MLN Connects™ National Provider Calls

• Open Payments (the Sunshine Act): Registration, Review, and Dispute — Last Chance to Register
• ESRD Quality Incentive Program: Notice of Proposed Rulemaking for PY 2017 and 2018 — Last Chance to Register
• 2015 Medicare PFS Proposals for PQRS, Value Modifier, EHR Incentive Program, and the Physician Compare Website— Last Chance to Register
• National Partnership to Improve Dementia Care in Nursing Homes: Improved Care Transitions —Registration Now Open

 CMS Events

• PERM Cycle 3 Provider Education Webinar/Conference Call Session

 Announcements

• DMEPOS Competitive Bidding Round 2 Recompete and National Mail-Order Recompete Announced
• World Hepatitis Day – July 28
• Health Care Innovation Awards to Provide Better Health Care and Lower Costs
• Open Payments System Registration Began July 14
• Open Payments Review and Dispute Process Began July 14 and Ends August 27
• EHR Incentive Programs: Summary of Care Meaningful Use Requirements in Stage 2
• New PQRS FAQs Available
• FAQs on PQRS MAV Process Available

 Claims, Pricers, and Codes

• Update to the CWF Qualifying Stay Edit C7123 for Inpatient SNF Claims
• Hold Any Adjustments to Method II CAH Claims that Include Services for a Surgical Assistant
• Correction to Inappropriately Returned Hospice Claims
• July 2014 Outpatient Prospective Payment System Pricer File Update

 MLN Educational Products

• “Medicare Billing: 837I and Form CMS-1450” Web-Based Training Course — Released
• “Medicare Secondary Payer for Providers, Physicians, Other Suppliers, and Billing Staff” Fact Sheet — Revised
• “Advance Payment Accountable Care Organization (ACO) Model” Fact Sheet — Revised
• “Summary of Final Rule Provisions for Accountable Care Organizations under the Medicare Shared Savings Program” Fact Sheet — Revised
• “Methodology for Determining Shared Savings and Losses under the Medicare Shared Savings Program” Fact Sheet — Revised
• “Accountable Care Organizations: What Providers Need to Know” Fact Sheet — Revised
• “Improving Quality of Care for Medicare Patients: Accountable Care Organizations” Fact Sheet — Revised
• “Medicare Shared Savings Program and Rural Providers” Fact Sheet — Revised
• “Diagnosis Coding: Using the ICD-9-CM” Web-Based Training Course — Reminder
• New Continuing Education Association Now Accepting MLN Web-Based Training Courses
• MLN Products Available In Electronic Publication Format
• MLN Products Now Available In Hardcopy Format

  MLN Connects™ National Provider Calls

 Open Payments (the Sunshine Act): Registration, Review, and Dispute — Last Chance to Register

Tuesday, July 22; 2:30-4pm ET

To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.

As a physician or teaching hospital, are you aware of Open Payments (the Sunshine Act)? Now that you have completed Phase 1 of registration in the CMS Enterprise Portal, are you ready for Phase 2? Do you know that Phase 2 allows you to register in the Open Payments system, and then review and (if needed) dispute any of the data reported about you by the industry prior to public posting of the data?

During the time specified by CMS in Phase 2, physicians and teaching hospitals can voluntarily register with CMS to review information about payments or other transfers of value given to them by industry prior to public posting of the data. Physicians and teaching hospitals that choose to participate will initially need to register in the CMS Enterprise Portal (Phase 1 registration) in order to register in the Open Payments system to access and review the information submitted about them by industry and potentially dispute information with industry that they believe to be inaccurate or incomplete.

During this MLN Connects™ National Provider Call, CMS experts will give a brief introductory presentation about Open Payments and provide a step-by-step review of the registration and review and dispute process. This overview will be followed by answers to questions submitted prior to the call and an opportunity for participants to interact with our subject matter experts during a live question and answer session.

Agenda:

• Brief Open Payments overview
• Recap registration process in the CMS Enterprise Portal
• Provide step-by-step instructions on how to register in the Open Payments system and participate in the review and dispute process
• Answers to submitted questions
• Live Q&A session

Target Audience: Physicians, teaching hospitals, professional organizations, physician staff and other interested parties. Additional information is available on the July 22 call web page.

Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.

 

ESRD Quality Incentive Program: Notice of Proposed Rulemaking for PY 2017 and 2018 — Last Chance to Register

Wednesday, July 23; 2-3:30pm ET

To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.

During this MLN Connects™ National Provider Call, CMS experts will give a presentation on the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP). The ESRD QIP is a pay-for-performance quality initiative that ties a facility’s performance to a payment reduction over the course of a payment year (PY). This MLN Connects Call will focus on the ESRD Prospective Payment System (PPS) proposed rule with 30 day comment period, which includes rules for operationalizing the ESRD QIP in PY 2017 and PY 2018. A question and answer session will follow the presentation giving participants an opportunity to ask questions of subject matter experts.

Agenda:

• ESRD QIP legislative framework;
• Proposed measures, standards, scoring methodology, and payment reduction scale for PY 2017 and PY 2018
• Methods for reviewing and commenting on the proposed rule
• Question and answer session

Target Audience: Dialysis clinics and organizations, nephrologists, hospitals with dialysis units, billers/coders, and quality improvement experts.

Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.

 

2015 Medicare PFS Proposals for PQRS, Value Modifier, EHR Incentive Program, and the Physician Compare Website— Last Chance to Register

Thursday, July 24; 1:30-3pm ET

To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.

This MLN Connects™ National Provider Call provides an overview of the 2015 Physician Fee Schedule (PFS) proposed rule. This presentation will cover potential program updates to the Physician Quality Reporting System (PQRS). The topics covered include changes to reporting mechanisms, individual measures, measures groups for inclusion in 2015, criteria for satisfactorily reporting for an incentive, criteria for avoiding future payment adjustments, requirements for Medicare incentive program alignment, and satisfactory participation under the qualified clinical data registry option.

The presentation also provides an overview of the proposals for the value-based payment modifier, including how CMS proposes to continue to phase in and expand application of the value-based payment modifier in 2017 based on performance in 2015. The presentation also describes how the value-based payment modifier is aligned with the reporting requirements under the PQRS. This presentation further provides updates to Physician Compare and the Electronic Health Record (EHR) Incentive Program.

Agenda:

• Proposed changes to PQRS individual reporting requirements and PQRS Group Practice Reporting Option (GPRO)
• Proposed updates to Physician Compare and the EHR Incentive Program
• Review of the proposed value-based payment modifier policies under the 2015 proposed rule
• Plan for the future of the PQRS GPRO
• Where to call for help

Target Audience:  Physicians, practitioners, therapists, medical group practices, practice managers, medical and specialty societies, payers, insurers.

This MLN Connects Call is being evaluated by CMS for CME and CEU continuing education credit (CE). Refer to the call detail page for more information.

 

National Partnership to Improve Dementia Care in Nursing Homes: Improved Care Transitions —Registration Now Open

Tuesday, August 19; 1:30-3pm ET

To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.

During this MLN Connects™ National Provider Call, speakers will discuss the role of physician leadership in working with hospitalists to improve care transitions and the importance of open communication between physicians and nurse practitioners across care settings. CMS subject matter experts will provide National Partnership updates, share progress of the Focused Dementia Care Survey Pilot, and discuss next steps. A question and answer session will follow the presentation.

The CMS National Partnership to Improve Dementia Care in Nursing homes was developed to improve dementia care through the use of individualized, comprehensive care approaches. The partnership promotes a systematic process to evaluate each person and identify approaches that are most likely to benefit that individual. The goal of the partnership is to continue to reduce the use of unnecessary antipsychotic medications, as well as other potentially harmful medications in nursing homes and eventually other care settings as well.

Agenda:

• Partnership updates
• Successful care transitions: Role of physician leadership and importance of open communication across care settings
• Next steps

Target Audience: Consumer and advocacy groups, nursing home providers, surveyor community, prescribers, professional associations, and other interested stakeholders.

Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.

 

CMS Events

 

PERM Cycle 3 Provider Education Webinar/Conference Call Session

Wednesday, July 30; 3-4pm ET

CMS is hosting a Payment Error Rate Measurement (PERM) provider education webinar/conference call for Medicare providers who also provide Medicaid and Children’s Health Insurance Program (CHIP) services. Complete details are available in the webinar announcement.

