Corporate Compliance

Transmittals and MLN Matters articles: CMS updates OCE, ASP drug pricing files, and more

Medicare Insider, September 16, 2008

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CMS rescinds previous transmittal on Inpatient Prospective Payment System (IPPS) post-acute transfer policy

On September 12, CMS rescinded its May 20, 2008, transmittal (Change Request 6012) regarding the IPPS post-acute transfer policy because it reflected incorrect program policy. It will not be reissued.

View the transmittal.

CMS issues transmittal on limitation on recoupment of overpayments for providers, physicians, and suppliers

On September 12, CMS issued a transmittal implementing a statutory change under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which relates to the way CMS recoups certain overpayments.

Effective date: September 29, 2008
Implementation date: September 29, 2008

View the transmittal.

CMS issues transmittal on payment for implanted prosthetic devices for Part B inpatients in hospitals paid under the Medicare hospital Outpatient Prospective Payment System (OPPS)

On September 12, CMS issued a transmittal on payment for implanted prosthetic devices furnished to Medicare beneficiaries who are inpatients of hospitals paid under the OPPS when the beneficiary does not have Part A coverage.

Effective date: January 1, 2009
Implementation date: January 5, 2009

View the transmittal.

CMS issues transmittal updating the temporary hook created to hold OPPS claims that include certain drug HCPCS codes

On September 12, CMS issued a transmittal maintaining and updating the hook that holds OPPS claims with certain drug HCPCS codes.

Effective date: January 1, 2009
Implementation date: January 5, 2009

View the transmittal.

CMS issues transmittal on October 2008 quarterly average sales price (ASP) Medicare Part B drug pricing files

On September 12, CMS issued a transmittal on the release of the October 2008 quarterly ASP Medicare Part B drug pricing files.

Effective date: October 1, 2008
Implementation date: October 6, 2008

View the transmittal.

CMS corrects implementation date in previous transmittals on artificial hearts

On September 10, CMS issued two transmittals to correct the implementation dates for two previous transmittals related to artificial hearts. All other material remains the same.

Effective date: May 1, 2008
Implementation date: December 1, 2008

View the transmittal implementing the correction to the Medicare National Coverage Determinations Manual.

View the transmittal implementing the correction to the Medicare Claims Processing Manual.

View a related MLN Matters article.

CMS updates Integrated Outpatient Code Editor (I/OCE)

On September 8, CMS announced its October 1 update to the I/OCE. (See “Note from Hugh” above.)

Effective Date: October 1, 2008
Implementation Date: October 6, 2008

View the transmittal.

View a related MLN Matters article.

CMS releases MLN Matters articles

CMS released six MLN Matters articles last week relating to transmittals previously announced in the Medicare Weekly Update.



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