MEDICARE UPDATE 2009

MEDICARE UPDATE 2009
For additional information contact:
CPA Wanda Marrero at 787-622-2200 or
CPA Teresa Figueroa at 787-378-3425
Friday, August 14, 2009
Early bird until July 31, 2009:
$150 HFMA Members
$185 Non HFMA Members
$165 Three or more from same institution
After July 31, 2009:
$165 HFMA Members
$215 Non HFMA Members
$195 Three or more from same institution
Registration form is attached
San Juan Hotel & Casino, Isla
Verde
PROGRAM
Washington Update
Mrs. Delia La Santa,
Auxiliary Secretary of Federal Affairs
Mr. Domingo Nevárez,
Executive Director ASES
ICD 10
Mrs. Sally Montes,
Assistant Vice President HIM on Call
Mrs. Sandra Peña, Director Billing Compliance
and Revenue Cycle Services, HIM. On
Call
Facing the RAC-The New Challenge
Ms. Ada Vélez,
Performance Improvement Consultant
ICD 10 Workshop
Mrs. Sally Montes,
Assistant Vice President HIM on Call
Mrs Sandra Pena, Director HIM on Call
Introduction to FCSO and Provider Audit
and Reimbursement
Mr. Bill Tisdale, Director of Provider Audit
and Reimbursement,
First Coast Service Options
The New Provider Statistical and
Reimbursement System
Mr. Tony Matos, Branch Manager, Provider
Audit and Reimbursement,
First Coast Service Options
Medicare Update 2009 Program — Agenda
7:30 a.m. – 8:45 a.m. Registration and Breakfast
8:45 a.m. – 9:00 a.m. Welcome
9:00 a.m. – 10:00 a.m. Washington Update – Changes recently approved by the Federal Government, with impact In PR
Speakers:
Mrs. Delia La Santa, Auxiliary Secretary of Federal Affairs, Health Department of the Commonwealth of PR
Mr. Domingo Nevárez, Executive Director ASES
10:00 a.m. – 10:15 a.m. Morning Break
10:15 a.m. – 12:15 p.m. General Morning Session - ICD-10
Speakers:
Mrs. Sally Montes, Assistant Vice-President, H.I.M. on Call
Mrs. Sandra Peña, Director Billing Compliance and Revenue Cycle Services, H.I.M. on Call
12:15 M –1:30 p.m. Lunch
1:30 p.m. – 3:00 p.m. Concurrent Sessions
Session 1:
Facing the RAC-The New Challenge
Speaker
Ms. Ada Velez, Performance Improvement Consultant
Session 2:
ICD-10 Workshop
Speakers
Mrs. Sally Montes, Assistant Vice-President, H.I.M. on Call
Mrs. Sandra Peña, Director Billing Compliance and Revenue Cycle Services, H.I.M. on Call
3:00 p.m. - 3:15 p.m. Afternoon break
3:15 p.m. – 4:30 p.m. General Afternoon Session
Topic: Introduction to FCSO and Provider audit and Reimbursement
Speaker:
Mr. Bill Tisdale, Director of Provider Audit and Reimbursement, First Coast Service Options
Topic: The New Provider Statistical and Reimbursement System
Speaker:
Mr. Tony Matos, Branch Manager, Provider Audit and Reimbursement, First Coast Service Options
4:30 p.m. Cocktail
Oportunidad de educación al proveedor: Requisitos para la presentación del formulario CMS-1500 (08/05)

(Este documento es copia igual al enviado a Afamep para su publicación. Debido al tipo de documento se realizaron ajustes al formato)
Martes, 18 de agosto / 4:00 PM-5:30 PM
Idioma en que se ofrece el evento: Español
Este webcast educacional gratuito está a disposición de los proveedores de cuidados de la salud localizados en la Florida, Puerto Rico y las Islas Vírgenes de los Estados Unidos y tiene por finalidad ofrecer detalles sobre los requisitos del formulario CMS-1500 (08/05).
¿Esta usted recibiendo reclamaciones denegadas o reclamaciones devueltas como no procesables o RUC por sus siglas en
ingles?
¿Quiere reducir el número de errores en sus reclamaciones?
¿Quiere familiarizarse con los requisitos del formulario CMS (08/05)?
Si usted respondió afirmativamente a estas preguntas, este webcast es para usted. Este webcast consistirá de una presentación interactiva y la navegación del sitio Web para encontrar la información que usted necesita.
La presentación terminará con un periodo de preguntas y respuestas. Únase a nosotros en esta sesión informativa y obtenga respuesta a sus preguntas por los expertos de Medicare. No se pierda esta gran oportunidad educacional.
Para participar en este webcast, inscríbase antes del 17 de agosto.
Haga clic en el siguiente enlace, http://medicareespanol.fcso.com/Wrapped/143806.asp para las instrucciones de inscripción.
>Estimados proveedores del Medicare en Puerto Rico,
FYI
Raúl Alicea, MBA/HCM, CHA | Health Insurance Specialist | Provider Outreach & Education | Consortium for Medicare Health Plan Operations | Centers for Medicare and Medicaid Services| ’ 787-771-3687 | 7 787-771-3689 | * raul.alicea@cms.hhs.gov
"A soft answer turneth away wrath; A gentle tongue is a tree of life; In the house of the righteous is much treasure; the lips of the wise disperse knowledge"
Please consider the environment before printing this e-mail.
>-----Original Message-----
>From: Karnes, Kimberly [mailto:Kimberly.Karnes@fcso.com]
>Sent: Friday, June 05, 2009 4:33 PM
>Subject: First Coast Service Options (J9 MAC) quiere destacar webcasts educativos
>importantes para proveedores de Medicare en Puerto Rico
>
>Estimados proveedores del Medicare en Puerto Rico,
>
>First Coast Service Options, Inc. (FCSO) asumío su nuevo rol como el contratista
>administrativo de Medicare (MAC) para Puerto Rico el 2 de marzo. La principal
>prioridad de nuestro departamento de educación al proveedor es brindarles la
>información y los recursos que necesitan para entender y facturar correctamente el
>programa de Medicare.
