Thursday, April 8, 2021
- PEPPERs for LTCHs, CAHs, IRFs, IPFs, Hospices, & SNFs
- Preparedness Resources: Cybersecurity & Post-Acute Sequelae of SARS-CoV-2
- Minority Health: Medicare Covers Preventive Services
- Changes in the Hospice Item Set Manual V3.00 Webinar — April 15
- Medicare Part A Cost Report: Easier File Uploads for e-Filing in MCReF Webcast — April 29
- Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) - July 2021
- Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.2, Effective July 1, 2021
- Update to the Payment for Grandfathered Tribal Federally Qualified Health Centers (FQHCs) for Calendar Year (CY) 2021
- April 2021 Update of the Ambulatory Surgical Center (ASC) Payment System
- Penalty for Delayed Request for Anticipated Payment (RAP) Submission – Implementation — Revised
- Dementia Care Call: Audio Recording & Transcript
- Open Payments Call: Audio Recording & Transcript
- SNF Resident Mood Interview Video
- 2021 Medicare Part C & Part D Reporting Requirements & Data Validation Web-Based Training — Revised
View this edition as PDF (PDF)
News
PEPPERs for LTCHs, CAHs, IRFs, IPFs, Hospices, & SNFs
Fourth quarter fiscal year 2020 Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) are available for Long-Term Care Hospitals (LTCHs), Critical Access Hospitals (CAHs), Inpatient Rehabilitation Facilities (IRFs), Inpatient Psychiatric Facilities (IPFs), hospices, and Skilled Nursing Facilities (SNFs). These reports summarize provider-specific data for Medicare services that may be at risk for improper payments. Use your data to support internal auditing and monitoring activities.
More Information:
- Visit the Distribution webpage for guidance accessing your report
- Visit the PEPPER Resources website for user’s guides, recorded training sessions, FAQs, and examples of how other providers are using the report
- Contact the Help Desk if you have questions or need help getting your report
- Send us your feedback or suggestions
Preparedness Resources: Cybersecurity & Post-Acute Sequelae of SARS-CoV-2
The Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) released new resources in The Express:
- Healthcare System Cybersecurity Response: Experiences and Considerations webinar recording
- Post-Acute Sequelae of SARS-CoV-2 technical assistance request: describes post COVID-19 long haul symptoms and potential treatment approaches
- Ebola/Viral Hemorrhagic Fevers topic collection: updated
More Information:
- ASPR TRACIE fact sheet
- ASPR TRACIE COVID-19 Resources webpage
Minority Health: Medicare Covers Preventive Services
Racial and ethnic minorities experience a disproportionate burden of preventable disease, including diabetes, heart disease, kidney failure, and obesity. Medicare covers preventive services, and your patients pay nothing if you accept assignment.
During National Minority Health Month and this public health emergency, talk to your patients about the importance of preventive care.
More Information:
- Medicare Preventive Services educational tool
- Preventive Services webpage
- CMS Office of Minority Health webpage
- Medicare Stratified Reporting
- HHS National Minority Health Month webpage
- Information for your patients on preventive and screening services
Compliance
Hospice Aide Services: Enhancing RN Supervision
An Office of Inspector General (OIG) report found that Registered Nurses (RNs) didn’t always:
- Visit hospice patients’ homes at least once every 14 days to assess the quality of care and services provided by hospice aides
- Document these visits as required
Review the Enhancing RN Supervision of Hospice Aide Services (PDF) fact sheet to learn about roles and documentation. Additional resources:
- Hospice Conditions of Participation Final Rule
- Medicare Fee-for-Service Response to the Public Health Emergency on COVID-19 (PDF) MLN Matters Article
- State Operations Manual Appendix M – Guidance to Surveyors: Hospice (PDF)
Claims, Pricers, & Codes
OPPS Pricer File: April 2021
CMS posted the second quarter 2021 Pricer text file on the Outpatient Prospective Payment System (OPPS) Pricer webpage.
Events
Changes in the Hospice Item Set Manual V3.00 Webinar — April 15
Thursday, April 15 from 2 - 3:30 pm ET
Register for the webinar. Space is limited.
Find out what you need to know about changes included in the Hospice Item Set Manual V3.00. Topics:
- Hospice Quality Reporting Program requirements
- Data sources
- New quality measure created from administrative data
- Resources
For more Information, email PACTraining@econometricainc.com.
