- Resources & Flexibilities to Assist with Public Health Emergency in Mississippi Due to Recent Storms
- Program for Evaluating Payment Patterns Electronic Reports
- Advance Beneficiary Notice of Noncoverage: Form Renewal
- New Recovery Audit Contractor for Region 2 Starting Spring 2023
- Comprehensive Error Rate Testing Review Contractor Company Changed Name
- Help Improve the Health of Minority Populations
News
Resources & Flexibilities to Assist with Public Health Emergency in Mississippi Due to Recent Storms
On March 27, HHS Secretary Xavier Becerra determined that a public health emergency exists in Mississippi, retroactive to March 24, as the result of severe storms, flooding, straight-line winds, and tornadoes. We’re ready to help with resources and waivers to ensure hospitals and other facilities can continue to operate and provide access to care.
CMS waivers are available to providers affected by the severe storm and remain affected by the COVID-19 pandemic.
More Information:
- News alert
- Request additional flexibilities specific to the storm
Program for Evaluating Payment Patterns Electronic Reports
Fourth quarter FY 2022 Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) are available for:
- Long-term care hospitals
- Critical access hospitals
- Inpatient rehabilitation facilities
- Inpatient psychiatric facilities
- Hospices
- Skilled nursing facilities (SNFs)
These reports summarize provider-specific data for Medicare services that may be at risk for improper payments. Use the data to support auditing and monitoring activities.
See the Hospice and SNF User’s Guides for information on new target areas:
- Hospice:
- Average Number of Medicare Part B Claims for Beneficiaries Residing at Home
- Average Number of Medicare Part B Claims for Beneficiaries Residing in an Assisted Living Facility, Nursing Facility, or Skilled Nursing Facility
- SNF: High Nursing Case Mix
More Information:
- Visit the Distribution Schedule webpage to find out how to get your report
- Visit the PEPPER Resources webpage to review recorded training sessions, FAQs, and examples of how other hospitals are using the report
- Visit the Help Desk if you have questions
- Send feedback or suggestions
Advance Beneficiary Notice of Noncoverage: Form Renewal
The Office of Management and Budget approved the Advance Beneficiary Notice of Noncoverage (Form CMS-R-131) for renewal. This renewed form expires January 31, 2026. The expiration date is the only change to the form.
You may use the renewed form now, but you must use it beginning June 30, 2023, when the previous version expires.
New Recovery Audit Contractor for Region 2 Starting Spring 2023
CMS awarded Performant Recovery, Inc. the new Recovery Audit Contractor (RAC) contract for Region 2; see the chart or map to find out if your state is affected. They’re expected to begin reviews in Spring 2023.
Cotiviti, LLC, the RAC previously responsible for reviews in Region 2, remains under contract with us to support the RAC Program. Contact them about review results letters (complex reviews), informational letters (automated reviews), and no findings letters (complex reviews) they completed on or before September 16, 2022.
Check the review completion date or RAC name on your letter to identify the correct contact:
- Cotiviti, LLC: Email RACinfo@Cotiviti.com, or call 866-360-2507
- Performant Recovery, Inc.: Email info@Performantrac.com, or call 866-201-0580
Comprehensive Error Rate Testing Review Contractor Company Changed Name
The Comprehensive Error Rate Testing (CERT) Review Contractor, formerly known as NCI Information Systems, Inc. changed their company name to Empower AI, Inc. Their email domain is @empower.ai.
Contact:
- Customer service department at CertProvider@empower.ai: Ask questions about your documentation request
- Mail room at CertMail@empower.ai: Submit medical records, or get password help
Help Improve the Health of Minority Populations
Health inequities affect people from underserved and marginalized communities. During National Minority Health Month:
- Talk with your patients about the importance of preventive care, and recommend appropriate Medicare-covered preventive services
- Encourage your patients to make the most of their health coverage to live a long, healthy life
This year’s theme is “Better Health Through Better Understanding.” CMS offers health equity technical assistance to help you address health disparities. The program offers:
- Personalized coaching
- Resources
- Data collection and analysis
- Help developing a language access plan
Medicare covers preventive services, and generally, your patients pay nothing if you accept assignment. Find out when your patient is eligible for services. If you need help, contact your eligibility service provider.
More Information:
- CMS Health Equity Conference on June 7–8: Register for the event
- Preventive & screening services webpage: Get information for your patients
Claims, Pricers, & Codes
RARCs, CARCs, Medicare Remit Easy Print, & PC Print: April Update
Get updated remittance advice remark codes (RARCs) and claim adjustment reason codes (CARCs), and learn what to do if you use Medicare Remit Easy Print or PC Print.
More Information:
- Sections 40.5, 60.2, and 60.3 Medicare Claims Processing Manual, Chapter 22 (PDF)
- Instruction to your Medicare Administrative Contractor (PDF)
Events
PCG Provider Compliance Focus Group: Provider Compliance Activities Post-PHE — May 9
Tuesday, May 9 from 1–4 pm ET
How can CMS improve its processes and eliminate unnecessary requirements for medical review and prior authorizations? Join us, and let us know.
Target audience: physicians, non-physician practitioners, billing specialists, suppliers, associations, coders, and medical review contractors
MLN Matters® Articles
Hospital Outpatient Prospective Payment System: April 2023 Update — Revised
Learn about payment system updates and new codes (PDF) for:
- COVID-19
- Drugs, biologicals, and radiopharmaceuticals
- Devices
- Other items and services
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