Important Medicare updates
Medicare Update for CAHs, July 27, 2011
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CMS posted a new version of the lab NCD manual for the third quarter.
CMS released a display copy of a proposed rule to make changes to the OPPS for 2012.
CMS released for public inspection a copy of the physician fee schedule proposed rule for 2012.
On July 15, CMS issued a transmittal to make quarterly updates to the end-stage renal disease prospective payment system (ESRD PPS).
Effective date: The effective date for the ICD-9-CM updates is October 1, 2011; the effective date for the DME list corrections is January 1, 2011
Implementation date: October 3, 2011
CMS posts NCD for autologous cellular immunotherapy treatment of metastatic prostate cancer
On July 8, CMS issued two transmittals related to coverage of autologous cellular immunotherapy treatment - sipuleucel-T; PROVENGE®. CMS has concluded that sipuleucel-T improves health outcomes for Medicare beneficiaries with asymptomatic or minimally symptomatic metastatic castrate-resistant (hormone refractory) prostate cancer, and thus is reasonable and necessary for this on-label indication.
Effective date: June 30, 2011
Implementation date: August 8, 2011 and January 3, 2012 (CWF frequency edit only)
View the National Coverage Determination Manual transmittal.
View the Claims Processing Manual transmittal.
On July 8, CMS issued two transmittals to make changes to the Claims Processing Manual and the Benefit Policy Manual regarding the timing of the influenza vaccine.
Effective date: August 8, 2011
Implementation date: August 8, 2011
View the Claims Processing Manual transmittal.
View the Benefit Policy Manual transmittal.
CMS rescinded and replaced a previously released transmittal
Transmittals and MLN Matters articles: CMS posts MLN Matters article
CMS issued an MLN Matters article related to a previously released transmittal
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