The presentations will include:

• The PERM process and provider responsibilities during a PERM review
• Frequent mistakes and best practices
• The Electronic Submission of Medical Documentation (esMD) program

To join the meeting:

• Registration is not required, however, space is limited
• Join the webinar
• Audio: 877-267-1577

 

Announcements

 

DMEPOS Competitive Bidding Round 2 Recompete and National Mail-Order Recompete Announced

On July 15, CMS announced plans to recompete the supplier contracts awarded in Round 2 of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. CMS is required by law to recompete contracts under the DMEPOS Competitive Bidding Program at least once every three years. The Round 2 contract period for all product categories expires on June 30, 2016.

CMS is conducting the Round 2 Recompete in the same geographic areas that were included in Round 2. See the Latest News and Announcementsto learn about product categories, zip code updates, and the Office of Management and Budget’s changes to metropolitan statistical area designations.

National Mail-Order Recompete

CMS will also be conducting the national mail-order recompete for diabetic testing supplies at the same time as the Round 2 Recompete . The national mail-order recompete will include all parts of the United States, including the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, and American Samoa.

Important Dates

July 15, 2014

• CMS begins pre-bidding supplier awareness program

Fall, 2014

• CMS announces bidding schedule
• CMS begins bidder education program
• Bidder registration period to obtain user ID and passwords begins

Winter, 2015

• Bidding begins

Interested in bidding? Prepare now

See the Latest News and Announcementsto learn how to prepare for bidding by reviewing and updating your Medicare enrollment and getting licensed and accredited.

CMS has updated the DMEPOS Competitive Bidding website so users will be able to easily navigate the web pages by specific rounds and topics. Visit often for the latest information on the DMEPOS competitive bidding program.

 

World Hepatitis Day – July 28

July 28 is World Hepatitis Day. This health observance aims to increase awareness and understanding of viral hepatitis as a major global health threat. Medicare provides coverage for many preventive services including the hepatitis B (HBV) vaccine under Medicare Part B. This vaccine is available to certain Medicare beneficiaries at intermediate or high risk for contracting hepatitis B. Medicare beneficiaries who are currently positive for antibodies for hepatitis B are not eligible for this benefit. The copayment/coinsurance and deductible are waived for this benefit.

For More Information:

• MLN Quick Reference Information: Preventive Services
• MLN Quick Reference Immunization: Medicare Immunization Billing
• World Hepatitis Alliance: World Hepatitis Day 2014

 

Health Care Innovation Awards to Provide Better Health Care and Lower Costs

On July 9, HHS Secretary Sylvia Mathews Burwell announced new prospective awardees to test innovative care models, bringing the total amount of funding to as much as $360 million for 39 recipients spanning 27 states and the District of Columbia. These models are designed to deliver better health care and lower costs under the Health Care Innovation Awards program.

The prospective (not yet final) awards range from an expected $2 million to $23.8 million over a three year period. These awards are made possible by the Affordable Care Act and round out the anticipated recipients for round two of the Health Care Innovation Awards program. Examples include projects to promote better care for persons living with HIV/AIDS, reduce unnecessary use of emergency departments, improve pediatric dental care, promote prevention and management of cardiovascular disorders, and to improve care coordination in rural areas of the country. Earlier this year, HHS announced 12 prospective round two recipients receiving as much as $110 million in combined funding and testing models in 13 states. Prospective recipients will receive their final Notice of Award later this summer.

Prospective recipients in round two of the Health Care Innovation Awards will be testing models in the following areas, but not limited to:

• Five prospective awards will focus on improving emergency care;
• Ten prospective awards will focus on improving care for children;
• Four prospective awards will focus on promoting prevention and improving management of cardiovascular diseases;
• Seven prospective awards will focus on promoting better rural care coordination and telehealth;
• Seven prospective awards will focus on improving care for frail elderly patients or providing support for aging in the community; and
• Two prospective awards will focus on promoting better care for persons living with HIV/AIDs.     

In 2012, 107 organizations located in urban and rural areas, all 50 states, the District of Columbia and Puerto Rico, received awards through round one of the initiative. The second round of Health Care Innovation Awards differs from the first round in that CMS specifically sought innovations in four areas: rapidly reducing costs for patients in outpatient hospital and post-acute settings; improving care for populations with specialized needs; testing improved financial and clinical models for specific types of providers; linking clinical care delivery to preventive and population health.

