Washington Report –January, 2006
Bill Finerfrock
Capitol Associates
President Submits 2007 Budget – Medicare on Radar Screen
On February 6, 2006, President Bush submitted his proposed budget for Fiscal Year 2007 (October 1,
2006 – September 30, 2007). The Administration is proposing several legislative and administrative
reforms that will result, if adopted, in lower Medicare expenditures over the next several years.
According to the budget documents submitted to Congress, the Medicare budget will,
“..build on long-term Administration priorities for Medicare, such as improving quality
and preventing medical errors, encouraging efficient and appropriate payment for
services, fostering competition, and promoting beneficiary involvement in health care
decisions.”
Some of the specific proposals put forth in the budget are:
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productivity adjustments to providers in the determination of yearly updates
a zero percent payment update for skilled nursing facilities, home health agencies, and inpatient
rehabilitation facilities
an update of the market basket minus 0.45 percent for hospitals
reduce payment updates for hospice and ambulance services by 0.4 percent for 2007
phase out bad debt reimbursement to providers between 2007 and 2011.
In addition to these specific legislative proposals, the budget documents highlight a number of
administrative initiatives the Centers for Medicare and Medicaid Services intends to pursue over the
next few years. To review the HHS budget documents and relevant explanatory statements, go to:
http://www.hhs.gov/budget/07budget/2007BudgetInBrief.pdf
The budget submitted by the President is technically a recommendation and not binding on the
Congress. Each house of Congress will now begin working on their budget proposals. Congress is
expected to adopt a Concurrent Budget Resolution in late Spring. Unlike most bills, the budget
resolution does NOT go to the President for signature. While Congress, by tradition, seeks to adhere to
the budget, the fact is that the budget is not officially binding on the Congress and merely serves an
advisory role in the appropriations process.
Congress Finally Approves Deficit Reduction Bill
On February 2, by a vote of 216 – 214, the House approved the Deficit Reduction Act of 2005. This bill
was carried over from 2005 due to modifications made prior to final passage by the Senate. Below are
some of the highlights (or lowlights depending upon your perspective) of the bill.
Of particular interest to billing companies and the physicians you work with was the language that
repealed the 4.4% cut in the physician fee schedule and its replacement with a one-year freeze in
physician payments.
Updates payments for physician services
- Prevents physician payment cuts in 2006 by providing a freeze in payment rates for physician services.
Allows beneficiary ownership of certain durable medical equipment (DME)
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Provides for beneficiary ownership of certain items of DME after the 13th month of rental (for
items for which rental begins after January 1, 2006.)
Provides for beneficiary ownership of oxygen equipment after the 36th month of rental.
Pays for service and maintenance of such DME when such maintenance is actually provided.
Continues the current law first month purchase option for power wheelchairs.
Reforms payments for imaging services
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Achieves savings from reductions in reimbursements for multiple images on contiguous body parts
in 2006 and 2007. These savings would be returned to taxpayers rather than to physicians as
increased practice expenses for other services.
Ensures that payment rates for imaging services delivered in physician offices do not exceed
payment rates for identical imaging services delivered in hospital outpatient departments.
Reforms payments for procedures in ambulatory surgical centers (ASCs).
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Ensures that payment rates for services delivered in ASCs do not exceed payment rates for the same
services in hospital outpatient departments. Begins January 1, 2007.
Increases payment for dialysis services
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Provides a 1.6 percent update to end-stage renal disease (ESRD) facilities for 2006.
Revises payment for therapy services
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Allows therapy caps to take effect in 2006, per current law. Allows patients to apply for
additional therapy services if their treatment is expected to exceed the cap.
Requires the Centers for Medicare and Medicaid Services (CMS) to improve coding to reduce
inappropriate payments for therapy services.
