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National Provider Call: Hospital Value-Based Purchasing Program – Registration Now Open

From: CMS E-mail Notice – 2/9/12

Conference Call

Tue Feb 28; 1:30-3pm ET

The Centers for Medicare & Medicaid Services (CMS) will be creating hospital-specific performance reports that simulate the FY2013 Hospital Value-Based Purchasing Program for each hospital to review; the simulated reports will employ hospital data from prior years to construct each hospital’s baseline period and performance period scores. To prepare providers for interpreting the simulated report, this National Provider Call will discuss a sample report that shows what hospitals can expect when they receive their own reports.

Target Audience: Hospitals, Quality Improvement Organizations, medical coders, physician office staff, provider billing staff, health records staff, vendors, and all Medicare Fee-For-Service providers.

Agenda:

• §  Opening Remarks
• §  Program Announcements
• §  Overview of the Hospital Value-Based Purchasing Program
• §  Presentation and Walkthrough of the Hospital-Specific Report
• §  Question & Answer Session

Registration Information: In order to receive the call-in information, you must register for the call. Registration will close at 12pm on the day of the call or when available space has been filled; no exceptions will be made, so please register early. For more details, including instructions on registering for the call, please visit http://www.eventsvc.com/blhtechnologies.

Presentation: The presentation for this call will be posted at least one day in advance at http://www.CMS.gov/Hospital-Value-Based-Purchasing, in the “Downloads” section of the page.

CMS Updated the EHR Information Center – New Self-Service Options

From: CMS E-mail – 2/9/12

Text of E-mail

Following months of review and collective input, the Electronic Health Record (EHR) Information Center Interactive Voice Response (IVR) system has been enhanced to provide users with an increased number of options and services to make accessing and reviewing data easier than ever before.

For eligible professionals (EPs), eligible hospitals, or critical access hospitals (CAHs), the revised functionality vastly improves the efficiency in obtaining desired information, while also offering a more varied amount of information and options for callers. CMS is proud to announce that providers can now obtain information through an extensive IVR Self-Service option. Included in this option is a reinforced privacy protection module that requires your individual National Provider Identifier (NPI), the last five digits of your Tax Identification Number (TIN), and your EHR registration ID. Once accepted, this newly enhanced Self-Service tool allows you to:

• Obtain registration status
• Acquire attestation status
• Review payment information
• Check progress towards meeting the $24,000 threshold amount

Users may access these new options by dialing 888-734-6433, pressing 3 for Self-Service, and entering the authentication elements. These options will be available on the IVR effective Thu Feb 16.

EHR Information Center Hours of Operation: 7:30am-6:30pm CT, Monday through Friday, except federal holidays. (Note that General Information and Self-Service options may be reached via IVR 24 hours a day, except during periods of planned system maintenance or upgrades).

Supplementary information on the program may also be viewed by visiting the FAQs sectionof the EHR Incentive Programs website, where users can search for any questions they have about the Medicare or Medicaid EHR Incentive Programs.

Want more information about the EHR Incentive Programs? Make sure to visit the EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

Inpatient Prospective Payment System FY2012 Pricer File Update

From: CMS E-mail – 2/8/12

Text of E-mail

The FY2012 Inpatient Prospective Payment System (INP PPS) PC Pricer has been updated with newer provider data, and is now available on the CMS website at http://www.CMS.gov/PCPricer/03_inpatient.asp. This Pricer is for claims dated from 10/01/2011 to 09/30/2012, and the update is dated 02/07/2012.

House and Senate at Impasse on Medicare Payments

From: NY Times – 2/6/12

Article Excerpt:

WASHINGTON — House and Senate negotiators are deadlocked over how to prevent a deep cut in Medicare payments to doctors who treat millions of Medicare beneficiaries, an impasse that could threaten broader legislation on a payroll tax cut.

Lawmakers in both parties said they wanted to give doctors a small increase, but could not agree on how to cover the cost. The issue, which is being negotiated as part of the talks over maintaining a reduction in payroll taxes for 160 million Americans, pits health care providers against one another — doctors versus hospitals — in a type of conflict that is most likely to become more common as the federal government tries to throttle back the growth of Medicare costs. The payroll legislation would also continue jobless benefits for many of the nation’s unemployed.