>
>Durante los próximos meses, FCSO quiere destacar cuatro webcasts educativos que
>enfocan en temas importantes a los proveedores en Puerto Rico. Les pedimos que
>compartan este anuncio con los miembros de sus organizaciones para que éstos
>aprovechen estas oportunidades de informarse e interactuar directamente con los
>expertos en Medicare de FCSO.
>
>Para inscribirse y leer sobre estos eventos y otros más, les exhortamos que accedan
>nuestro calendario de eventos educativos utilizando el enlance provisto:
>http://medicareespanol.fcso.com/Educacion_recursos/143443.asp. Si no ha
>participado todavía en un webcast de FCSO, adjunto incluyo preguntas más
>frecuentes sobre como participar en estos eventos interactivos.
>
>Webcasts de FCSO en junio y julio
>Evento: Cambios en el proceso de inscripción del proveedor - petición de cambio (CR)
>6310 (Parte A/B) - Webcast
>Fecha y hora: Miércoles, 16 de junio a las 4:00 PM-5:30 PM
>Esta sesión interactiva incluirá detalles sobre la extensión de tiempo disponible
>para informar cambios a su información de inscripción, los cambios en la política de
>facturación retrospectiva y muchos otros temas relacionados.
>
>Evento: Determinando el nivel de código de evaluación y manejo (E/M) apropiado -
>Webcast
>Fecha y hora: Miércoles, 15 de julio a las 4:00 PM-5:00 PM
>En este evento discutiremos los componentes de E/M, revisaremos escenarios de
>una factura actual y explicaremos como nuestro departamento de revisión médica
>aplica las guías de E/M para determinar el nivel apropiado.
>
>Evento: Webcast sobre transportación de ambulancia de no emergencia (Parte B)-
>Webcast
>Fecha y hora: Jueves el 16 de julio a las 4:00 PM-5:00 PM
>Este evento está diseñado para ayudar a entender la determinación de cobertura
>local (LCD) sobre servicios de ambulancias terrestre no-emergencia para Medicare
>Parte B, que entrará en vigor el 30 de junio de 2009, así como otros requisitos
>importantes de facturación de servicios de ambulancia. Esta LCD establecerá
>limitaciones de cobertura para servicio de ambulancia terrestre no-emergencia.
>
>Evento: Requisitos para la presentación del formulario CMS-1500 (08/05) - Webcast
>Fecha y hora: Martes, 18 de agosto a las 4:00 PM-5:30 PM
>Durante este evento ofreceremos detalles sobre los requisitos del formulario CMS-
>1500 (08/05) y su equivalente en versión electrónica (electronic media claim,
>EMC)para ayudar a los proveedores reducir el número de reclamaciones denegadas
>y errores en la CMS 1500.
>
> <>
>
>
>First Coast Service Options, Inc., and its affiliates are not responsible for errors or
>omissions in the transmission of this e-mail message. Any personal comments made
>in this e-mail do not reflect the views of First Coast Service Options, Inc., or its
>affiliates. The information contained in this document may be confidential and is
>intended solely for the use of the individual or entity to whom it is addressed. This
>document may also contain material that is privileged or protected from disclosure
>under applicable law. If you are not the intended recipient or the individual
>responsible for delivery to the intended recipient, please (1) be advised that any use,
>dissemination, forwarding, or copying of this document IS STRICTLY PROHIBITED;
>and (2) notify sender immediately by telephone and destroy the document. Thank
>you.
Oportunidades de aprendizaje, asistencia y educación al proveedor
Cursos de aprendizaje en línea disponibles
Calendario de eventos educacionales de Medicare de FCSO
Tipo de evento | Fecha | Descripción |
|---|---|---|
Junio 10 | Tema: Quiropráctico (Parte B) Tipo: Webcast Hora: 11:30 AM-12:30 PM Idioma en que se ofrece el evento: Inglés Dirigido a: Florida, Puerto Rico y las Islas Vírgenes de los Estados Unidos | |
Junio 11 | Tema: e-Prescribing: Programa de incentivo de receta electrónica de Medicare 2009 (Parte B) Tipo: Webcast Hora: 11:30 PM-1:00 PM Idioma en que se ofrece el evento: Inglés Dirigido a: Florida, Puerto Rico, y las Islas Vírgenes de los Estados Unidos | |
Junio 16 | Tema: (Cambios en el proceso de inscripción del proveedor - CR 6310 (Parte A/B) Tipo: Webcast Hora: 4:00 PM-5:00 PM Idioma en que se ofrece el evento: Español Dirigido a: Puerto Rico | |
Junio 17 | Tema: Infórmese de como utilizamos sus opiniones para mejorar los servicios que ofrecemos Tipo: Webcast Hora: 11:30 AM-12:30 PM Idioma en que se ofrece el evento: Inglés Dirigido a: Florida, Puerto Rico, y las Islas Vírgenes de los Estados Unidos | |
Junio 17 | Tema: Infórmese de como utilizamos sus opiniones para mejorar los servicios que ofrecemos Tipo: Webcast Hora: 4:00 AM-5:00 PM Idioma en que se ofrece el evento: Español Dirigido a: Puerto Rico | |
Julio 14 | Tema: Serie de temas de actualidad: Cambios y actualizaciones de Parte B 2009 Tipo: Webcast Hora: 11:30 AM-12:30 PM Idioma en que se ofrece el evento: Inglés Dirigido a: Florida y las Islas Vírgenes de los Estados Unidos | |
Julio 15 | Tema: Serie de temas de actualidad: Cambios y actualizaciones de Parte A 2009 Tipo: Webcast Hora: 11:30 AM-12:30 PM Idioma en que se ofrece el evento: Inglés Dirigido a: Florida y las Islas Vírgenes de los Estados Unidos | |
Julio 15 | Tema: Determinando el nivel de código de evaluación y manejo (E/M) apropiado Tipo: Webcast Hora: 4:00 PM-5:30 PM Idioma en que se ofrece el evento: Español Dirigido a: Puerto Rico | |
