Corporate Compliance

The week in Medicare updates

Medicare Insider, June 17, 2014

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July update to the calendar year (CY) 2014 Medicare Physician Fee Schedule Database
 
On June 6, CMS released a change request regarding payment files issued to contractors based upon the CY 2014 Medicare Physician Fee Schedule Final Rule. This change request amends those payment files. This Recurring Update Notification applies to Pub. 100-04, Medicare Claims Processing Manual, Chapter 23, Section 30.1.
 
Effective date: July 1, 2014
Implementation date: July 7, 2014
 
View Transmittal R2974CP.
View MLN Matters article MM8773.
 
Implementing the Recompetition Award for the Jurisdiction N (formerly Jurisdiction 9) Part A/Part B Medicare Administrative Contractor (A/B MAC) Workload  
 
On June 6, CMS released a change request to announce the Jurisdiction N A/B MAC recompetition procurement was awarded to the incumbent contractor, First Coast Service Options, Inc. The MAC designation will change from J9 to JN. The current MAC workload numbers of 09101, 09201, 09102, 09202, and 09302 will remain the same.
 
Effective date: February 14, 2014
Implementation date: July 8, 2014
 
View Transmittal R1390OTN.
 
CMS requests comments on several forms
 
On June 13, CMS announced an opportunity for the public to comment regarding CMS–10123 and 10124, Notice of Provider Non-Coverage and Detailed Explanation of Non-Coverage; CMS–10147, Standardized Pharmacy Notice: Your Prescription Cannot be Filled (f/k/a Medicare Prescription Drug Coverage and Your Rights); CMS–10252, Data use agreement Certificate of Disposition for data acquired from CMS; CMS– 10305, Part C Medicare Advantage Reporting Requirements and Supporting Regulations; and CMS–R–268, CMS Survey Tool for http://www.cms.gov and http://www.medicare.gov. Comments are due by August 12.
 
View the notice in the Federal Register.
Leave a comment.
 
Lung cancer screening with low dose computed tomography
 
On June 12, CMS posted transcripts and meeting minutes from an April 30 meeting regarding lung cancer screening with low dose computed tomography.
 
View the notice.
 
Survey and enforcement process for skilled nursing facilities and nursing facilities
 
On June 12, CMS released instruction that revises and expands current Medicare and Medicaid guidance regarding the imposition and collection of civil money penalties by CMS when nursing homes are not in compliance with federal participation requirements in accordance with section 6111 of the Affordable Care Act of 2010. This change request rescinds and replaces Transmittal 113, dated April 25, 2014, to include titles, deletions to the transmittal page, and Chapter 9 table of contents page to reflect new exhibits. All other information remains the same.
 
Effective date: January 1, 2012
Implementation date: January 1, 2012 
 
View Transmittal R118SOMA.
 
Community mental health center (CMHC) certifications of compliance submission
 
On June 13, CMS released a change request to instruct contractors on the processing of CMHC certifications of compliance with § 485.918(b)(1), Conditions of Participation for Community Mental Health Centers.
Effective date: July 15, 2014
Implementation date: July 15, 2014
 
View Transmittal R521PI.
View MLN Matters article MM8784.
 
Changes to the Laboratory National Coverage Determination (NCD) Software
 
On June 13, CMS released a change request stating the Laboratory NCD Edit Software will be updated to continue the processing of the ICD-9 diagnosis codes. The Protecting Access to Medicare Act of 2014 (Pub. L. No. 113-93), enacted on April 1, said ICD-10 will not be adopted prior to October 1, 2015. Accordingly, the HHS expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015.
 
Effective date: October 1, 2014
Implementation date: October 6, 2014
 
View Transmittal R2976CP.



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