For more information about the Health Care Innovation Awards program prospective recipients. Learn more about other innovative models being tested by the CMS Innovation Center.

Full text of this excerpted HHS press release (issued July 9).

 

Open Payments System Registration Began July 14

Physicians and teaching hospitals began registering in the Open Payments system on July 14. Although registering in the Open Payments system is voluntary, it becomes a mandatory process if physicians and teaching hospitals want the opportunity to review and dispute data submitted by applicable manufacturers and applicable group purchasing organizations (GPOs) prior to public posting on September 30, 2014.

In order to review or dispute data submitted by industry for the 2013 reporting period, physicians must be registered—and have reviewed any data reported about them—on or before August 27, 2014, the end of the initial 45-day review and dispute period. With identity verification as part of the registration process, CMS recommends completing the registration process as soon as possible.

For more information:

• Register for the July 22 MLN Connects™ National Provider Call
• Visit the Open Payments website
• Contact the Help Desk at [email protected]. Live Help Desk support is available by calling 855-326-8366, Monday through Friday, from 7:30am to 6:30pm CT, excluding Federal holidays.

 

Open Payments Review and Dispute Process Began July 14 and Ends August 27

The Open Payments review, dispute and correction process began on July 14 and ends on August 27. This process spans a total of 60 days. The initial 45-day period (July 14 through August 27) is for physicians and teaching hospitals to review and initiate any disputes they may have regarding the data reported about them by applicable manufacturers and applicable group purchasing organizations (GPOs). The remaining 15-day period (August 28 through September 11) is additional time that has been provided to industry to submit dispute corrections.

Two key activities will take place during the review, dispute, and correction period:

• Before CMS releases any data publicly, physicians and teaching hospitals (who are registered in the CMS Enterprise Portal and the Open Payments system) may review and, if necessary, initiate disputes relating to data submitted about them; and,
• Applicable manufacturers and applicable GPOs will analyze these disputes and work with physicians and teaching hospitals to come to agreement on any necessary corrections.

In order to review or dispute data submitted by industry for the 2013 reporting period, physicians must be registered—and have reviewed any data reported about them—on or before August 27, 2014. 

How Physicians and Teaching Hospitals Can Prepare for the Review and Dispute Process:

• Register in the Open Payments system (have your CMS Enterprise Portal user ID and password readily available—created in Phase 1);
• Delegate roles and responsibilities by nominating system users to fill specific user roles (think of individuals you want to interact with the Open Payments system on your behalf, such as a physician or teaching hospital authorized representative/official);
• Gather any records of payments, transfers of value, ownership or investments that you may have received between August 1, 2013 and December 31, 2013;
• Ask your local industry representative if any organization they represent has reported to CMS any data on payments, transfers of value you have received, ownership or investment interests you have held; if so, ask for a copy;
• Review and dispute data submitted by applicable manufacturers and applicable GPOs prior to public posting of the data. Note: Any data that is disputed, if not corrected by industry, will still be made public but will be marked as disputed. Learn more about the review and dispute process.
• Organize your industry contact information as you will be working directly with them to resolve any disputes or answer any questions you may have in regards to the data they’ve reported.

Note: Registration in the Enterprise Portal is a separate process from registration in the Open Payments system. But, Enterprise Portal registration is a required first step to allow for registration in the Open Payments system.

For more information:

• Register for the July 22 MLN Connects™ National Provider Call
• Visit the Open Payments website
• Contact the Help Desk at [email protected]. Live Help Desk support is available by calling 855-326-8366, Monday through Friday, from 7:30am to 6:30pm CT, excluding Federal holidays.

 

EHR Incentive Programs: Summary of Care Meaningful Use Requirements in Stage 2

If you are an eligible provider participating in the Electronic Health Record (EHR) Incentive Programs, you will have the option of reporting the Summary of Care menu objective in Stage 1, but will be required to meet the core objective in Stage 2. The intent of the objective is to demonstrate that a provider has the full capability to use their certified EHR technology to successfully transmit a summary of care document to a different EHR vendor in a live setting.