Julio 16 | Tema: Webcast sobre transportación de ambulancia de no emergencia (Parte B) Tipo: Webcast Hora: 4:00 PM-5:30 PM Idioma en que se ofrece el evento: Español Dirigido a: Puerto Rico | |
Julio 21 | Tema: Serie de temas de actualidad: Cambios y actualizaciones de Parte A 2009 Tipo: Webcast Hora: 2:00 PM-3:30 PM Idioma en que se ofrece el evento: Español Dirigido a: Puerto Rico | |
Julio 21 | Tema: Nueva serie de Evaluación y Manejo: talleres que cubren servicios E/M de un paciente típico -- sesión 1 (Parte B) Tipo: Webcast Hora: 11:30 AM–1:00 PM Idioma en que se ofrece el evento: Inglés Dirigido a: Florida, Puerto Rico y las Islas Vírgenes de los Estados Unidos | |
Julio 22 | Tema: Serie de temas de actualidad: Cambios y actualizaciones de Parte B 2009 Tipo: Webcast Hora: 4:00 PM-5:30 PM Idioma en que se ofrece el evento: Español Dirigido a: Puerto Rico | |
Agosto 18 | Tema: Requisitos para la presentación del formulario CMS-1500 Tipo: Webcast Hora: 4:00 PM-5:30 PM Idioma en que se ofrece el evento: Español Dirigido a: Florida, Puerto Rico y las Islas Vírgenes de los Estados Unidos | |
Septiembre 1-2 | Tema: Evento educacional Medifest Tipo: Seminario/simposio en persona Hora: 8:00 AM-5:30 PM Idioma en que se ofrece el evento: Inglés Dirigido a: Florida, Puerto Rico y las Islas Vírgenes de los Estados Unidos | |
Septiembre 8 | Tema: Serie de temas de actualidad: Cambios y actualizaciones de Parte B 2009 Tipo: Webcast Hora: 11:30 AM-12:30 PM Idioma en que se ofrece el evento: Inglés Dirigido a: Florida y las Islas Vírgenes de los Estados Unidos | |
Septiembre 9 | Tema: Serie de temas de actualidad: Cambios y actualizaciones de Parte A 2009 Tipo: Webcast Hora: 11:30 AM-12:30 PM Idioma en que se ofrece el evento: Inglés Dirigido a: Florida y las Islas Vírgenes de los Estados Unidos | |
Septiembre 22 | Tema: Serie de temas de actualidad: Cambios y actualizaciones de Parte A 2009 Tipo: Webcast Hora: 2:00 PM-3:30 PM Idioma en que se ofrece el evento: Español Dirigido a: Puerto Rico | |
Septiembre 23 | Tema: Serie de temas de actualidad: Cambios y actualizaciones de Parte B 2009 Tipo: Webcast Hora: 4:00 PM-5:30 PM Idioma en que se ofrece el evento: Español Dirigido a: Puerto Rico |
Iconos clave
Dos formas fáciles de inscribirse
Instrucciones para inscribirse por Internet
Instrucciones para inscripción por medio de Fax (para proveedores sin acceso a Internet)
Como solicitar ayuda
¿No tiene tiempo de asistir a un evento?
Manténgase informado: Vea el calendario de los próximos eventos dedicados a nuestros proveedores

IMPORTANTE INFORMACION PARA LOS QUE TRABAJAN CON EQUIPO MEDICO (DME) - Get Ready for DMEPOS Competitive Bidding!
From: CMS CMSProviderResource <CMSProviderResource@cms.hhs.gov>
Date: Fri, May 29, 2009 at 5:50 PM
Subject: GET READY FOR DMEPOS COMPETITIVE BIDDING!
To: ALL_FFS_PROVIDERS@list.nih.gov
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), enacted on July 15, 2008, made limited changes to the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program, including a requirement that competition to re-bid Round 1 occur in 2009. On January 16, 2009, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment period that incorporates into regulations only those provisions of MIPPA related to the DMEPOS competitive bidding program that are self-implementing and necessary to conduct the Round 1 rebid competition in 2009. That rule became effective on April 18, 2009. To ensure that suppliers have ample time to prepare for the competition, CMS has announced the following next steps for the program:
SPRING 2009
Ø CMS BEGINS PRE-BIDDING SUPPLIER AWARENESS CAMPAIGN
Ø PROGRAM ADVISORY AND OVERSIGHT COMMITTEE (PAOC) MEETING (JUNE 4, 2009)
SUMMER 2009
Ø CMS ANNOUNCES BIDDING SCHEDULE/SCHEDULE OF EDUCATION EVENTS
Ø CMS BEGINS BIDDER EDUCATION CAMPAIGN
Ø BIDDER REGISTRATION PERIOD TO OBTAIN USER IDS AND PASSWORDS BEGINS
FALL 2009
Ø BIDDING BEGINS
If you are a supplier interested in bidding, prepare now – don’t wait!
Ø UPDATE YOUR NSC FILES: DMEPOS supplier standard # 2 requires ALL suppliers to notify the National Supplier Clearinghouse (NSC) of any change to the information provided on the Medicare enrollment application (CMS-855S) within 30 days of the change. DMEPOS suppliers should use the 3/09 version of the CMS-855S and should review and update:
• The list of products and services found in section 2.D;
• The Authorized Official(s) information in sections 6A and 15; and
• The correspondence address in section 2A2 of the CMS-855S.
This is especially important for suppliers who will be involved in the Medicare DMEPOS Competitive Bidding Program. These suppliers must ensure the information listed on their supplier files is accurate to enable participation in this program. Information and instructions on how to submit a change of information may be found on the NSC Web site (http://www.palmettogba.com/nsc) and by following this path: Supplier Enrollment/Change of Information/Change of Information Guide.
Ø GET LICENSED: Suppliers submitting a bid for a product category in a competitive bidding area (CBA) must meet all DMEPOS state licensure requirements and other applicable state licensure requirements, if any, for that product category for every state in that CBA. Prior to submitting a bid for a CBA and product category, the supplier must have a copy of the applicable state licenses on file with the NSC. As part of the bid evaluation we will verify with the NSC that the supplier has on file a copy of all applicable required state license(s).
