of cancer located in the region where the esophagus joins the stomach. READ MORE JOP Articles on 340B and Payment Reform On April 15, 2014, ASCO's Journal of Oncology Practice (JOP) published two articles for early release: An ASCO policy statement on the 340B program (which included program recommendations) and an article regarding physician payment reform. You can visit the early release webpage on the JOP website to read these articles or click on the links provided below. Policy Statement on the 340B Drug Pricing Program by the American Society of Clinical Oncology Potential Approaches to Sustainable, Long-Lasting Payment Reform in Oncology Pfizer Has Brought Its Patient Assistance Programs Together To better address changing patient needs, Pfizer has consolidated its U.S.-based patient assistance programs. For more than 25 years, Pfizer has offered an array of programs to help eligible patients in the U.S. get access to its medicines. From 2009 to 2013, the company helped more than 3 million uninsured and underinsured patients get access to more than 37 million prescriptions, equaling more than $7.3 billion. On April 1, 2014, in response to changing needs, Pfizer has brought its patient assistance programs together under one program called Pfizer RxPathways. The new name is intended to better reflect the purpose of the program – to provide patients with “pathways” to get access to their Pfizer medicine – and will replace most Pfizer patient assistance programs; including FirstResource. Pfizer RxPathways offers a range of support services, including insurance counseling, co-pay help, and medicines provided free or at a savings. Eligibility requirements are the same as for the previous programs and vary by type of assistance. Patients who are currently receiving their medicines through Pfizer Helpful Answers and FirstResource will be automatically enrolled in Pfizer RxPathways and do not have to take any action to continue receiving their medicines. Also, to learn more, visit www.PfizerRxPathways.com. Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 21 Other News Cancer Doctors Plan to Compare Value of Expensive Drugs Cancer Drugs: Too Expensive to Compare? (Modern Healthcare) Apr 17, 2014 The prices of some cancer drugs are so high that they preclude trials comparing their effectiveness, according to two National Cancer Institute researchers. A task force of clinical oncologists, meanwhile, is working on an algorithm for making such comparisons. (Bloomberg) Apr 17, 2014 - The world’s largest organization of cancer doctors plans to rate the cost effectiveness of expensive oncology drugs, and will urge physicians to use the ratings to discuss the costs with their patients. READ MORE READ MORE Recent News Regarding HIPAA Violations Chris Christie's NJ Budget Proposal Slashes Funding for Cancer Research (NJ.com The Star-Ledger [Newark, NJ]) Apr 19, 2014 - New Jersey’s leading cancer research organization faces the loss of about a third of its funding in Gov. Chris Christie’s proposed budget, provoking criticism from those concerned by the cut of $10 million in state subsidies. READ ARTICLE On April 22, the United States Department of Health and Human Services Office for Civil Rights (OCR) reported that two entities paid $1,975,220 collectively to resolve potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules. This was a result of two compliance reviews and investigations of reported security breaches. The full article can be found HERE. HIPAA Compliance is extremely important. OCR has six educational programs for health care providers on compliance with various aspects of the HIPAA Privacy and Security Rules. Each of these programs is available with free Continuing Medical Education credits for physicians and Continuing Education credits for health care professionals. One module focuses specifically on mobile device security. The programs are available … \ CLICK HERE Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 22 Other News JUST RELEASED! ASCO Research Program Quality Assessment Tool: Basics for a Quality Community-Based Research Site WEBCAST: The Evolving Use of White Bagging in Oncology Kantar Health examines the current trend of increased use of "white bagging" in community oncology practices, and the dual drivers of payer encouragement and physician choice. Specialty distributors and GPOs support "buy and bill" as the primary method of distribution of oncology drugs. However, a diverse array of competing specialty pharmacies (SPs) already commanding the majority of the oral market, continue to make headway into physician buy and bill via white bagging with the support of payers. ASCO's Community Research Forum recently released the ASCO Research Program Quality Assessment Tool. The Tool is designed to help community-based research sites exceed the minimum standards of conducting clinical research and provides an overview of ASCO's recommendations for the important components of an internal quality assessment program. A checklist