All MA organizations (MAOs) that are effective before 1/1/2009 must submit a QIP and CCIP to CMS using their standard submission templates. The templates can be found here: http://optimalsolutionsgroup.com/CMS/index.html Questions can be answered by the CMS contractor: EMAIL: maqro@optimalsolutionsgroup.com PHONE: 866-962-6826 CMS has extended the data submission deadline to Aug 27, 2010. This is...
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Compliance
Deadline for QIP and CCIP Data Submissions Extended to Aug 27, 2010
CMS Updates MAPD and Cost Plan 2010 Reporting Tech Specifications
CMS has posted an update their 2010 MA Part C and Cost Plan Technical Reporting Specifications. The update contains clarifications to commonly asked questions from plans. Part C reporting is a compliance requirement and plans that fail to submit data on time and in good fail will receive a compliance letter and notification. The...
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Surprise CMS Move Will Cost Hospitals for Multiple Push Injections of Same Drug
AISHealth and the 3/6/06 Report on Medicare Compliance are reporting Hospitals are about to lose money for intravenous push injections because of a surprise move by CMS, experts say. CMS said recently that hospitals can’t charge Medicare for more than one IV push injection of the same drug during the same patient encounter (HCPCS...
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Deficit Reduction Act Enacted!
Here are the highlights of the Deficit Reduction Act signed in to law on February 8, 2006: Fee for Services payments to physicians will NOT be reduced by 4.4%. Claims that have been already processed will be reprocessed. Retro payments will be paid through July 1, 2006. Increase in the base payments to ESRD...
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CMS Issues guidance on Part B vs. D Coverage
On a January 24, 2006 conference call Craig Miner and Lawrence Kocot issued guidance on how plans should and should not be determining drug coverage under Parts B and D. “Part D plans should not be requiring a Part B rejection as their first step before they’ll start thinking about covering it under Part...
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National Provider Identifier – Subparts
Implementation of the National Provider Identifier(NPI) is moving forward. We should stay on top of the current implementation calendar and recent CMS guidance. Here is a link to the CMS site where there is a letter clarifying CMSs expectations on determining subparts to covered entities who should bill CMS using unique NPIs. Here is...
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Medicare and Pay For Performance
P4P is already on its way and most organizations that manage Medicare lines of businesses are not preparing for the changes in data collection and reporting. Here is a good article outlining the P4P programs already in demonstration with CMS and where they are headed. Now is the time for us to pay attention...
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Want To Create A New Medicare Plan in 2007?
CMS is hosting a Satellite/Webcast on Tuesday, January 31, 2006 from 1:00-4:00pm EST. The goal of this broadcast is to provide Health Plans, Employers, Unions, and Part D Sponsors and potential applicants with an update on changes and/or revisions on the following topics: Overview of the Medicare Advantage Application requirements and process for the...
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Part D CREDITABLE COVERAGE DISCLOSURE TO CMS
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires entities that provide prescription drug coverage to Medicare Part D eligible individuals to disclose to CMS whether the coverage is creditable or non-creditable. CMS has issued guidance on the form, manner and timing of providing the Disclosure Notice to CMS. This Disclosure to...
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