Ø GET ACCREDITED: CMS would like to remind DMEPOS suppliers again that time is running out to obtain accreditation by the September 30, 2009 deadline or risk having their Medicare Part B billing privileges revoked on October 1, 2009. Accreditation takes an average of 6 months to complete. It is very important for DMEPOS suppliers to contact an accreditation organization right away to obtain information about the accreditation process and submit an application. Suppliers must be accredited for a product category in order to submit a bid for that product category. CMS cannot contract with suppliers that are not accredited by a CMS-approved accreditation organization.
Further information on the DMEPOS accreditation requirements along with a list of the accreditation organizations and those professionals and other persons exempted from accreditation may be found at the CMS website: http://www.cms.hhs.gov/MedicareProviderSupEnroll/01_Overview.asp .
Ø GET BONDED: CMS would like to remind DMEPOS suppliers that certain suppliers will need to obtain and submit a surety bond by the October 2, 2009 deadline or risk having their Medicare Part B billing privileges revoked. Suppliers subject to the bonding requirement must be bonded in order to bid in the DMEPOS competitive bidding program. A list of sureties from which a bond can be secured is found at the Department of the Treasury’s “List of Certified (Surety Bond) Companies;” the web site is located at:
www.fms.treas.gov/c570/c570_a-z.html.
Visit the CMS web site at http://www.cms.hhs.gov/DMEPOSCompetitiveBid/
for the latest information on the DMEPOS competitive bidding program.
To view the Press Release, please click: http://www.cms.hhs.gov/apps/media/press_releases.asp.
Medicare 2009 Conference on June 23, 2009
Mark your calendar for the Medicare 2009 Conference on June 23, 2009 at the Rio Piedras’s Rotary Club. Attached are the registration form and a map of the Rotary Club. Complete the registration form and forward it on or before June 17 to the following e-mail address: prfo@cms.hhs.gov. Read registration instructions carefully included in the Registration Form. This is a basic Medicare A, B, C and D Training with updates. DO NOT REGISTER THROUGH THIS E-MAIL.
Raúl Alicea, MBA/HCM, CHA | Health Insurance Specialist | Provider Outreach & Education | Consortium for Medicare Health Plan Operations | Centers for Medicare and Medicaid Services| ’ 787-771-3687 | 7 787-771-3689 | * raul.alicea@cms.hhs.gov
"A soft answer turneth away wrath; A gentle tongue is a tree of life; In the house of the righteous is much treasure; the lips of the wise disperse knowledge"
Please consider the environment before printing this e-mail.
MEDICARE CONFERENCE 2009
Mark your calendar for the Medicare 2009 Conference on June 23, 2009 at the Rio Piedras’s Rotary Club. Attached are the registration form and a map of the Rotary Club. Complete the registration form and forward it on or before June 17 to the following e-mail address: prfo@cms.hhs.gov. Read registration instructions carefully included in the Registration Form. DO NOT REGISTER THROUGH THIS E-MAIL.
"A soft answer turneth away wrath; A gentle tongue is a tree of life; In the house of the righteous is much treasure; the lips of the wise disperse knowledge"
FYI
Raúl Alicea, MBA/HCM, CHA | Health Insurance Specialist | Provider Outreach & Education | Consortium for Medicare Health Plan Operations | Centers for Medicare and Medicaid Services| ' 787-771-3687 | 7 787-771-3689 | * raul.alicea@cms.hhs.gov
"A soft answer turneth away wrath; A gentle tongue is a tree of life; In the house of the righteous is much treasure; the lips of the wise disperse knowledge"
Please consider the environment before printing this e-mail.
From: AHA Central Office [mailto:AHACentralOffice@mail149.subscribermail.com]
Sent: Monday, March 23, 2009 12:48 PM
To: Alicea, Raul (CMS/CMHPO)
Subject: AHA Coding Clinic presents Neoplasm Coding Seminar
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Importante Información Relacionada con Medicare / First Coast
FYI Raúl Alicea, MBA/HCM, CHA | Health Insurance Specialist | Provider Outreach & Education | Consortium for Medicare Health Plan Operations | Centers for Medicare and Medicaid Services| ' 787-771-3687 | 7 787-771-3689 | * raul.alicea@cms.hhs.gov "The secret of joy in work is contained in one word – “EXCELLENCE”. To know how to do something well is to enjoy it" From: Favio F. Miranda Aldarondo [mailto:fmiranda@leadersteps.com] Estimado Raul: Saludos. Me complace compartir contigo la informacion adjunta. Sientete en total libertad de compartir la misma. Reclamaciones Medicare Parte A y B // Transición de Triple S a First Coast... En ASSERTUS estamos Listos. El pasado 25 de febrero de 2009, recibimos la certificación por parte First Coast Service Option, Inc., de que ASSERTUS ha pasado exitosamente las pruebas para procesar las reclamaciones de Medicare parte A y B. Vea más en: www.assertus.com Sinceramente, Favio F. Miranda t 787.518.2615 ____ FYI Raúl Alicea, MBA/HCM, CHA | Health Insurance Specialist | Provider Outreach & Education | Consortium for Medicare Health Plan Operations | Centers for Medicare and Medicaid Services| ' 787-771-3687 | 7 787-771-3689 | * raul.alicea@cms.hhs.gov "The secret of joy in work is contained in one word – “EXCELLENCE”. To know how to do something well is to enjoy it" Part A Billing and coverage Updates to the Medicare Claims Processing Manual for ambulance services Transition from an FI/carrier to a Medicare administrative contractor Forms Request for redetermination form Hospital Disclosure of physician ownership in hospitals CPT codes, descriptions, and other data only are copyright 2008 American Medical Association (or such other date of publication of CPT). All rights reserved. Applicable FARS/DFARS apply. Links to third party Web sites. This message may contain links to sites operated by third parties. Such links are provided for your reference only. FCSO does not control such sites and is not responsible for their content. The inclusion of such links within this message does not suggest any endorsement of the material on such sites or any association with their operators. This message was sent from First Coast Service Options to raul.alicea-morales@cms.hhs.gov. It was sent from: First Coast Service Options, Inc., 532 Riverside Avenue , Jacksonville , FL 32202 . You can modify/update your subscription via the link below.