tool is also provided to help sites conduct an assessment of whether their program includes these important components. The Tool is available for free. For access, CLICK HERE. VIEW WEBCAST OF INTEREST: Aetna, MOASC Contracting Network, Cardinal Health Specialty Solutions Aim To Improve Quality, Costs of Cancer Care in California Key Points: This program identifies clinical best practices that improve cancer treatment and make it more affordable. A steering committee of California oncologists has been formed to support the program. They will continue to update evidence-based treatment plans and supportive care plans for certain types of cancer. “By helping our members to develop and implement cancer care pathways, we can help ensure oncologists are fairly reimbursed for the quality care they provide to patients while removing unnecessary costs from the health care system. At the same time, oncologists have a clear voice in the future of patient care,” said Dr. Vu Phan, president, MOASC Contracting Network. READ MORE Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions Patient Assistance N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 23 NJSOM Featured Corporate Sponsor Assistance Program NJSOM will profile a different Corporate Sponsor Assistance Program each Reimbursement E-News ACCC's 2014 Patient Assistance and Reimbursement Guide Help your patients and your cancer program! Accordingly, cancer programs are spending increased time helping patients identify and access resources to help with costs related to their treatment, medications, missed work hours, transportation, and more. ACCC's 2014 PAP Guide is designed to help busy clinicians with these responsibilities, and much more. View PAP Guide Online Health Care Professionals Incyte is committed to providing timely and accurate product information to health care professionals upon request. If you have a question, please contact our Medical Information team toll free at 1-855-4MEDINFO (855-463-3463). E-mail: medinfo@incyte.com. Normal business hours: 8 a.m. to 8 p.m. ET, Mon-Fri. Patient Assistance Patients living with myelofibrosis face many challenges. IncyteCARES (Connecting to Access, Reimbursement, Education and Support), is a comprehensive program created by Incyte to connect eligible patients to access and reimbursement services, plus ongoing education and resources, during their treatment with Jakafi. Patients can access information about Jakafi and the IncyteCARES program by calling toll-free at 1-855-4-Jakafi (855-452-5234) or visiting www.jakafi.com. Indication Jakafi is a prescription medicine used to treat people with intermediate or high-risk myelofibrosis (MF), including primary MF, post–polycythemia vera MF and post–essential thrombocythemia MF. To access their website CLICK HERE Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 24 Frequently Asked Questions Reimbursement Questions & Answers If you have reimbursement questions you need answers to, please submit them to njsombilling@gmail.com. QUESTION: How can a group or facility that loses a physician use locum tenens while recruiting a new physician? ANSWER: The group will contract with locum tenens physicians and pay them on a fixed amount per diem. This payment to the contracted physicians is considered paid by the regular physician (the group pays the locum tenens physician on behalf of the regular physician). The group may bill for the contracted physician for up to 60 days. The claim contains HCPCS modifier Q6. The claim must include both the group NPI and the regular physician’s NPI. The group must keep on file a record of each service provided by the substitute physician, associated with the substitute physician’s NPI when required, and make this record available to Medicare upon request. %%%%%%%%%%%%% QUESTION: Does a locum tenens physician need to complete a Medicare provider enrollment application prior to be a locum tenens physician? ANSWER: No, currently locum tenens physicians are not required to be enrolled in the Medicare program. %%%%%%%%%%%%% QUESTION: Do resident physicians fall under the guidelines for locum tenens? ANSWER: Currently, locum tenens physicians are not required to be enrolled in the Medicare program. A locum tenens physician is one who has an unrestricted license to practice in the state in which the services will be provided, has no practice of his/ her own, moves from area to area as needed, and Continued on next page… Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 25 Frequently Asked Questions receives payment from the regular physician on a fixed amount per diem. The locum tenens physician has the status of an independent contractor rather than of an employee. The locum tenens physician must have a NPI number also. A resident would need to meet these guidelines to qualify. %%%%%%%%%%%%% QUESTION: Where do we find the guidelines for locum tenens? ANSWER: The guidelines are found in the CMS Medicare Claims Processing Manual (Pub. 100-04), chapter 1, section 30.2.11 (http://www.cms.gov/Regulations-and-Guidance/Guidance/ Manuals/downloads/clm104c01.pdf). %%%%%%%%%%%%% QUESTION: Can a Nurse Practitioner, wiring within their scope of care, bill an office visit for counseling based on time when face to face with the patient reviewing chemotherapy protocol ordered by the MD including potential side effects, etc., writes prescriptions for all oral medications within the protocol, advises patient of optional programs for physical and mental support during and after chemo and listens to patients questions and needs), as incident to (if the MD is in the suite and readily available) or as single provider? This is a follow up visit and not the same day as the visit with the MD. ANSWER: A non-physician practitioner (NPP) can bill services based on time when the counseling & coordination of care guidelines are met. These are discussed in the 1995 and the 1997 Documentation Guidelines (DG). The documentation should show the total face-to-face time with the patient in an office setting, or the total face-to-face time or time spent on the floor or unit in a facility setting. The documentation should also show the time and nature spent in counseling and/or coordinating care. The total time spent cannot be rounded. The time used must meet or exceed that noted in the procedure code chosen. In addition, the time used to determine the procedure code is only time spent with the practitioner providing the service. Time spent with other members of the office staff does not contribute to the time spent with the practitioner. When the NPP is providing a service as incident to the physician, time can also be used when the service meets both the incident to guidelines and the counseling & coordination of care guidelines. For the incident to requirement, the services have to have been provided under the physician's plan of care for the individual patient. If the NPP goes outside of the established plan of care, the services no longer meet the incident to requirements and therefore, must be billed under the NPP's provider number. %%%%%%%%%%%%% QUESTION: When sending additional information to Medicare – responding to an audit, is it ok to highlight the items we want to be sure they see? Continued on next page… Front Page News Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions N JS O M R ei m b u rs em en t E - N ews May 2014 I s s u e 17 Pag e 26 Thank You New Jersey Society of Oncology Managers Board of Trustees ANSWER: Medicare encourages providers to take the initiative and review medical records prior to submission. Items like the physician order, drug waste, signatures, etc. are sometimes difficult for the auditor to see. However, highlighting to draw attention to a specific part of the medical record may render the information unreadable. A better practice is to circle or mark the information with an asterisk or, establish a checklist and number the items required and then mark the items with the various numbers within the record. The auditor will be sure to catch all necessary information quickly and your result is likely to be positive. President: Linda DeAngelis Mercer Bucks Hematology Oncology Email: lmdeangelis@verizon.net %%%%%%%%%%%%% Vice President: QUESTION: We were wondering if we hired a pharmacist will we be able to bill for the mixing of the chemotherapy? Currently our nurses mix. Jeanne McCarty Burlington County Hematology Oncology Email: bchemonc@verizon.net ANSWER: You cannot separately bill for the mixing fee. The mixing of the drug is in the “Relative Value Units” for the administration code. When you are paid for the administration, the payer is also reimbursing for mixing the drug. Secretary: Karen Deaner Adult Medical Oncology Hematology Group Email: kdeaner990@gmail.com Treasurer: Denise Johnstone Essex Oncology of North Jersey, PA Email: dj@essexoncology.com Editor Michelle Weiss Weiss Oncology Consulting Email: njsombilling@gmail.com Front Page News NJSOM Newsletter Disclaimer This newsletter is intended for informational purposes only. NJSOM makes no warranties or representations, express or implied, as to the accuracy or completeness, timeliness or usefulness of any opinions, advice, services or other information contained or referenced in this newsletter. Information is provided for reference only and is not intended to provide reimbursement or legal advice. Laws, regulations, and policies concerning reimbursement are complex and are updated frequently and should be verified by the user. Please consult your legal counsel or reimbursement specialist for any reimbursement or billing questions. CPT codes are owned and trademarked by the American Medical Association. All Rights Reserved. No portion of this publication may be copied without the express written permission of NJSOM. In no event may any portion of this publication be reprinted and used for commercial purposes by any party other than NJSOM. Novitas Solutions Inc. CMS Medicare Other Payer Updates Other News Patient Assistance Frequently Asked Questions