To view a more complete summary of the Deficit Reduction Act, go to:
http://waysandmeans.house.gov/media/pdf/dra/121805medicareprovisions.pdf
CMS to Restore Physician Payments As Quickly As Possible
According to statements made by several high ranking CMS officials, the agency will move as quickly
as possible to restore the physician payments once the President signs the necessary legislation into law.
At press time, President Bush had not formally signed the Deficit Reduction Act into law but his
signature was expected “soon”.
A statement released by CMS just prior to the final vote said,
“Upon enactment of the legislation, CMS will issue instructions to
Medicare’s contractors (both carriers and fiscal intermediaries) concerning
the processing and reprocessing of claims for services beginning on the
effective date in order to reflect the revised update of zero percent. CMS
expects that the contractors will implement the revised update and begin
paying claims received after the legislation takes effect within two business
days following enactment of the legislation.”
Also, the CMS statement notes that Carriers and Intermediaries will be instructed to automatically
reprocess claims that were already paid that included the 4.4% reduction. According to CMS officials,
you will not be required to resubmit those claims for payment.
Finally, questions have been raised regarding the collection of the appropriate co-payment given that the
Medicare rate will be changing. Concern has been raised that failure by the providers to make the
necessary correction in the beneficiary co-pay, could be interpreted by the Inspector General’s office as
a kickback. However, CMS has raised this issue with the OIG and based upon those conversations,
“CMS believes that where a beneficiary has already been charged for the appropriate
cost-sharing amount under an existing physician fee schedule, and an additional costsharing amount is subsequently due because of a retroactive application of a statutory
fee schedule adjustment, a waiver of the additional cost-sharing amount would be
unlikely to serve as an inducement to the beneficiary. Accordingly, standing alone,
short-term routine waivers of the additional, retroactive cost-sharing amount would not
seem to constitute an improper beneficiary inducement.”
Provider Satisfaction Survey
In early January, CMS, through a private contractor, began surveying Medicare providers on their
satisfaction with their Carriers and Intermediaries. Officially referred to as the Medicare Provider
Satisfaction Survey (MPSS), this is a major initiative by the Centers for Medicare and Medicaid
Services to determine what physicians, hospitals and others think about the entities the government uses
to process all types of Medicare claims.
Those providers randomly selected to participate in the survey would have received the survey in early
January and they were asked to complete and return the survey by the end of January. According to
CMS officials that have spoken with HBMA staff, while providers were asked to return the survey by
the end of January, CMS will continue to accept the surveys for several months and incorporate all of
the findings into their report.
The Provider Satisfaction Survey is an on-going project of CMS and will be refined and continued for
the next several years. Although the physicians and hospitals will be the recipients of the survey, these
providers are encouraged to have the survey completed by the individuals who know the most about the
Carriers and Intermediaries. Below is a sampling of the types of questions CMS is asking providers.
The survey is broken down into 7 functional areas:
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Provider Inquiries
Provider Communications
Claims Processing
Appeals
Provider Enrollment
Medical Review
Provider Audit and Reimbursement
HBMA staff has been in touch with both the CMS staff and the outside contractor hired to conduct the
survey and provided input into the survey process. According to CMS officials, the Department will be
soliciting official input on future survey questions and documents and the survey process in the next few
months. CMS expects to conduct a random sampling of physicians and other providers every January
for the next several years. The information obtained from these surveys will be used as part of the CMS
contractor reform process, as well as used as part of the process to determine whether an existing
Medicare Contractor will continue to be used in the future. The Agency has expressed an interest in
receiving feedback from HBMA on the survey questions and process.
If you would like to see a copy of the “draft” survey, go to:
http://www.cms.hhs.gov/MCPSS/downloads/surveyinstrument.pdf
HBMA Submits Comments on Electronic Claims Attachments
On September 23, 2005, the Centers for Medicare and Medicaid Services (CMS) solicited comments
from the public on electronically requesting and supplying additional health care information in the form
of an electronic attachment to support submitted health care claims data. The original deadline for
comments was November 23rd, however, due to the complexity and technical nature of the subject
matter, CMS extended the deadline until January 23rd.