Meeting Stage 2 Summary of Care Requirements
To count toward the objective, the transition or referral must take place between providers with different billing identities such as a different National Provider Identifier (NPI) or hospital CMS Certification Number (CCN).

If the receiving provider already has access to the certified EHR technology (CEHRT) of the initiating provider of the transition or referral, simply accessing the patient’s health information does not count toward meeting this objective. However, if the initiating provider also sends a summary of care document, this transition can be included in the denominator and the numerator as long as it is counted consistently across the organization and across both measures if:

• For Measure 1, a summary of care document is also provided by any means
• For Measure 2, a summary of care document is provided using the same technical standards used if the receiving provider did not have access to the CEHRT

What to Include for Measure 1: Include the transitions of care in which a summary of care document was provided to the recipient of the transition or referral by any means.

What to Include for Measure 2: Include the transitions of care in which a summary of care document was transmitted electronically using a CEHRT to the recipient, or via exchange facilitated by an organization that is an eHealth Exchange participant.

What to Include for Measure 3: A single summary of care document sent to a provider using a different EHR and EHR Vendor or a test with the CMS and the Office of the National Coordinator of Health IT (ONC) Randomizer test system would meet the measure.

Measure 3 requires sending one record to someone on a different vendor system one time. If that happens in the course of fulfilling Measure 2, there is no need to do a test. The test EHR only exists for providers who never send to someone on a completely different vendor than their own. Providers that use the same CEHRT and share a network for which their organization either has operational control of or license to use can conduct one test for the successful electronic exchange of a summary of care document with either a different EHR technology or the CMS designated test EHR that covers all providers in the organization. 

For More Information
For more information about the Summary of Care requirements, review the following materials:

• Stage 1 Summary of Care spec sheets for eligible professionals and eligible hospitals
• Stage 2 Summary of Care spec sheets for eligible professionals and eligible hospitals
• Provider User Guide for the NIST EHR Randomizer Tool

 

New PQRS FAQs Available

To keep you updated with information on the Physician Quality Reporting System (PQRS), CMS has recently added three new FAQs to the website. Review these FAQs for guidance on calculating a tuberculosis prevention measure, reporting with fewer than 9 applicable measures across 3 domains, and determining a PQRS incentive payment when more than one reporting method is used.

New FAQs:

• I am attempting to report within the 2014 PQRS for Measure #337: Tuberculosis Prevention for Psoriasis and Psoriatic Arthritis Patients on a Biological Immune Response Modifier. Are only those patients that are on a biologic immune response modifier prescribed by the eligible professional included in the denominator of the measure? Read the answer here.
• How do I report for the 2014 PQRS if there are fewer than 9 applicable electronic clinical quality measures (eCQMs) across 3 National Quality Strategy (NQS) domains for my practice and does the 0% performance rate apply to 2014 PQRS EHR Reporting? Read the answer here.
• For 2014, how will my PQRS incentive payment and/or payment adjustment be determined if I report satisfactorily using more than one reporting method? Read the answer here.

Want more information about PQRS?
Make sure to visit the PQRS website for the latest news and updates on PQRS. You can also contact the QualityNet Help Desk at 866-288-8912 or via [email protected]. They are available from 7am to 7pm CT Monday through Friday.

 

FAQs on PQRS MAV Process Available

CMS has recently added four new FAQs to the website. Review these FAQs to learn more about how the Measure-Applicability Validation (MAV) process affects 2014 Physician Quality Reporting System (PQRS) incentive eligibility.

New MAV FAQs:

• What is MAV? Read the answer here.
• When does MAV apply? Read the answer here.
• What happens if we report less than nine measures across three domains? Read the answer here.
• How does CMS apply the MAV Clinical Relation/Domain Test for PQRS? Read the answer here.

Additional MAV Resources:

For more information about the MAV process, review the PQRS Analysis and Payment web page and visit the PQRS website for the latest news and updates on PQRS. For questions about PQRS and the MAV process, contact the QualityNet Help Desk at 866-288-8912 or via [email protected]. They are available from 7am to 7pm CT Monday through Friday.