Medicare Part A Cost Report: Easier File Uploads for e-Filing in MCReF Webcast — April 29
Thursday, April 29 from 1 - 2:30 pm ET
Register for our Medicare Learning Network webcast.
Medicare Part A providers: Learn about the new user-friendly upload feature for the Medicare Cost Report e-Filing (MCReF) system. The new feature allows you to:
- Submit documents without turning them into ZIP files
- Tag documents
- Get alerts about missing documents
Also during this webcast:
- Get an overview of the system
- Attend a Q&A session
Use MCReF to:
- Submit cost reports (Individually or in bulk) for fiscal years ending on or after December 31, 2017.
- Track the status of cost reports with fiscal years ending after December 31, 2009.
- You have the option to electronically transmit your cost report through MCReF or mail or hand deliver it to your Medicare Administrative Contractor. You must use MCReF if you choose to submit electronically.
You may send questions in advance to OFMDPAOQuestions@cms.hhs.gov with “MCReF Webcast” in the subject line. We’ll answer your questions during the webcast or use them to develop educational materials. For more information, see the MLN Matters Article (PDF) and webpage.
If you can’t stream audio through your computer for this webcast, you can call in.
Target Audience:
- Medicare Part A providers
- Entities that file cost reports for providers
MLN Matters® Articles
Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) - July 2021
CMS issued a new MLN Matters Article MM12225 on Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) - July 2021 (PDF). Learn about changes to HCPCS codes, ZIP codes, and single payment amounts.
Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.2, Effective July 1, 2021
CMS issued a new MLN Matters Article MM12226 on Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.2, Effective July 1, 2021 (PDF). Learn about changes to the edits.
Update to the Payment for Grandfathered Tribal Federally Qualified Health Centers (FQHCs) for Calendar Year (CY) 2021
CMS issued a new MLN Matters Article MM12202 on Update to the Payment for Grandfathered Tribal Federally Qualified Health Centers (FQHCs) for Calendar Year (CY) 2021 (PDF). Learn about the updated FQHC prospective payment system base payment rate.
April 2021 Update of the Ambulatory Surgical Center (ASC) Payment System
CMS issued a new MLN Matters Article MM12183 on April 2021 Update of the Ambulatory Surgical Center (ASC) Payment System (PDF). Learn about changes to payment policies and billing instructions.
Penalty for Delayed Request for Anticipated Payment (RAP) Submission – Implementation — Revised
CMS revised MLN Matters Article MM111855 on Penalty for Delayed Request for Anticipated Payment (RAP) Submission -- Implementation (PDF). Learn about changes to reporting instructions that make sure claims successfully match their corresponding RAP.
Publications
How to Use the Medicaid NCCI Tools
CMS issued a new Medicare Learning Network booklet, How to Use the Medicaid NCCI Tools. Learn how to:
- Navigate the webpages
- Work with edits
- Access and use files
Hospital Value-Based Purchasing — Revised
CMS revised the Medicare Learning Network booklet, Hospital Value-Based Purchasing. Learn about:
- Acute-care hospital incentive payments for providing quality care
- Provider relief due to the COVID-19 public health emergency
- New hospital domains and relative weights
- Revised hospital measures
- Revised baseline and performance periods
Multimedia
Dementia Care Call: Audio Recording & Transcript
An audio recording (ZIP) and transcript (PDF) are available for the March 23 Medicare Learning Network call on Long-Term Care: Dementia-related Psychosis. Learn about earn about appropriate assessment, accurate diagnosis, and approaches to care.
Open Payments Call: Audio Recording & Transcript
An audio recording (ZIP) and transcript (PDF) are available for the March 25 Medicare Learning Network call on Open Payments & You. Find out how to review and dispute 2020 payment data before it’s published on the CMS website.
SNF Resident Mood Interview Video
Watch the Resident Mood Interview (PHQ-9©) for the Skilled Nursing Facility (SNF) Setting video to learn how to:
- Properly code D0200 and D0300
- Improve your interviews
- Complete the Total Severity Score
2021 Medicare Part C & Part D Reporting Requirements & Data Validation Web-Based Training — Revised
A revised Medicare Learning Network 2021 Medicare Part C & Part D Reporting Requirements & Data Validation web-based training course is available. Learn how to:
- Plan
- Validate data
- Analyze results and submit findings
- Complete post-validation activities
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