Get ready to administer the COVID-19 vaccine when it’s available. Read the enrollment section of our COVID-19 provider toolkit to see if you need to take action now:

Many Medicare-enrolled providers don’t have to take any action until a vaccine is available – make sure your provider-type enrollment is all set
Some Medicare-enrolled providers must also separately enroll as a mass immunizer to administer and bill for COVID-19 vaccines when they’re available – find out if you must also enroll as a mass immunizer
If you’re not a Medicare-enrolled provider, you must enroll as a mass immunizer or other Medicare provider type that can bill for administering vaccines

Enrolling over the phone a mass immunizer is easy and quick — call your MAC-specific enrollment hotline (PDF) and give your valid legal business name, national provider identifier, tax identification number, practice location, and state license, if applicable.

Hospital Price Transparency: Requirements Effective January 1

In 2 months, each hospital operating in the United States is required to provide clear, accessible pricing information online about the items and services they provide in 2 ways:

Comprehensive machine-readable file with all items and services
Display of shoppable services in a consumer-friendly format

Is your organization prepared to be compliant? Visit the new Hospital Price Transparency website for resources to help you prepare:

SNF Quality Reporting Program: October Refresh

The October refresh of Skilled Nursing Facility (SNF) Quality Reporting data is available. Visit the Nursing Home Compare website, Care Compare website, and Provider Data Catalog to view the data.

For More Information:

SNF Quality Public Reporting webpage
Email SNFQRPPRQuestions@cms.hhs.gov

Flu Shots: Each Visit is an Opportunity

Flu shots are free for your Medicare patients if you accept assignment. Medicare Part B covers 1 flu shot per flu season and additional flu shots if medically necessary.

Every patient visit is an opportunity to promote the flu shot. The CDC recommends annual flu shots for everyone 6 months and older.

For More Information:

CMS Flu Shot webpage
CDC Flu website

Compliance

Inhalant Drugs: Bill Correctly

An Office of Inspector General (OIG) report found that CMS improperly paid suppliers for inhalation drugs. Review the Provider Compliance Tips for Nebulizers and Related Drugs (PDF) fact sheet to help you bill correctly. Additional resources:

Medicare Benefit Policy Manual, Chapter 15 (PDF), Sections 110, 110.1, 110.3
Medicare Program Integrity Manual, Chapter 5 (PDF), Sections 5.2, 5.7, 5.8, 5.9
2018 Medicare Fee-for-Service Supplemental Improper Payment Data (PDF)
National Coverage Determination for Durable Medical Equipment Reference List (280.1) webpage
Liberty Medical, LLC, Received Unallowable Medicare Payments for Inhalation Drugs OIG Report, August 2018
Lincare Pharmacy Services Inc. Generally Complied With Medicare Requirements When Billing for Inhalation Drugs OIG Report, December 2017

Events

CMS-CDC Fundamentals of COVID-19 Prevention for Nursing Home Management Call — November 5

Thursday, November 5 from 4 to 5 pm ET

CMS, CDC, and the Quality Improvement Organization (QIO) Program present this live Q&A series:

Register for Q&A sessions
Submit questions in advance to DVACSupport@thebizzellgroup.com
Visit the QIO Program FAQ webpage

Target Audience: Clinical and administrative nursing home staff members.

MLN Matters® Articles

Special Provisions for Radiology Additional Documentation Requests

CMS issued a new MLN Matters Article MM11659 on Special Provisions for Radiology Additional Documentation Requests (PDF). Learn about a pilot process for MACs to ask for documentation during medical review.

Update to Chapter 10 of Publication (Pub.) 100-08 - Enrollment Policies for Home Infusion Therapy (HIT) Suppliers

CMS issued a new MLN Matters Article MM11954 on Update to Chapter 10 of Publication (Pub.) 100-08 - Enrollment Policies for Home Infusion Therapy (HIT) Suppliers (PDF). Learn about eligibility and enrollment requirements.

October Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule — Revised

CMS revised MLN Matters Article MM11956 on October Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule (PDF) to clarify the claims processing jurisdiction for code K1009.

Penalty for Delayed Request for Anticipated Payment (RAP) Submission -- Implementation — Revised

CMS revised MLN Matters Article MM11855 on Penalty for Delayed Request for Anticipated Payment (RAP) Submission -- Implementation (PDF) to include remittance advice messages.

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – October 2020 Update — Revised

CMS revised MLN Matters Article MM11939 on Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – October 2020 Update (PDF) to add:

Additional information about codes 3170F, 0599T, and A4226
New codes: 86408, 86409, 86413, and 99072

Publications

Medicare Wellness Visits

CMS issued a new Medicare Learning Network educational tool, Medicare Wellness Visits. Learn about the Initial Preventive Physical Examination (IPPE) and Annual Wellness Visit (AWV), including:

Differences between IPPE, AWV, and routine physical
FAQs
Resources

Multimedia

SNF Quality Reporting Program: Confusion Assessment Method Video Tutorial

CMS released a video tutorial for the Skilled Nursing Facility (SNF) Quality Reporting Program on the Confusion Assessment Method (CAM©) cognitive assessment. Learn about:

Standardized data assessment guidance strategies
Accurate coding using live-action resident scenarios

This video tutorial is 25 minutes. Visit the Training webpage for more information.

SNF Quality Reporting Program: Brief Interview for Mental Status Video Tutorial

CMS released a video tutorial for the Skilled Nursing Facility (SNF) Quality Reporting Program on the Brief Interview for Mental Status (BIMS) cognitive assessment. Learn about:

Standardized data assessment guidance strategies
Accurate coding using live-action patient/resident scenarios

This video tutorial is 22 minutes. Visit the Training webpage for more information.

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2020-11-05-MLNC

News

COVID-19 Vaccine: Find Out How to Prepare