Sent: Thursday, March 19, 2009 9:03 AM
To: Alicea, Raul (CMS/CMHPO); Alicea, Raul (CMS/CMHPO)
Subject: Assertus - First Coast
f 787.957.6087
Modified: 3/16/2009 Business: Part A, Part B Location: FL, PR, USVI
The key purpose of these manual changes is to eliminate references to the reasonable charge payment methodology and the transition to the ambulance fee schedule, which took place from April 2002 through December 2006. [MM6347]
Modified: 3/13/2009 Business: Part A, Part B Location: FL, PR, USVI
This article was revised on March 11, 2009, to add definitions of an outgoing and incoming contractor and to remind affected providers of upcoming Medicare contractor transitions. [SE0837, PERL 200903-17]
Modified: 3/13/2009 Business: Part A Location: FL
This is for an appeal and not to be used when requesting a claim adjustment.
Modified: 3/13/2009 Business: Part A Location: FL, PR, USVI
The fiscal year (FY) 2008 and FY 2009 inpatient prospective payment system regulations require hospitals to disclose to patients whether they are physician-owned, and if so, to disclose the physician owners’ names. [MM6306]
DISCLAIMERS
___________________________________
Click on the link below for calling information about the PQRI conference call TODAY at 3:30 p.m.
http://www.acc.org/advocacy/advoc_issues/medicare_pqri031209.cfm
Raúl Alicea, MBA/HCM, CHA | Health Insurance Specialist | Provider Outreach & Education | Consortium for Medicare Health Plan Operations | Centers for Medicare and Medicaid Services| ' 787-771-3687 | 7 787-771-3689 | * raul.alicea@cms.hhs.gov
"The secret of joy in work is contained in one word – “EXCELLENCE”. To know how to do something well is to enjoy it"
03/12/09 FCSO Parte B/A (Información General) eNews: Un recorrido por el sitio Web para proveedores en Puerto Rico
Please, share with colleagues.
Raúl Alicea, MBA/HCM, CHA
Health Insurance Specialist
Provider Outreach & Education
Centers for Medicare & Medicaid Services
P 787-771-3660
F 787-771-3689
C 787-300-0389
"The secret of joy in work is contained in one word - EXCELLENCE. To know how to do something well is to enjoy it"
| Parte B | |
| Un recorrido por el sitio Web rediseñado del proveedor (proveedores de Puerto Rico) | |
Webcast: 20 de marzo de 2009, 5:00 PM-6:30 PM Idioma en que será ofrecido el evento: español
El contratista administrativo de Medicare (MAC) de jurisdicción nueve (J9), conferido a First Coast Service Options Inc. (FCSO), ha expandido la comunidad de proveedores de FCSO para incluir profesionales del cuidado de la salud e instalaciones hospitalarias en Florida, Puerto Rico y las Islas Vírgenes de los Estados Unidos. Mientras nos dirigimos juntos al nuevo ambiente de MAC, nuestra primera prioridad será mantenerlo informado sobre las últimas noticias de Medicare y proveerle con los recursos que usted necesita para continuar su labor como proveedor de Medicare. El sitio Web es uno de los recursos más utilizados de nuestros proveedores, el cual sirve como una ventana de información abierta las 24 horas del día, incluyendo artículos, herramientas de inscripción del proveedor, publicaciones, tarifas fijas, próximos eventos del proveedor, y mucho más. En respuesta a los valiosos comentarios de nuestros proveedores, hemos rediseñado nuestro sitio Web para brindarles un mejor servicio. Descubre las maravillas del cambio Para celebrar el estreno de nuestro nuevo sitio Web y darle la bienvenida a nuestros más recientes miembros de la comunidad de proveedores, nosotros administraremos un webcast para introducir a los proveedores a nuestro nuevo sitio Web. Durante el webcast, le guiaremos a través de nuestro nuevo sitio Web y le diremos en detalle las nuevas mejorías, incluyendo una navegación mas intuitiva, un mejor sistema de búsqueda, y nuevas herramientas que le ayudarán a encontrar exactamente la información que usted busca más rápida y fácilmente que nunca. Estos cambios fueron realizados teniendo a nuestros valiosos proveedores en mente. Es nuestra meta el asegurar que cada visita hecha a nuestro sitio Web del proveedor sea una placentera y productiva. ¿Quiere saber más? Únase a nosotros. Luego de la presentación habrá una sesión de preguntas y respuestas. Para participar en este webcast, inscríbase antes del 19 de marzo de 2009. Haga clic aquí para instrucciones de inscripción. Únase a nosotros para este evento importante y usted podrá descubrir las maravillas del cambio. |
| Icon Legend |
| Disclaimers |
| CPT codes, descriptions, and other data only are copyright 2007 American Medical Association (or such other date of publication of CPT). All rights reserved. Applicable FARS/DFARS apply. |
| Links to third party Web sites. This message may contain links to sites operated by third parties. Such links are provided for your reference only. FCSO does not control such sites and is not responsible for their content. The inclusion of such links within this message does not suggest any endorsement of the material on such sites or any association with their operators. |
| View this message in the iContact Community: |
| Parte A | |
| Un recorrido por el sitio Web rediseñado del proveedor (proveedores de Puerto Rico) | |
Webcast: 20 de marzo de 2009, 5:00 PM-6:30 PM Idioma en que será ofrecido el evento: español
El contratista administrativo de Medicare (MAC) de jurisdicción nueve (J9), conferido a First Coast Service Options Inc. (FCSO), ha expandido la comunidad de proveedores de FCSO para incluir profesionales del cuidado de la salud e instalaciones hospitalarias en Florida, Puerto Rico y las Islas Vírgenes de los Estados Unidos. Mientras nos dirigimos juntos al nuevo ambiente de MAC, nuestra primera prioridad será mantenerlo informado sobre las últimas noticias de Medicare y proveerle con los recursos que usted necesita para continuar su labor como proveedor de Medicare. El sitio Web es uno de los recursos más utilizados de nuestros proveedores, el cual sirve como una ventana de información abierta las 24 horas del día, incluyendo artículos, herramientas de inscripción del proveedor, publicaciones, tarifas fijas, próximos eventos del proveedor, y mucho más. En respuesta a los valiosos comentarios de nuestros proveedores, hemos rediseñado nuestro sitio Web para brindarles un mejor servicio. Descubre las maravillas del cambio Para celebrar el estreno de nuestro nuevo sitio Web y darle la bienvenida a nuestros más recientes miembros de la comunidad de proveedores, nosotros administraremos un webcast para introducir a los proveedores a nuestro nuevo sitio Web. Durante el webcast, le guiaremos a través de nuestro nuevo sitio Web y le diremos en detalle las nuevas mejorías, incluyendo una navegación mas intuitiva, un mejor sistema de búsqueda, y nuevas herramientas que le ayudarán a encontrar exactamente la información que usted busca más rápida y fácilmente que nunca. Estos cambios fueron realizados teniendo a nuestros valiosos proveedores en mente. Es nuestra meta el asegurar que cada visita hecha a nuestro sitio Web del proveedor sea una placentera y productiva. ¿Quiere saber más? Únase a nosotros. Luego de la presentación habrá una sesión de preguntas y respuestas. Para participar en este webcast, inscríbase antes del 19 de marzo de 2009. Haga clic aquí para instrucciones de inscripción. Únase a nosotros para este evento importante y usted podrá descubrir las maravillas del cambio. |
