Practicing Prevention in Physician OfficesPreventing Medicare Consumers from Getting Sick The prevention of major illness is the first step in maintaining a healthy lifestyle. It seems so simple, yet every day Medicare consumers who can and should get screenings and vaccinations don’t. There is a very real need for more effective strategies for delivering preventive medicine to those who need it the most.
In the 9th Scope of Work, we are helping health care providers use their electronic health record system to implement care management processes to improve the rate of patients that receive:
Breast & colorectal cancer screenings
Influenza & pneumococcal immunizations
News from the Medicare Learning Network
In the 9th Scope of Work, we are helping health care providers use their electronic health record system to implement care management processes to improve the rate of patients that receive:
Breast & colorectal cancer screenings
Influenza & pneumococcal immunizations
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News from the Medicare Learning Network
- Updates from the Medicare Learning Network
Did you know that the Medicare Preventive Services Series Part 2 web-based training course (WBT) is currently available free of charge, on the CMS website?
This course includes coverage, coding, and billing information for Medicare coverage of the following preventive services:- The initial preventive physical exam (IPPE),
- Ultrasound screening for abdominal aortic aneurysms (AAA),
- Colorectal cancer screening,
- Cardiovascular screening blood tests,
- Diabetes screening tests,
- Supplies and other services for beneficiaries with diabetes,
- Diabetes self-management training and medical nutritional therapy, and
- Smoking and tobacco-use cessation counseling services.
Taking this online course will help you and your staff understand Medicare rules surrounding these important benefits. Not only that, but if you pass this course, you can earn continuing education credit.
You can access this course, free of charge, at any time, by visiting the Preventive Services Educational products page at on the CMS web site. Scroll down to the “Related Links Inside CMS” section and click on “Web Based Training Modules” to take the course.
- The Medicare Learning Network is now podcasting. Their premier production – “New Maximum Period for the Submission of Medicare Claims,” which reminds Medicare Fee-for-Service providers of the current claims submission deadline, is now available. To access the podcast, visit the CMS web site.
- The Medicare Remit Easy Print Brochure (revised May 2010) provides information about free software that enables professional providers and suppliers to view and print remittance information, is now available in print format from the Medicare Learning Network. To place your order, visit www.cms.gov/MLNGenInfo, scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”
- The revised National Provider Identifier Tip Sheet: Guidance for Organization Health Care Providers Who Apply for National Provider Identifiers (NPIs) for Their Health Care Provider Employees (June 2010) is available on the CMS web site. This resource details the steps an organization that is a health care provider should take when applying for an employee’s NPI, on an individual record-by-record basis. Available in PDF format, the fact sheet may be downloaded or printed from the "Education Resources" section of the NPI web pages, located at www.cms.gov/NationalProvIdentStand/04_education.asp on the CMS web site.
- Recently Released MLN Matters Articles of Particular Interest
- MLN Matters Article #MM7014 - Home Health Agencies (HHAs) Providing Durable Medical Equipment (DME) in Competitive Bidding Areas
The Centers for Medicare & Medicaid Services (CMS) has released MLN Matters Article #MM7014 to alert Home Health Agencies (HHAs) that edits will be in place, effective for services on or after January 1, 2011, to prevent them from billing competitively-bid DME items in competitive bidding areas and consequently, preventing the inappropriate payment of competitively-bid DME items to HHAs. For more details, please read the article at www.cms.gov/MLNMattersArticles/downloads/MM7014.pdf on the CMS web site.
- MLN Matters Article #MM7080 - Timely Claims Filing: Additional Instructions
The Centers for Medicare & Medicaid Services (CMS) has released MLN Matters Article #MM7080 to expand the Medicare Fee-For-Service (FFS) reimbursement instructions outlined in Change Request 6960 that specified the basic timely filing standards established for FFS reimbursement. Those basic standards are a result of Section 6404 of the Patient Protection and Affordable Care Act of 2010 (ACA), which states that claims with dates of service on or after January 1, 2010, received later than one calendar year beyond the date of service will be denied by Medicare. For more details, please read the article at http://www.cms.gov/MLNMattersArticles/downloads/MM7080.pdf on the CMS web site.
- MLN Matters Article #MM6934 - Durable Medical Equipment National Competitive Bidding Implementation 10G: Paying for Oxygen Equipment when Grandfathered
The Centers for Medicare & Medicaid Services (CMS) has released MLN Matters Article #MM6934 to alert suppliers that a non-contract supplier who chose to be a grandfathered supplier for oxygen and oxygen equipment should also furnish additional oxygen equipment when medically necessary after the start of a Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program to beneficiaries residing in a Competitive Bidding Area (CBA) who are already receiving oxygen equipment from the grandfathered supplier, as described in Change Request 6934. For more details, please read the article at www.cms.gov/MLNMattersArticles/downloads/MM6934.pdf on the CMS web site.
- MLN Matters Article #MM7014 - Home Health Agencies (HHAs) Providing Durable Medical Equipment (DME) in Competitive Bidding Areas