viernes, 10 de mayo de 2013

Home Health, Hospice & Durable Medical Equipment Open Door Forum - Centers for Medicare & Medicaid Services

http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODF_hhhdme.html

Information You Need: New Medicare Equipment and Supplies Program In Your Community

If you help people with Original Medicare get certain durable medical equipment and supplies, such as oxygen, walkers, or wheelchairs, you should know about a Medicare program, called the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) competitive bidding program, that saves money for taxpayers and people with Medicare and may change the suppliers people with Medicare will need to use.

The first round of the program went into effect in nine areas of the country on January 1, 2011, reducing money spent for equipment included in the program by over 42 percent in its first year of operation while maintaining access to quality equipment and supplies. Now the program’s benefits are coming to people with Original Medicare near you, and there is some important information you need to know. Round 2 of the program is scheduled to begin on July 1, 2013, and expands it to 91 additional areas across the country. These areas can be found in the fact sheet at http://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/Downloads/DMEPOSBeneFactSheetMarch2013.pdf.

When the program starts, people with Original Medicare who live in or travel to one of these areas and need the items listed below will likely need to get these items from contract suppliers if they want Medicare to help pay, unless their current suppliers decide to become grandfathered suppliers (non-contract suppliers that choose to continue to provide certain rented medical equipment or oxygen under the terms of the program).

So people will need to find out which suppliers are Medicare contract suppliers to make sure Medicare can help pay for their medical equipment or supplies. You can find out if a supplier is a contract supplier for the program by visiting http://www.medicare.gov/supplierdirectory/search.html or by calling 1-800-MEDICARE (1-800-633-4227).

The 8 product categories that are included in Round 2 of the program are:

1. Oxygen, oxygen equipment, and supplies;

2. Standard (power and manual) wheelchairs, scooters, and related accessories;

3. Enteral nutrients, equipment, and supplies;

4. Continuous Positive Airway Pressure (CPAP) devices, Respiratory Assist Devices (RADs) and related supplies and accessories;

5. Hospital beds and related accessories;

6. Walkers and related accessories;

7. Support surfaces (Group 2 mattresses and overlays); and

8. Negative Pressure Wound Therapy pumps and related supplies and accessories.

In addition to the categories of items listed, Medicare will be starting a national mail-order program for diabetic testing supplies at the same time as Round 2. The national mail-order program will include all parts of the United States, including the 50 States, the District of Columbia, Puerto Rico, the US Virgin Islands, Guam, and American Samoa. When the national mail-order program starts, people with Original Medicare will need to use a contract supplier for diabetic testing supplies delivered to their homes.

Starting May 13, 2013, Medicare is mailing information to people with Medicare in the 91 Round 2 areas who use the items included in the program, in addition to those who use diabetic testing supplies across the country. Approximately 5.7 million people with Medicare will get a letter and information. You can review the letters, introductory brochure, national mail-order program fact sheet and other program education materials by visiting http://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/DMEPOS_Toolkit.html

If you help people with Original Medicare who live in or travel to one of the Round 2 areas and who need one of the items included in the program or who use diabetic testing supplies, please make this information available to them.

Home Health, Hospice & Durable Medical Equipment Open Door Forum

Overview:

The Home Health, Hospice & Durable Medical Equipment Open Door Forum (ODF) addresses the concerns of three unique health care areas within the Medicare & Medicaid programs. Issues related to Home Health PPS, the newly proposed competitive bidding for DME and the Medicare Hospice benefit are all topics the forum has covered. Many of the issues covered bridge concerns within all three settings and the combination of the topics under one Forum has been useful to many participants. We continue to hold Special ODFs when individual policy issues require special attention. Timely announcements and clarifications regarding important rulemaking, agency program initiatives and other related areas are also included in the forums.
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If you help people with Original Medicare get certain durable medical equipment and supplies, such as oxygen, walkers, or wheelchairs, you should know about a Medicare program, called the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) competitive bidding program, that saves money for taxpayers and people with Medicare and may change the suppliers people with Medicare will need to use. Please see the Downloads section below for the link titled: "Information You Need: New Medicare Equipment and Supplies Program In Your Community."

CMS Seeks Public Comment on Defining QIO Service Areas - Comments Accepted through Friday, May 31, 2013. Please see Downloads section below for full announcement.

CMS will host a National Provider Call on Wednesday, May 22, 2013, titled: National Physician Payment Transparency Program (Open Payments) - What You Need To Know. Please see Downloads section below for full announcement.