 

Claims, Pricers, and Codes

 

Update to the CWF Qualifying Stay Edit C7123 for Inpatient SNF Claims

CMS recently resolved an issue concerning the Common Working File (CWF) qualifying stay edit C7123 to allow Skilled Nursing Facility (SNF) claims that contain an accurate qualifying hospital stay to bypass edit C7123. SNF providers that have received this edit in error may adjust their affected claims or contact their Medicare Administrative Contractor (MAC) in order to have their claims adjusted. CMS is currently working on a permanent coding fix for CWF edit C7123 that will address all possible bypass scenarios for the edit. SNF providers should contact their MAC with any questions or concerns.

 

Hold Any Adjustments to Method II CAH Claims that Include Services for a Surgical Assistant

Method II Critical Access Hospital (CAH) claims that include services for a surgical assistant will be held until the system is fixed on July 28, 2014. No action is required by providers. Beginning on July 28th, claims that were processed incorrectly from April 1, 2012 through July 28, 2014, will be adjusted for the following criteria:

• Type of Bill (TOB) = 85x
• CAHs Method II (optional Method = ‘J’) – Page 10, PROVIDER REIM METH = J
• Revenue Code = 96x, 97x, or 98x, excluding 963 and 964
• Modifier = AS, 80, 81 and/or 82 with covered charges greater than zero
• Healthcare Common Procedure Coding (HCPC) = 10000 – 69999

 

Correction to Inappropriately Returned Hospice Claims

Hospices are required to report certain prescription drugs and durable medical equipment items, effective April 1, 2014; see MLN Matters^® Article MM8358. Currently, some hospice claims reporting these items are being returned to providers in error. These claims are returned with reason codes W7061 and W7072. CMS had directed Medicare Administrative Contractors (MACs) that process hospice claims to override these reason codes, so the claims will process appropriately. MAC implementation dates for this correction may vary, so hospices should check their MAC website for the date to begin resubmitting the returned claims

 

July 2014 Outpatient Prospective Payment System Pricer File Update

The Outpatient Prospective Payment System (OPPS) Pricer web page has been updated with a Pricer file for July 2014. This file is available for use and may be downloaded from the OPPS Pricer web page under “3^rd Quarter 2014 Files.”

 

MLN Educational Products

 

“Medicare Billing: 837I and Form CMS-1450” Web-Based Training Course — Released

The “Medicare Billing: 837I and Form CMS-1450” Web-Based Training Course (WBT) was released and is now available. This WBT is designed to provide Medicare billing information for health care professionals working in an institutional provider setting, such as hospitals, skilled nursing facilities, and home health agencies among others. It includes information on claims essentials and processing, the 837I electronic format, and the paper claim Form CMS-1450. Continuing education credits are available to learners who successfully complete this course. See course description for more information.

To access WBTs, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page.

 

“Medicare Secondary Payer for Providers, Physicians, Other Suppliers, and Billing Staff” Fact Sheet — Revised

The “Medicare Secondary Payer for Providers, Physicians, Other Suppliers, and Billing Staff” Fact Sheet (ICN 006903) was revised and is now available in a downloadable format. This fact sheet is designed to provide education on the Medicare Secondary Payer (MSP) provisions. It includes information on MSP basics, common situations when Medicare may pay first or second, Medicare conditional payments, the Coordination of Benefits rules, and the role of the Benefits Coordination & Recovery Center.

 

“Advance Payment Accountable Care Organization (ACO) Model” Fact Sheet — Revised

 

The “Advance Payment Accountable Care Organization (ACO) Model” Fact Sheet (ICN 907403) was revised and is now available in a downloadable format. This fact sheet is designed to provide education on the advance payment model for ACOs. It includes a summary of the Advance Payment ACO Model, background, and information on the structure of payments, recoupment of advance payments, eligibility, and the application process.

 

“Summary of Final Rule Provisions for Accountable Care Organizations under the Medicare Shared Savings Program” Fact Sheet — Revised

The “Summary of Final Rule Provisions for Accountable Care Organizations under the Medicare Shared Savings Program” Fact Sheet (ICN 907404) was revised and is now available in a downloadable format. This fact sheet is designed to provide education on the provisions of the final rule that implements the Medicare Shared Savings Program with Accountable Care Organizations (ACOs). It includes background, information on how ACOs impact beneficiaries, eligibility requirements to form an ACO, and information on monitoring and tying payment to improved care at lower costs.