| Icon Legend |
| Disclaimers |
| CPT codes, descriptions, and other data only are copyright 2007 American Medical Association (or such other date of publication of CPT). All rights reserved. Applicable FARS/DFARS apply. |
| Links to third party Web sites. This message may contain links to sites operated by third parties. Such links are provided for your reference only. FCSO does not control such sites and is not responsible for their content. The inclusion of such links within this message does not suggest any endorsement of the material on such sites or any association with their operators. |
|
02/24/09 FCSO J9 Transition Information eNews: Premiere of Spanish provider Web site
"The secret of joy in work is contained in one word - EXCELLENCE. To know how to do something well is to enjoy it"
From: First Coast Service Options [mailto:fcso.provider.education@fcso.com]
Sent: Tuesday, February 24, 2009 2:41 PM
To: Alicea, Raul (CMS/CMHPO)
Subject: 02/24/09 FCSO J9 Transition Information eNews: Premiere of Spanish provider Web site
|
J9 transition information: Premiere of Spanish provider Web site |
Two sites: Better service for FCSO’s provider community |
With the recent launch of its redesigned provider Web site medicare.fcso.com, First Coast Service Options Inc. (FCSO) has been able to offer providers the benefit of more intuitive navigation, enhanced search capabilities, and brand-new features to help save valuable time. FCSO is pleased to announce the debut of a brand-new Medicare provider resource, especially designed for the Spanish-speaking members of the provider community, on March 1: medicareespanol.fcso.com. |
A new era of opportunity begins |
FCSO is proud of the distinguished reputation it has built with the Centers for Medicare & Medicaid Services (CMS) as a trusted Medicare administrator since the program’s inception in 1966. For more than four decades, FCSO’s mission has been to safeguard the integrity of the Medicare program and to furnish the highest quality service for its providers. |
We welcome your feedback |
We invite you to explore medicare.fcso.com and medicareespanol.fcso.com and to share your comments and suggestions. Many of the changes we have implemented were inspired by ideas offered by providers, and we welcome your feedback on our newest endeavors. Just visit your preferred site and select “Web Site Feedback” from the Quick Find Box drop-down menu. We look forward to hearing from you. |
MEDICARE PHYSICIANS AND NON-PHYSICIAN PRACTITIONERS
Raúl Alicea, MBA/HCM, CHA
Health Insurance Specialist
Provider Outreach & Education
Centers for Medicare & Medicaid Services
P 787-771-3660
F 787-771-3689
C 787-300-0389
"The secret of joy in work is contained in one word - EXCELLENCE. To know how to do something well is to enjoy it"
CMS asks that you share this important information with all of your association members and State and local chapters. Thanks!
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
MEDICARE PHYSICIANS AND NON-PHYSICIAN PRACTITIONERS
INTERNET-BASED MEDICARE ENROLLMENT
February 19, 2009
Now there’s a better way for physicians and non-physician practitioners to enroll or make a change in their Medicare enrollment information. The Internet-based Provider Enrollment, Chain and Ownership System (PECOS) will allow physicians and non-physician practitioners to enroll, make a change in their Medicare enrollment, or view their Medicare enrollment information on file with Medicare.Internet-based PECOS is a scenario-driven application process with front-end editing capabilities and built-in help screens. The scenario-driven application process will ensure that physicians and non-physician practitioners complete and submit only the information necessary to enroll or make a change in their Medicare enrollment record.
There are three basic steps to completing an enrollment action using Internet-based PECOS . Physicians and non-physician practitioners must:
1. Have an NPPES User ID and password to use Internet-based PECOS .
For security reasons, physicians and non-physician practitioners should change passwords periodically, at least once a year. For information on how to change a password, go to the NPPES Application Help page available at https://nppes.cms.hhs.gov/NPPES/Welcome.do and select the “Reset Password Page” under the NPPES Application help page.
2. Go to Internet-based PECOS at https://pecos.cms.hhs.gov and complete, review, and submit the electronic enrollment application via Internet-based PECOS .
3. Print, sign and date the two-page Certification Statement and mail the Certification Statement and all supporting paper documentation to the Medicare contractor within 7 days of electronic submission.
Note: A Medicare contractor will not process an Internet enrollment application without the signed and dated Certification Statement. In addition, the effective date of filing an enrollment application is the date the Medicare contractor receives the signed Certification Statement that is associated with the Internet submission.
While CMS encourages physicians and non-physician practitioners print and retain a copy of the enrollment record for their records, physicians and non-physician practitioners should only mail the two-page Certification Statement to the designated contractor.
Additional Information
For information about Internet-based PECOS, including important information that physicians and non-physician practitioners should know before submitting a Medicare enrollment application via Internet-based PECOS , go to www.cms.hhs.gov/MedicareProviderSupEnroll.