HBMA, on behalf of its membership, submitted formal comments on this important issue.
In addition to offering specific suggestions for changes, HBMA took the opportunity to express the
billing community’s disappointment that the goals of simplifying and streamlining the claims
submission and payment process have largely gone unrealized. Specifically, the HBMA comments
noted,
“HBMA would like to express its disappointment that the Health Insurance
Portability and Accountability Act (HIPAA) was adopted in the mid-‘90s and we
have yet to realize the benefits promised when this legislation was adopted. While
most providers and billing companies have made major investments in purchasing
and utilizing the technology necessary to submit electronic claims, we have not
seen a similar commitment on the part of many commercial third party payers to
remitting claims payments and data in an electronically efficient manner.
Consequently, while third party payers have met the letter of the law in terms of
remittance of electronic claims information, the remittance information is often so
inconsistent that it’s impractical to process electronically. We have billing
companies that are less automated today, than they were 10 years ago.”
HBMA also noted that the continue use of so-called “companion guides” has largely allowed third party
payers to avoid the development and use of standardized forms and formats. Contact Bill Finerfrock at
bf@capitolassociates.com if you would like to obtain a copy of HBMA’s comments.
CMS issues New Guidance on NPI
The following information was issued recently by the Department of Health and Human Services.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires the
adoption of a standard unique identifier for health care providers. The NPI Final Rule
issued January 23, 2004 adopted the NPI as this standard.
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The NPI is a 10-digit, intelligence free numeric identifier (10 digit number).
Intelligence free means that the numbers do not carry information about health
care providers, such as the state in which they practice or their provider type or
specialization
The NPI will replace health care provider identifiers in use today in HIPAA
standard transactions. Those numbers include Medicare legacy IDs (UPIN,
OSCAR, PIN, and National Supplier Clearinghouse or NSC)
The provider’s NPI will not change and will remain with the provider regardless
of job or location changes
Ensure a provider is licensed or credentialed
Guarantee payment by a health plan
Enroll a provider in a health plan
Turn a provider into a covered provider
Require a provider to conduct HIPAA transactions
Simpler electronic transmission of HIPAA standard transactions
Standard unique health identifiers for health care providers, health plans, and
employers
More efficient coordination of benefits transactions
All health care providers (e.g., physicians, suppliers, hospitals, and others) are
eligible for NPIs. Health care providers are individuals or organizations that
render health care
All health care providers who are HIPAA-covered entities, whether they are
individuals (such as physicians, nurses, dentists, chiropractors, physical therapists, or
pharmacists) or organizations (such as hospitals, home health agencies, clinics, nursing
homes, residential treatment centers, laboratories, ambulance companies, group
practices, HMOs, suppliers of durable medical equipment, pharmacies, etc.) must
obtain an NPI to identify themselves in HIPAA standard transactions
It is a health care provider who transmits any health information in electronic
form in connection with a transaction for which the Secretary of HHS has
adopted a standard, even if the health care provider uses a business associate to
do so.
The following are some Frequently Asked Questions CMS has received with regard to
the NPI. These may help answer some of your questions about the NPI.
Is a sole proprietor/sole proprietorship an individual or an organization?
A sole proprietor/sole proprietorship is an individual and is eligible for a single NPI.
The sole proprietor must apply for the NPI using his or her own SSN, not an EIN even
if he/she has an EIN. Because a sole proprietor/sole proprietorship is an individual,
he/she cannot be a subpart and cannot designate subparts.
Who cannot receive an NPI?
Any entity that does not meet the definition of a “health care provider” at 45 CFR
160.103, which would include billing services, value-added networks, re-pricers, health
care clearinghouses, non-emergency transportation services, and others.
When can we apply for the NPI?
Health care providers can apply now for their NPI on the National Plan and Provider
Enumeration System (NPPES) web site
https://nppes.cms.hhs.gov/NPPES/Welcome.do.