 

“Methodology for Determining Shared Savings and Losses under the Medicare Shared Savings Program” Fact Sheet — Revised

The “Methodology for Determining Shared Savings and Losses under the Medicare Shared Savings Program” Fact Sheet (ICN 907405) was revised and is now available in a downloadable format. This fact sheet is designed to provide education on the methodology for determining shared savings and losses under the Medicare Shared Savings Program. It includes an overview of the program, a description of the two tracks providers can choose, and a description of how Medicare determines the shared savings or loss.

 

“Accountable Care Organizations: What Providers Need to Know” Fact Sheet — Revised

The “Accountable Care Organizations: What Providers Need to Know” Fact Sheet (ICN 907406) was revised and is now available in a downloadable format. This fact sheet is designed to provide education on Accountable Care Organizations (ACO) under the Medicare Shared Savings Program. It includes a definition of an ACO, and information on how to participate in an ACO, how shared savings will work, how this program is aligned with other quality initiatives, and how ACOs help doctors coordinate care.

 

“Improving Quality of Care for Medicare Patients: Accountable Care Organizations” Fact Sheet — Revised

The “Improving Quality of Care for Medicare Patients: Accountable Care Organizations” Fact Sheet (ICN 907407) was revised and is now available in a downloadable format. This fact sheet is designed to provide education on improving quality of care under Accountable Care Organizations (ACOs). It includes a table of quality measures under the program.

 

“Medicare Shared Savings Program and Rural Providers” Fact Sheet — Revised

The “Medicare Shared Savings Program and Rural Providers” Fact Sheet (ICN 907408) was revised and is now available in a downloadable format. This fact sheet is designed to provide education on how the Medicare Shared Savings Program impacts rural providers. It includes information on federally qualified health centers, rural health clinics, critical access hospitals and how this program impacts them.

 

“Diagnosis Coding: Using the ICD-9-CM” Web-Based Training Course — Reminder

The “Diagnosis Coding: Using the ICD-9-CM” Web-Based Training Course (WBT) is available. This WBT is designed to provide education on the use of ICD-9-CM. It includes information on how to select accurate diagnosis codes from the ICD-9-CM volumes and how to use diagnosis codes correctly on Medicare claim forms. Continuing education credits are available to learners who successfully complete this course. See course description for more information.

To access WBTs, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page.

 

New Continuing Education Association Now Accepting MLN Web-Based Training Courses

The latest continuing education association to accept MLN web-based training (WBT) courses is the National Center for Competency Testing (NCCT). NCCT joins the AAPC, American Association of Medical Assistants (AAMA), the American Association of Medical Audit Specialists (AAMAS), the American Medical Billing Association (AMBA), the California Certifying Board for Medical Assistants (CCBMA), the Healthcare Billing & Management Association (HBMA), the Medical Association of Billers (MAB), and the National Academy of Ambulance Coding (NAAC).

For more information about continuing education associations that accept MLN WBT courses, visit the Association Approvals for WBT Credits web page. If the association you belong to accepts outside credit sources and is not on the list, you should contact them to see if they are interested in working with the MLN. If they are interested, the association should email [email protected].

 

MLN Products Available In Electronic Publication Format

The following fact sheets are now available as an electronic publication (EPUB) and through a QR code. Instructions for downloading EPUBs and how to scan a QR code are available at “How To Download a Medicare Learning Network® (MLN) Electronic Publication” on the CMS website.

• “The Basics of Medicare Enrollment for Institutional Providers” Fact Sheet (ICN 903783) is designed to provide education on basic Medicare enrollment information and how to ensure institutional providers are qualified and eligible to enroll in the Medicare Program. It includes information on how to enroll in the Medicare Program, how to report changes, and a list of resources.
• The “Medicare Remit Easy Print Software” Fact Sheet (ICN 006740) is designed to provide education about Medicare Remit Easy Print (MREP) software that enables physicians and suppliers to view and print their remittance information. It includes a basic software overview, the benefits of using electronic remittance information, minimum system requirements, and additional resources available on the Internet.

 MLN Products Now Available In Hardcopy Format

 To access a new or revised product available for order in a hard copy format, go to MLN Products  and scroll down to the bottom of the web page to the “Related Links” section and click on the “MLN Product Ordering Page.”