The Centers for Medicare & Medicaid Services (CMS) will make Internet-based PECOS to all organizational providers and suppliers (except durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers) later this year.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Mary Case forValerie A. Haugen, Director
Division of Provider Information Planning & Development
Provider Communications Group, CMS
(410) 786-6690
Valerie.Haugen@cms.hhs.gov
Visit the Medicare Learning Network ~ it’s free!
MEDICARE PHYSICIANS AND NON-PHYSICIAN PRACTITIONERS
Raúl Alicea, MBA/HCM, CHA
Health Insurance Specialist
Provider Outreach & Education
Centers for Medicare & Medicaid Services
P 787-771-3660
F 787-771-3689
C 787-300-0389
"The secret of joy in work is contained in one word - EXCELLENCE. To know how to do something well is to enjoy it"
CMS asks that you share this important information with all of your association members and State and local chapters. Thanks!
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
MEDICARE PHYSICIANS AND NON-PHYSICIAN PRACTITIONERS
INTERNET-BASED MEDICARE ENROLLMENT
February 19, 2009
Now there’s a better way for physicians and non-physician practitioners to enroll or make a change in their Medicare enrollment information. The Internet-based Provider Enrollment, Chain and Ownership System (PECOS) will allow physicians and non-physician practitioners to enroll, make a change in their Medicare enrollment, or view their Medicare enrollment information on file with Medicare.Internet-based PECOS is a scenario-driven application process with front-end editing capabilities and built-in help screens. The scenario-driven application process will ensure that physicians and non-physician practitioners complete and submit only the information necessary to enroll or make a change in their Medicare enrollment record.
There are three basic steps to completing an enrollment action using Internet-based PECOS . Physicians and non-physician practitioners must:
1. Have an NPPES User ID and password to use Internet-based PECOS .
For security reasons, physicians and non-physician practitioners should change passwords periodically, at least once a year. For information on how to change a password, go to the NPPES Application Help page available at https://nppes.cms.hhs.gov/NPPES/Welcome.do and select the “Reset Password Page” under the NPPES Application help page.
2. Go to Internet-based PECOS at https://pecos.cms.hhs.gov and complete, review, and submit the electronic enrollment application via Internet-based PECOS .
3. Print, sign and date the two-page Certification Statement and mail the Certification Statement and all supporting paper documentation to the Medicare contractor within 7 days of electronic submission.
Note: A Medicare contractor will not process an Internet enrollment application without the signed and dated Certification Statement. In addition, the effective date of filing an enrollment application is the date the Medicare contractor receives the signed Certification Statement that is associated with the Internet submission.
While CMS encourages physicians and non-physician practitioners print and retain a copy of the enrollment record for their records, physicians and non-physician practitioners should only mail the two-page Certification Statement to the designated contractor.
Additional Information
For information about Internet-based PECOS, including important information that physicians and non-physician practitioners should know before submitting a Medicare enrollment application via Internet-based PECOS , go to www.cms.hhs.gov/MedicareProviderSupEnroll.
The Centers for Medicare & Medicaid Services (CMS) will make Internet-based PECOS to all organizational providers and suppliers (except durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers) later this year.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Mary Case forValerie A. Haugen, Director
Division of Provider Information Planning & Development
Provider Communications Group, CMS
(410) 786-6690
Valerie.Haugen@cms.hhs.gov
Visit the Medicare Learning Network ~ it’s free!
IMPORTANTE INFORMACION DE MEDICARE PARA USTED
Starting 2009, First Coast will be the Medicare Parts A and B Contractors (MAC) for Jurisdiction 9 which includes Puerto Rico . Visit their website at: http://www.floridamedicare.com/index.asp for additional information on the transition process. To receive news about the MAC joins the First Coast mailing list at the following link: http://www.floridamedicare.com/Home/107867.asp
Raúl Alicea, MBA/HCM, CHA
Health Insurance Specialist
Provider Outreach & Education
Centers for Medicare & Medicaid Services
P 787-771-3660
F 787-771-3689
C 787-300-0389
"The secret of joy in work is contained in one word - EXCELLENCE. To know how to do something well is to enjoy it"
"The secret of joy in work is contained in one word - EXCELLENCE. To know how to do something well is to enjoy it"
Raúl Alicea, MBA/HCM, CHA
Health Insurance Specialist
Provider Outreach & Education
Centers for Medicare & Medicaid Services
P 787-771-3660
F 787-771-3689
C 787-300-0389
"The secret of joy in work is contained in one word - EXCELLENCE. To know how to do something well is to enjoy it"
Medicare tools to compare 2009 options are online now…
Beneficiaries can now visit www.Medicare.gov to access the Medicare Prescription Drug Plan finder and Medicare Options Compare to review their options for 2009. The Plan Finder allows beneficiaries to compare prescription drug coverage from both PDPs and MA-PDs and to view premiums, formularies, and availability of coverage in the gap. The Medicare Options Compare tool allows beneficiaries to compare Medicare health plan options, such as HMOs and PPOs.
The general version of the “Medicare & You 2009” handbook is also available online. This general version contains information about 2009 costs, covered services, beneficiary choices, help for those with limited income and resources, and beneficiary rights and protections. Additionally, there are 59 geographic-specific versions of the handbook which include drug and health plan comparison charts for particular states or regions. These handbooks are currently being mailed to people with Medicare and partners through out the country.
Important information about Part D Fraud, Waste, and Abuse Training Requirements…
Please see this important notice from the CMS Office of Financial Management. I’ve pasted the full text of this notice immediately below.
CLARIFICATION OF CMS’ REQUIREMENT FOR PART D FRAUD, WASTE, AND ABUSE TRAINING LISTSERVE ALERT
The Centers for Medicare and Medicaid Services (CMS) has received hundreds of phone calls and emails from Part D Sponsors and their first tier, downstream, and related entities about the fraud, waste, and abuse training requirement that becomes effective as of January 1, 2009.