What is the deadline for applying and when will the NPI be effective?
HIPAA covered entities such as health care providers who conduct HIPAA standard
transactions, health care clearinghouses, and all but small health plans, must use only
the NPI to identify HIPAA covered health care providers in standard transactions by
May 23, 2007. Small health plans (less than 5 million dollars in annual revenues) must
use only the NPI by May 23, 2008.
Medicare Fee-For-Service (FFS) providers can begin to use the NPI January 3, 2006.
Medicare systems will accept claims with an NPI, but an existing Medicare legacy
identifier must also be on the claim. Starting October 2, 2006, Medicare FFS
providers may submit an existing Medicare legacy identifier and/or an NPI on claims.
Non-Medicare Fee-For-Service providers or suppliers, need to be aware of the NPI
readiness schedule for each of the health plans with which they do business, as well as
any practice management system companies or billing companies (if used). Providers
should determine when each health plan intends to implement the NPI in HIPAA
standard transactions.
Will the NPI replace the Medicare certification or enrollment process?
No. The NPI will not change or replace the current Medicare enrollment or
certification process. A HIPAA covered provider or supplier will not receive payment
from Medicare until it is properly enrolled and certified in the Medicare program.
If you would like to review the actual document, go to:
http://www.cms.hhs.gov/NationalProvIdentStand/Downloads/NPIFactSheet_010906.pdf
CMS Releases 2005 Financial Report
The Centers for Medicare and Medicaid Services (CMS) has released the 2005 Financial Report. The
report is prepared annually by the agency’s Chief Financial Officer.
If you having trouble sleeping and want some late-night reading to pass away those quiet hours, you
might want to consider obtaining a copy of this report. To obtain a downloadable copy, go to:
http://www.cms.hhs.gov/CFOReport/Downloads/2005_CMS_Financial_Report.pdf
Some of the things you will find out by reading the report that you may not have known:
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CMS is one of the largest purchasers of health care in the world
Medicare and Medicaid represent 33 cents of every dollar spent on health care in the U.S.
CMS employs approximately 4,750 people mostly in their Baltimore, MD and Washington, DC
offices
CMS “outlay” or “cash disbursements” were nearly $500 Billion in Fiscal Year 2005
Medicare spending accounts for 12 Percent of the entire Federal Budget
More than 35 MILLION “aged” persons were enrolled in Medicare
6.6 Million disabled persons were enrolled in Medicare
In 1966, a total of 19 million people (aged and disabled combined) were enrolled in Medicare
Medicare processes over ONE BILLION (said slowly ala Dr. Evil) claims per year
Although children account for one-half of Medicaid enrollees, they account for only 18 percent of
Medicaid outlays
Elderly and disabled persons comprise 26 percent of Medicaid enrollees but account for 64 percent
of spending.
HSAs and Other “Market Reforms” Coming to a Patient Near You?
In his state of the Union address, President Bush once again touted his strong belief that a consumer
directed health care system was the answer to rising health care costs. Foremost among various
initiatives the President wants to encourage in order to achieve this lofty goal, is promotion of Health
Savings Accounts (HSAs).
Specifically, the President is recommending that Congress approve tax credits for purchasing HSAs,
increasing the amount individuals can contribute to an HSA, and making HSA premiums tax deductible.
The President is also promoting the creation of Association Health Plans, something that has enjoyed the
support of HBMA and many member companies because of its benefits to small businesses that wish to
provide an affordable health insurance product for their employees.
Furthermore, the FY 2007 budget also expands tax deductions for out-of-pocket medical expenses.
According to the budget documents submitted to Congress, the Administration believes that these
changes will, “…make health care more affordable by helping the uninsured pay their health care costs
as well as by allowing people with insurance to deduct a greater portion of the money they spend on copayments, deductibles, and care that is not covered.”
