Thursday, June 27, 2019
- Medicare Shared Savings Program: Submit Notice of Intent to Apply by June 28
- MIPS Data Validation and Audit for Performance Years 2017 and 2018
- Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – July 2019 Update — Revised
- Clarification of Billing and Payment Policies for Negative Pressure Wound Therapy (NPWT) Using a Disposable Device — Revised
View this edition as a PDF (PDF)
News
Medicare Shared Savings Program: Submit Notice of Intent to Apply by June 28
There is only one day left to submit a Notice of Intent to Apply (NOIA) via the Accountable Care Organization (ACO) Management System (ACO-MS) for a January 1, 2020, start date. You must submit a NOIA if you intend to apply to the BASIC track or ENHANCED track of the Medicare Shared Savings Program, for a Skilled Nursing Facility (SNF) 3-Day Rule Waiver, and/or to establish and operate a Beneficiary Incentive Program:
- NOIA submissions are due no later than June 28 at noon ET
- A NOIA submission does not bind your organization to submit an application; however, you must submit a NOIA to be eligible to apply
- Submit only one NOIA per ACO
- You can make changes to your track, repayment mechanisms, and other NOIA-related information during the application submission period
ACOs that applied for a July 1, 2019, start date and withdrew their application or were denied are eligible to submit a NOIA for the January 1, 2020 start date. If the NOIA is approved, you will be able to access ACO-MS using your existing login credentials.
The application submission period is July 1 through July 29 at noon ET.
For More Information
- Shared Savings Program website
- Application Types & Timeline webpage
- Application Toolkit webpage
- ACO-MS Contact Us/FAQ webpage
- NOIA Guidance (PDF)
- ACO Participant List and Participant Agreement Guidance (PDF)
- SNF 3-Day Rule Waiver Guidance (PDF)
- Repayment Mechanism Arrangements Guidance (PDF)
- Email questions to
MIPS Data Validation and Audit for Performance Years 2017 and 2018
CMS contracted with Guidehouse to conduct data validation and audits of some Merit-based Incentive Payment System (MIPS) eligible clinicians. Data validation and audits will help ensure MIPS is operating with accurate and useful data. MIPS eligible clinicians, groups, and virtual groups are required by regulation - Opens in a new window to comply with data sharing requests, providing all data as requested by CMS.
If you are selected for data validation and/or audit, you will receive a request for information from Guidehouse via email or by certified mail. You have 45 calendar days from the date of the notice to provide the requested information.
For More Information:
- 2017 MIPS Data Validation Criteria"> 2017 MIPS Data Validation Criteria - Opens in a new window
- 2018 MIPS Data Validation Criteria"> 2018 MIPS Data Validation Criteria - Opens in a new window
- Direct questions to or 1-866-288-8292 (TTY 1-877-715- 6222), Monday through Friday from 8am-8 PM ET
Claims, Pricers & Codes
FY 2020 ICD-10-CM Diagnosis Code Updates
The FY 2020 ICD-10-CM diagnosis code updates are available on the 2020 ICD-10-CM webpage.
Events
DMEPOS Competitive Bidding: Round 2021 Webcast Series
Register for the last webcast in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program series:
- Registering and Submitting a Bid - Part 2"> Registering and Submitting a Bid - Part 2 - Opens in a new window on July 23 from 3-4 pm ET
- You can submit questions during the webcast; however, to increase the likelihood of your question being answered, submit it in advance to with “Webcast Question” in the subject line
On-demand sessions for previous webcasts are available through the registration link:
- Bid Surety Bond and Lead Item Pricing - Opens in a new window on May 14
- Preparing and Submitting Financial Documents"> Preparing and Submitting Financial Documents - Opens in a new window on May 21
- Registering and Submitting a Bid - Part 1"> Registering and Submitting a Bid - Part 1 - Opens in a new window on June 11
Resources such as slides and other handouts will be available during both the live and on-demand sessions.
MLN Matters® Articles
Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – July 2019 Update — Revised
A revised MLN Matters Article MM11296 on Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – July 2019 Update (PDF) is available. Learn about ten new HCPCS codes, effective for claims with dates of service on or after July 1, 2019.
Clarification of Billing and Payment Policies for Negative Pressure Wound Therapy (NPWT) Using a Disposable Device — Revised
A revised MLN Matters Article SE17027 on Clarification of Billing and Payment Policies for Negative Pressure Wound Therapy (NPWT) Using a Disposable Device (PDF) is available. Learn about billing and payment for this service under a home health plan of care.
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