The next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum is scheduled for Wednesday, May 8, 2013 from 2:00pm – 3:00pm, ET. If you wish to participate, dial 1-800-837-1935; Conference ID: 78867258. Please see the Downloads section below for the full announcement including agenda. Thank you for your continued interest in the CMS Open Door Forums.

Hospice providers must enter and attest to their NQF #0209 data on the data entry website no later than 11:59pm ET on April 1, 2013 in order to comply with Payment Year 2014 NQF #0209 requirements. Providers that have not already begun entering their NQF #0209 data for the Hospice Quality Reporting Program (HQRP) Payment Year 2014 cycle should begin doing so immediately. In order to avoid a 2 percentage point reduction in Annual Payment Update (APU) for FY 2014, providers must have submitted data for both the structural measure and the NQF #0209 measure by the specified deadlines: January 31, 2013 for the structural measure and April 1, 2013 for the NQF #0209 measure. Providers that may have missed the structural measure deadline can still visit the data entry website, create an account, and enter their NQF #0209 data. The link to the data entry site, along with a Technical User Guide giving step-by-step instructions on the data entry process, can be found on the Data Submission portion of the CMS HQRP website.

The Centers for Medicare and Medicaid Services is pleased to announce the scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set. These changes have been posted to the HCPCS website at http://www.cms.gov/HCPCSReleaseCodeSets/02_HCPCS_Quarterly_Update.asp. Changes are effective on the date indicated on the update.

During the February 20, 2013 Home Health, Hospice & DME Open Door Forum, we noted the next Open Door Forum date would be April 3, 2013. This date has been changed. The April 3, 2013 Home Health, Hospice & DME ODF is cancelled. We will notify you when the new date is determined. Thank you for your continued interest in the CMS Open Door Forums.

National Provider Calls: Medicare Shared Savings Program Application Process — Registration Now Open
Tuesday, April 9; 2:30-4pm ET — Preparing to Apply
Tuesday, April 23; 1:30-3pm ET — Tips on Completing a Successful Application. See Downloads section below for full announcement.

Important Alert: Hospice providers that have not already begun entering their NQF #0209 data for the Payment Year 2014 cycle should begin doing so immediately. Providers must enter and attest to their data on the data entry website no later than 11:59pm ET on April 1, 2013 in order to comply with NQF #0209 requirements. In order to avoid a 2 percentage point reduction in Annual Payment Update (APU) for FY 2014, providers must have submitted data for both the structural measure and the NQF #0209 measure by the specified deadlines: January 31, 2013 for the structural measure and April 1, 2013 for the NQF #0209 measure.
Providers that may have missed the structural measure deadline can still visit the data entry website, create an account, and enter their NQF #0209 data. The link to the data entry site, along with a Technical User Guide giving step-by-step instructions on the data entry process, can be found on the Data Submission portion of the CMS HQRP website.
Hospice providers that anticipate needing a deactivation request for their HQRP user account should submit their account deactivation request to the Technical Help Desk via fax at 888-477-7871 or email at help@QTSO.com prior to March 25, 2013. Any deactivation requests received on or after March 25 puts a hospice organization at risk for missing the April 1 NQF #0209 deadline. Please note: all data submitted by a user who is deactivated is permanently deleted. Please see Downloads section below for more information.

On the February 20th Home Health, Hospice and DME ODF, CMS staff responded to a question regarding the Home Health Acute Care Hospitalization claims-based measure. The caller asked if the measure is risk adjusted and if not, was CMS considering risk adjustment in the future. CMS staff responded erroneously that the measure is not risk adjusted and there are no plans to risk adjust in the future. The correct response is that the Acute Care Hospitalization claims-based measure is already risk adjusted.

The next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum is scheduled for Wednesday, February 20, 2013 from 2:00pm – 3:00pm, ET. If you wish to participate, dial 1-800-837-1935; Conference ID: 78869441. Please see the Downloads section below for the full announcement including agenda. Thank you for your continued interest in the CMS Open Door Forums.

The Durable Medical Equipment, Orthotics and Supplies (DMEPOS) Competitive Bidding Program will be changing how some Medicare patients get covered supplies. Be sure to give your Medicare patients the correct information. Please review (copy and paste the link into your web browser) the following link for information for people who refer Medicare beneficiaries for DMEPOS: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSCompetitiveBid/index.html?redirect=/DMEPOSCompetitiveBid/01_overview.asp.

Urgent Hospice Quality Reporting Registration Information has been added to the Downloads section below. Thank you.

Please see the "New Electronic Mailing List to Keep Fee-For-Service Providers Informed" announcement in the Downloads section below.