HBMA member companies are encouraged to review and give thought to the implications of a health
care payment system that is based upon consumer driven purchases rather than insurance driven
purchases. For example, current estimates indicated that as many as 3 million Americans have an HAS
or high deductible health plan as their health insurance. These high deductible plans are intended to
protect the consumer from high, out-of-pocket expenses but rely upon the consumer to pay for routine or
less expensive care out-of-pocket.
In many ways, HSAs represent a sort of “back to the future” approach to health insurance. For those old
enough to remember, the HSAs are not dissimilar to the type of Blue Cross/Blue Shield plans that were
prevalent in the ‘60s. Under those plans, routine care was not covered by the insurance policy and only
“emergency” care was covered. Patients typically paid out of pocket for routine trips to the doctors for
such things as shots, or for colds or even minor injuries.
The key comparison is that in both instances, the vast majority of consumers paid cash for their health
care services and the physician’s office had little if any direct interaction with a third party payer. So,
what becomes of billing companies if, as we saw in the ‘60s, the vast majority of physician’s have a
cash relationship with patients instead of a billing relationship with insurance companies?
I believe it is fair to say that the billing community that we know today was largely created as an
unintended consequence of federal legislation called TEFRA or Tax Equity, Fiscal Responsibility Act.
That federal law, passed in the early ‘80s, prohibited hospitals from handling the billing for hospital
based physicians (emergency medicine, anesthesiology, radiology and pathology).
OIG Report Says Coding Errors led to Millions in Overpayments
Medicare does not normally allow additional payments for separate Evaluation and Management (E/M)
services performed by a provider on the same day as a procedure. However, if a provider performs a
service on the same day as a procedure that is significant, separately identifiable, and above and
beyond the usual preoperative and postoperative care associated with the procedure, modifier 25
may be attached to the claim to allow additional payment for the separate service. According to the
report, Medicare allowed $1.96 billion for approximately 29 million claims using modifier 25 in
calendar year 2002.
Based upon a review of randomly selected claims, the HHS Office of Inspector General (OIG) has
concluded that thirty-five percent of claims using modifier 25 that Medicare allowed in 2002 did not
meet program requirements, resulting in $538 million in improper payments.
The OIG believes that “Medicare should not have allowed payment for these claims because the E/M
services were not significant, separately identifiable, and above and beyond the usual preoperative and
care associated with the procedure.”
To prevent this from continue, the OIG recommends that CMS work with carriers to reduce the number
of claims submitted using modifier 25 that do not meet program requirements. Specifically, the OIG
suggests CMS:
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Reinforce the requirements that E/M services billed using modifier 25 be significant, separately
identifiable, and above and beyond the usual preoperative and postoperative care associated with
the procedure;
Encourage carriers to emphasize that appropriate documentation of both E/M services and
procedures must be maintained to support claims for payments using modifier 25 even though
the documentation is not required to be submitted with the claims; and
Emphasize that modifier 25 should only be used on claims for E/M services, and only when
these services are provided on the same day as another procedure.
The report notes that “CMS concurred with the OIG recommendations and indicated that it recently
made significant efforts to educate the provider community about the need for documentation to support
services billed to the Medicare program. CMS will also modify the “Medical Claims Processing
Manual” to clarify that appropriate documentation must be maintained to support claims for payments,
even though providers are not required to submit the documentation with the claim.”
If you would like to review the report, go to:
http://oig.hhs.gov/oei/reports/oei-07-03-00470.pdf
CMS Program Transmittals for January
The following program transmittals were issued by the Centers for Medicare and Medicaid Servics
between January 1 and February 8.
CMS uses transmittals to communicate new or changed policies or procedures that we will incorporate
into the CMS Online Manual System. The cover or transmittal page summarizes and specifies the
changes.
Transmittal
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Subject
Date
R135PI
Changes to the GTL Titles
02/06/2006
R136PI
Policy Changes to Program Integrity Manual.