In the absence of agreement, doctors’ fees will be cut 27 percent next month, and many doctors say they could not continue treating Medicare patients under the lower payments.

Read more…

SSI Data to be Released in 60 to 90 Days

From: HFMA Region 11 Conference – 1/30/12

Paul Crofton from the PRRB shared in a session earlier this week at the HFMA Region 11 conference, that CMS would be releasing the long awaited SSI information within the next 60 to 90 days.  The final PPS rules for FFY 2011 modified the match process and the paid claims information included in the SSI match from 6 months after the fiscal year to 15 months of paid claims information after the fiscal year (See 8/16/10 FR Excerpt). Based on the new criteria SSI criteria effective for issuances on or after October 1, 2010, we should be anticipating the following SSI issuances: 

•          FFY 2006 – Reprocessed Listing
•          FFY 2007 – Reprocessed Listing
•          FFY 2008 – New Release (After 3/31/10)
•          FFY 2009 – New Release (After 3/31/11)
•          FFY 2010 – New Release (After 3/31/12)

The delay in the SSI issuance has created a tremendous back log in the finalization of Medicare Hospital cost reports (Providers Qualifying for DSH).  We will be anticipating a deluge of finalized cost reports for the Spring and Summer of 2012.

From: USA Today – 1/12/12

Article Excerpt: 

Just 1% of Americans accounted for 22% of health care costs in 2009, according to a federal report released Wednesday. That’s about $90,000 per person, according to the Agency for Healthcare Research and Quality. U.S. residents spent $1.26 trillion that year on health care.  Five percent accounted for 50% of health care costs, about $36,000 each, the report said.

Read more…

MLN Matters Article SE1202 Revised – 1/12/12

MLN Summary:

Physicians who furnish services to Medicare beneficiaries in areas designated as primary care geographic HPSAs by the Health Resources and Services Administration (HRSA) as of December 31, 2011, are eligible for a 10 percent bonus payment for services furnished from January 1, 2012, to December 31, 2012. If an area does not have a geographic primary care HPSA designation, but does have a geographic mental health HPSA designation, then only psychiatrists furnishing services to Medicare beneficiaries in the designated area are eligible for the ten percent bonus.

From: National Quality Forum – Public Comment Draft – 1/11/12

This report was generated through the Measure Applications Partnership that is a public-private partnership that convened by the National Quality Forum.  The intent of the report was to provide input to the Department of Health and Human Services(HHS) on selecting performance measures for public reporting and payment purposes.  In this report, the panel recommends the rejection of about half of the measures that HHS is proposing to use to track and reward quality at hospitals and other facilities required by the healthcare law.

From: National Journal – 1/10/12

Article Excerpt: 

The federal government could save $148 billion over 10 years by increasing Medicare eligibility two years to age 67, the Congressional Budget Office reported on Tuesday. 

The projected savings are lower than CBO’s March estimate of $162 billion, but the earlier calculation did not include the premiums that seniors must pay into the program. A CBO official said that a senator requested the additional analysis of increasing the Medicare and Social Security eligibility ages.

Either way, the savings may not significantly cut the budget deficit but they could pay for a program such as the “doc fix”–a permanent solution to a temporary pay raise Congress must legislate for Medicare doctors every year.

CBO estimated the effects of increasing Medicare eligibility by two months every year beginning in 2014 for people who were born in 1949 until the Medicare eligibility age reached 67 in 2027 for people born in 1960.

Read more…

From: CMS E-mail Notification – 1/10/12

Text of CMS E-mail:

CMS has developed a workaround for Skilled Nursing Facility (SNF) and Swing Bed (SB) claims incorrectly returned to the provider for assessment reference date (ARD) reason code 31742 to allow these claims to process. Providers with claims returned due to the incorrect application of this reason code should send them back to Medicare for processing. Be sure to bill the correct ARDs with occurrence code 50 prior to sending these claims to Medicare for processing.