CMS Weekly Newsletter for May 1

Swine Flu Update
For the most current information about swine flu, visit the Centers for Disease Control and Prevention (CDC) website at: www.cdc.gov/swineflu. You will find consumer and provider fact sheets, current information, and steps you can take to protect yourself against infection.

Medicare’s Recovery Audit Contractor (RAC) Program

Medicare’s Recovery Audit Contractors (RACs) will review Medicare FFS claims on a post pay basis. The RACs will not be permitted to review any claims that were paid prior to October 1, 2007. CMS has issued requirements that will limit the number of medical records that RACs will be allowed to request from individual providers in Fiscal Year 2009. These request limits are posted in a document on the RAC page of the CMS website under the Downloads section here: http://www.cms.hhs.gov/RAC/03_RecentUpdates.asp (please see “RAC Medical Record Request Limits”).

The Recovery Audit Contractor (RAC) operating in the Region VI States of Arkansas, Louisiana, New Mexico, Oklahoma and Texas is Connolly Consulting Associates, Inc. of Wilton, Connecticut. Connolly Consulting can be reached by phone at (866) 360-2507.

The RACs and CMS are currently in the process of extensive public outreach and education in various States. A RAC Provider Outreach Schedule is available on the RAC page of the CMS website under the Downloads section here: http://www.cms.hhs.gov/RAC/03_RecentUpdates.asp (please see “RAC Provider Outreach Schedule”). The Provider Outreach events include Society and Association meetings, Conference Calls, and Webinars. Please check this document frequently for updated information and new events.
For additional information and resources concerning the RAC Program, please visit the RAC page on the CMS website here: http://www.cms.hhs.gov/rac

DMEPOS Supplier Accreditation – Time is Running Out
Deadline is September 30, 2009

Time is running out for suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) who bill Medicare under Part B to obtain accreditation by the September 30, 2009 deadline or risk having their Medicare Part B billing privileges revoked on October 1, 2009.  A new MLN Matters Special Edition article on this subject is now available.  This article outlines what you need to do if you have not yet complied with the Medicare Program’s supplier and quality standards to become accredited.  To view the article on the CMS website, go to:  http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0903.pdf.

While the accreditation process takes on average 6-7 months to complete, the process could take as long as 9 months to complete.  Accordingly, DMEPOS suppliers should contact an accreditation organization right away to obtain information about the accreditation process and submit an application.

In order to retain or obtain a Medicare Part B billing number, all DMEPOS suppliers (except for exempted professionals and other persons as specified by the Secretary) must comply with the Medicare program’s supplier standards and quality standards to become accredited. The accreditation requirement applies to suppliers of durable medical equipment, medical supplies, home dialysis supplies and equipment, therapeutic shoes, parenteral/enteral nutrition, transfusion medicine and prosthetic devices, and prosthetics and orthotics. 

Pharmacies, pedorthists, mastectomy fitters, orthopedic fitters/technicians and athletic trainers must also meet the September 30, 2009 deadline for DMEPOS accreditation.  
Certain eligible professionals and other persons as specified by the Secretary
are exempt from the accreditation requirement.  

Further information on the DMEPOS accreditation requirements along with a list
of the accreditation organizations and those professionals and other persons
exempted from accreditation may be found at the CMS website

Registration Now Open for Next National Conference Call for Providers Regarding ICD-10

Providers may now register for the Centers for Medicare & Medicaid Services’ ICD-10-CM/PCS Implementation and General Equivalence Mappings (Crosswalks) National Provider Conference Call that will be conducted on May 19, 2009 from 12:00 p.m. – 1:30 p.m. CENTRAL Daylight Time.

This conference call will include a discussion of the following topics:

• An overview of the ICD-10 final rule, which requires the implementation of ICD-10-CM/PCS on October 1, 2013;
• The differences between ICD-9-CM and ICD-10-CM/PCS codes; 
• The use of the General Equivalence Mappings that have been created to assist in converting policies, edits, and trend data from ICD-9-CM to ICD-10-CM/PCS; and
• The resources that are available to assist in planning for the transition from ICD-9-CM to ICD-10-CM/PCS.

Conference call discussion materials and registration information can be accessed at http://www.cms.hhs.gov/ICD10/07a_2009_CMS_Sponsored_Calls.asp

New From the Medicare Learning Network

Did you know that your local Medicare contractor (carrier, fiscal intermediary, or Medicare Administrative Contractor (MAC)) is a valuable source of news and information regarding Medicare business in your specific practice location? Through their electronic mailing lists, your local contractor can quickly provide you with information pertinent to your geographic area, such as local coverage determinations, local provider education activities, etc. If you have not done so already, you should go to your local contractor website and sign up for their listserv or e-mailing list. Many contractors have links on their home page to take you to their registration page to subscribe to their listserv. If you do not see a link on the homepage, just search their site for “listserv” or “e-mail list” to find the registration page. If you do not know the Web address of your contractor’s homepage, it is available at: http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS website.