03/01/2006
R16SOMA
Revisions to Chapter 2, "The Certification Process," Appendix E-"Providers of Outpatient Physical Therapy or Outpatient Speech
Language Pathology (OPT/OSP) Services," and Appendix K-"Comprehensive Outpatient Rehabilitation Facilities"
11/21/2005
R17SOMA
Revisions to Chapter 2 The Certification Process
01/20/2006
R200OTN
Mandatory Transition to New Registry That Satisfies Medicare Data
Reporting Requirements for Implantable Cardioverter Defibrillators
(ICDs)
02/13/2006
R201OTN
Calculation of the Interim Payment of Indirect Medical Education (IME)
Through the Inpatient PPS Pricer for Hospitals That Received an
Increase to Their Full-time Equivalent Resident Caps Under Section 422
of the Medicare Modernization Act (MMA), P.L. 108-173
03/31/2006
R203OTN
Revision for PPS Payment for Blood Clotting Factor Administered to
Hemophilia Inpatients
03/06/2006
R204OTN
Stage 1 Use and Editing of National Provider Identifier Numbers
Received in Electronic Data Interchange Transactions, via Direct Data
Entry Screens, or on Paper Claim Forms
01/03/2006
R205OTN
Beneficiary Change of Address
07/03/2006
R206OTN
Modifications/Additions to CR 3730, Frequent Hemodialysis Network
(FHN) Payments for Approved Clinical Trial Costs
03/03/2006
R208OTN
Analysis of Systems Changes Needed to Generate Unsolicited
Responses to the Veterans Administration (VA)
07/03/2006
R34GI
Change Management Process -- Electronic Change Information
Management Portal (eChimp)
01/03/2006
R36DEMO
2006 Oncology Demonstration Project
01/17/2006
R37DEMO
Revisions to CR 3816 - Low Vision Rehabilitation Demonstration
04/03/2006
R45MSP
Interest on MSP Debts
01/17/2006
R46NCD
Cardiac Catheterization Performed in Other Than a Hospital Setting
02/27/2006
R78MCM
Revisions to Chapter 5, "Quality Improvement".
N/A
R805CP
Annual Update to the Therapy Code List
02/06/2006
R806CP
Termination of Healthcare Common Procedure Coding System
(HCPCS) Codes Payable During the Transition to the Ambulance Fee
Schedule
02/06/2006
R807CP
Revision to IOM 100-4, Chapter 12, Sections 90.4.1.1 and 90.4.2
02/06/2006
R808CP
Nursing Facility Services (Codes 99304 - 99318)
01/23/2006
R809CP
Update to Payment Rates for Religious Nonmedical Health Care
Institution Services Furnished in the Home, Calendar Year 2006
02/13/2006
R811CP
Teaching Physician Services
02/13/2006
R812CP
Medicare Payment for Pre-administration-Related Services Associated
With Intravenous Immune Globulin Administration
02/13/2006
R813CP
Instructions for the Payment of Health Professional Shortage Area
(HPSA) and Physician Scarcity Area (PSA) Bonuses When the Place of
Service (POS) is "Home".