Quick facts about the requirement:
1) It is the Part D Sponsor’s responsibility to provide their first tier, downstream, and related entities with the appropriate training;
2) This training requirement becomes effective January 1, 2009. Since this is a yearly requirement, each Sponsor has from January 1, 2009 to December 31, 2009 to meet this requirement; and
3) This requirement could be cumbersome for first tier, downstream, and related entities because these entities often contract with multiple Part D Sponsors. To alleviate the necessity for first tier, downstream, and related entities to take training multiple times, there are a few associations that are working to create a training that will meet CMS’ requirements. The goal would be to offer training that employees from the Part D Sponsor and the first tier, downstream, and related entities could take once a year to meet their annual obligation with all the Part D Sponsors with which they contract.
If you would like more specific details, please read below:
The final rule entitled, "Revisions to the Medicare Advantage and Part D Prescription Drug Contract Determinations, Appeals, and Intermediate Sanctions Processes,” FR Doc. 07-5946 (72 FR 68700 through 68741), published December 5, 2007, updated the compliance plan requirements for Medicare Advantage (MA) organizations and Part D Sponsors. Specifically, the compliance regulation states that a compliance plan, which must include measures to detect, correct, and prevent fraud, waste and abuse, must consist of training, education, and effective lines of communication between the compliance officer and the organization’s employees, managers, and directors, as well as first tier, downstream, and related entities. This change clarifies that MA organizations and Part D Sponsors need to apply these training and communication requirements to all entities they are partnering with in the MA and Part D programs, not just the direct employees within their organizations.
MA organizations and Part D Sponsors are responsible for ensuring that all employees (including managers and directors) and the first tier, downstream, and related entities are provided appropriate training. MA organizations and Part D Sponsors must either provide the training directly to all of its employees (including managers and directors) and first tier, downstream, and related entities or provide the appropriate training materials to its employees (including managers and directors) and first tier, downstream, and related entities and ensure that the training has been taken. First tier, downstream, and related entities, including pharmacies, should not develop their own training. The first tier, downstream, and related entities can administer the training if the materials are provided by the Sponsor.
This change in the training requirement becomes effective January 1, 2009. Therefore, the mandatory training of the MA organization and the Part D Sponsor’s employees (including managers and directors) and the first tier, downstream, and related entities must begin January 1, 2009, and must be completed within one year (by December 31, 2009). The training does not need to be completed by January 1, 2009. Thereafter, the training on the Part D program must be provided on an annual basis.
CMS recognizes that because first tier, downstream and related entities, including pharmacies, often contract with many different MA and Part D plans, this requirement would impose a burden on the first tier, downstream and related entities that contract with multiple Sponsors. As a result, CMS is currently working with a few associations to assist the industry in developing a training program that meets CMS’ requirements. The training program would reduce the burden on first tier, downstream, and related entities since they would only have to take this training once a year, and the one time training would satisfy the CMS requirement for all MA Organizations and Part D Sponsors with which they are affiliated.
It is CMS’ hope that training that meets CMS’ requirements will be available soon. Until such time as this training program is available, MA Organizations and Part D Sponsors are responsible for either providing the training directly to all of their employees (including managers and directors) and first tier, downstream, and related entities or providing the appropriate materials to their employees (including managers and directors) and first tier, downstream, and related entities and ensuring that the training has been taken. If you have any questions about this policy, please contact either Stephanie Blaydes Kaisler at 410-786-0957 or Lynn Merritt-Nixon at 410-786-4652.
EN AVANCE LOS TRAMITES DEL ICD-10
ESTE ES EL MOMENTO DE ENVIAR SUS COMENTARIOS Y SUGERENCIAS ANTES QUE SE CONVIERTA EN LEY.
Raúl Alicea, MBA/HCM, CHA
Health Insurance Specialist
Provider Outreach & Education
Centers for Medicare & Medicaid Services
P 787-771-3660
F 787-771-3689
C 787-300-0389
Listen Medicare Te Educa through AlfaOmega Radio station at 88.5FM, 91.7FM and 90.3FM or through internet at www.alfaomegafm.com
From: 18 existing FFS provider listservs [mailto:ALL_FFS_PROVIDERS@LIST.NIH.GOV] On Behalf Of CMS CMSProviderResource
Sent: Monday, August 18, 2008 10:22 AM
To: ALL_FFS_PROVIDERS@LIST.NIH.GOV
Subject: Department of Health and Human Services (HHS) Proposes Adoption of ICD-10 Code Sets and Updated Electronic Transaction Standards
HHS Proposes Adoption of ICD-10 Code Sets and Updated Electronic Transaction Standards
Proposed Changes Would Improve Disease Tracking and Speed Transition
to an Electronic Health Care Environment
The Department of Health and Human Services (HHS) announced Friday a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10 code sets, effective October 1, 2011. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as health care claims. Version 5010 is essential to use of the ICD-10 codes.
In 2000, under authority provided by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the ICD-9-CM code sets were adopted for use in the administrative transactions by both the public and private sectors to report diagnoses and inpatient hospital procedures. Covered entities required to use the ICD-9-CM code sets include health plans, health care clearinghouses, and health care providers who transmit any electronic health information in connection with a transaction for which a standard has been adopted by HHS.
Developed almost 30 years ago, ICD-9 is now widely viewed as outdated because of its limited ability to accommodate new procedures and diagnoses. ICD-9 contains only 17,000 codes and is expected to start running out of available codes next year. By contrast, the ICD-10 code sets contain more than 155,000 codes and accommodate a host of new diagnoses and procedures. The additional codes will help to enable the implementation of electronic health records because they will provide more detail in the electronic transactions.
Comments on the ICD-10 code sets proposed rule are due by 5:00pm Eastern time on October 21, 2008.
Comments on the updated transaction standards proposed are due by 5:00pm Eastern time on October 21, 2008.
Both regulations may be viewed at www.cms.hhs.gov/TransactionCodeSetsStands/02_TransactionsandCodeSetsRegulations.asp.
To read the HHS press release issued, please click here: http://www.hhs.gov/news/press/2008pres/08/20080815a.html .
Fact sheets describing both proposed rules will be forthcoming at http://www.cms.hhs.gov/apps/media/fact_sheets.asp.