02/21/2006
R814CP
Claim Status Category Code and Claim Status Code Update
04/03/2006
R815CP
Healthcare Provider Taxonomy Codes (HPTC) Update
04/03/2006
R816CP
Coverage and Billing for Ultrasound Stimulation for Nonunion Fracture
Healing
04/03/2006
R817CP
Update to the Inpatient Provider Specific File (IPSF) and the Outpatient
Provider Specific File (OPSF) to Retain Provider Information
04/03/2006
R818CP
Smoking and Tobacco-Use Cessation Counseling Services: Common
Working File (CWF) Inquiry for Providers
04/03/2006
R819CP
Modification to QR Modifier Edit for Automatic Implantable Cardiac
Defibrillator (ICD) Services
04/03/2006
R820CP
Sites of Service Revenue Codes for Rural Health Clinics (RHCs) and
Federally Qualified Health Centers (FQHCs)
07/03/2006
R821CP
Billing and Payment of Certain Colorectal Cancer Screenings for NonPatients Type of Bill (TOB) 14X
07/03/2006
R822CP
Update of Radiopharmaceutical Imaging Agents HCPCS Codes
Applicable to PET Scan Services
07/03/2006
R823CP
New Temporary Code for Battery for Power Mobility Devices
07/03/2006
R824CP
Sites of Service Revenue Codes for Rural Health Clinics (RHCs) and
Federally Qualified Health Centers (FQHCs)
04/03/2006
R825CP
Update of Radiopharmaceutical Imaging Agents HCPCS Codes
Applicable to PET Scan Services
04/03/2006
R826CP
April Quarterly Update to the 2006 Annual Update of HCPCS Codes
Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB)
Enforcement
04/03/2006
R827CP
Use of 12X Type of Bill (TOB) for Billing Screening Mammography,
Screening Pelvic Examinations, and Screening Pap Smears
07/03/2006
R828CP
Mammography Facility Certification File - Updated Procedures and
Content
07/03/2006
R829CP
Modification of Roster Billing for Mass Immunizers Billing for
Inpatient Part B Services (Type of Bills (TOB) 12X and 22X)
07/03/2006
R830CP
Denial of Claims Not Timely Filed
07/03/2006
R831CP
Shared Systems Medicare Secondary Payer (MSP) Balancing Edit and
Administrative Simplification Compliance Act (ASCA) Enforcement
Update
07/03/2006
R832CP
Payment of Same Day Transfer Claims Under the Inpatient Psychiatric
Facility Prospective Payment System (IPF PPS)
07/03/2006
R833CP
Medicare Remit Easy Print (MREP) Enhancements, and Clarification of
Check Issue/EFT Effective Date
07/03/2006
R834CP
Revision to Health Professional Shortage Area (HPSA) and Physician
Scarcity Area (PSA) Bonus Billing for Some Globally Billed Services
07/03/2006
R835CP
New Temporary Codes for Adjustable Wheelchair Cushions
07/03/2006
R836CP
Inpatient Admission Followed by Discharge or Death Prior to Room
Assignment
07/03/2006
R837CP
Coordination of Benefits Agreement (COBA) Full Claim File Repair
Process
07/03/2006
R838CP
Corrections to Common Working File Editing of Home Health
Prospective Payment System Claims Regarding Non-covered Episodes
and Prior Inpatient Stays and Fiscal Intermediary Shared System
Implementation of 2006 Therapy Code Update
07/03/2006
R839CP
Additional Requirements for the Competitive Acquisition Program
(CAP) for Part B Drugs
07/03/2006
R840CP
Hospital Billing for Take-Home Drugs
07/03/2006
R841CP
MCS Screen Expansion for the Prescription Order Number for the
Competitive Acquisition Program (CAP) for Part B Drugs to be
Developed Over the July 2006 and October 2006 Release, With Final
Implementation on October 2, 2006
07/03/2006
R88FM
Clarification to IOM 100-06 , Sections 290.7 and 290.8
02/06/2006
R89FM
Mandated Use of Autoload Program in STAR, System Tracking for
Audit and Reimbursement
02/13/2006
R90FM
Recurring Update Notification for the Notice of New Interest Rate for
Medicare Overpayments and Underpayments
01/25/2006
SE0582
MMA - Sunset of the Provider Nomination Provision and the Policy to
Assign Providers to the Local Fiscal Intermediary (FI)
N/A
SE0602
Centers for Medicare & Medicaid Services (CMS) Seeks Provider
Input on Satisfaction with Medicare Fee-for-Service Contractor Services
SE0603
Medicare Prescription Drug Coverage: Essential Information and
Resources for Prescribing Health Care Professionals - The Eleventh in
the Medlearn Matters Series on the New Prescription Drug Plans
N/A
SE0605
Explanation of Systems Used by Medicare to Process Your Claims
N/A
04/03/2006