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Medigram - January 8, 2009


BREAKING NEWS

CMS selects Noridian Administrative Services, LLC to administer Medicare claims payments for Wisconsin

The Centers for Medicare & Medicaid Services (CMS) announced yesterday the final five contractors that will process and pay Medicare claims for health care services under the Medicare Fee-for-Service program. The current Medicare Part B contractor for Wisconsin, WPS headquartered in Madison, was not selected. Instead Noridian Administrative Services, LLC, (NAS) will administer claims payments for Jurisdiction 6, which is comprised of Wisconsin, Illinois and Minnesota.

The new contracts that will be administered for up to five years will process and pay 36 percent of the national volume of Medicare Part A (hospital insurance) and Part B (medical insurance) claims payments in 14 states, mostly in the South and Midwest. CMS now has met its goal of awarding all 15 Medicare Administrative Contractor (MAC) contracts.

The competitive selection of the new Part A and Part B MACs was made on a “best value” basis, according to a CMS press release.

NAS will immediately begin its implementation activities and will assume full responsibility for the claims processing work in Jurisdiction 6 no later than March 2010. During the implementation period, CMS reports that NAS will conduct extensive outreach to health care professionals, state medical associations and beneficiaries in its jurisdiction to provide education and information about the implementation.

NAS is headquartered in Fargo, ND. To learn more about NAS, visit www.noridianmedicare.com. To read the CMS press release announcing the contract, click here.

NEWS BRIEFS

Sign up to receive drug recall alerts on-line

The Health Care Notification Network (HCNN) is a secure, private network for physicians and physician assistants that delivers FDA-mandated drug recalls and Patient Safety Alerts immediately on-line, replacing the traditional paper-based method which relies on delivery via U.S. mail. The Wisconsin Medical Society has partnered with the HCNN and will notify subscribers via e-mail when an alert is forthcoming.

Key Features
  • Physician and physician assistant information registered with the HCNN—including e-mail addresses—will never be sold, shared or disclosed to any third parties, including the FDA, manufacturers and other HCNN users.
  • The HCNN service is completely free for physicians and physician assistants.
  • The HCNN does not include advertising or selling of any kind and funding for the network is provided by the manufacturers who are required by the FDA to issue drug recalls and Patient Safety Alerts.
  • Physicians and physician assistants may opt out of the HCNN at any time and receive the alerts via U.S. mail instead of electronically.
  • Physicians and physician assistants may designate other health care professionals that are part of their medical team to receive HCNN alerts in order to facilitate information flow and patient follow-up.
  • The HCNN fulfills the new FDA regulations for secure on-line delivery of patient safety Alerts.
  • The HCNN is far more efficient than current paper-based patient safety alerts. Delays in alert delivery may increase liability risk.
  • Nearly every major liability carrier and medical society is currently promoting the HCNN because of its ability to improve patient safety and reduce physician liability.
For more information or to register, please click here.


Division of Public Health launches new electronic surveillance system for disease reporting

In an effort to streamline disease reporting around the state, the Wisconsin Division of Public Health is implementing a new electronic surveillance system. The Wisconsin Electronic Disease Surveillance System (WEDSS) is a secure, Web-based system developed to facilitate reporting, investigation and surveillance of communicable diseases in Wisconsin. It is designed for public health staff, infection control practitioners, clinical laboratories, clinics and other disease reporters.

Proposed benefits of the system include improved security, information sharing and data analysis; time savings; reduced duplication and paperwork; and standardization. Training and implementation is being conducted this winter in eastern Wisconsin. Statewide implementation will continue through 2009 and 2010.

To learn more, contact your local health department or visit dhs.wisconsin.gov/wiphin/WEDSS.htm.


Joint Commission seeking input

The Joint Commission is conducting research to determine if sufficient interest exists to support further development of their Palliative Care Certification program. Certification will focus on how well an organization integrates national palliative care guidelines into the delivery of patient care services; the requirements place emphasis on the importance of patient-centered care and teamwork to meet the needs of seriously ill patients and their families. Interested physicians are encouraged to take part in this confidential on-line survey, which will take approximately 7 to 10 minutes to complete.


Medicare revises components of the ‘Welcome to Medicare’ physical

As a result of section 101(b) of the Medicare Improvement for Patients and Providers Act (MIPPA), the Centers for Medicare and Medicaid Services (CMS) has made several changes effective January 1, 2009 to the Initial Preventive Physical Exam (IPPE) or as it’s also known, the “Welcome to Medicare” physical exam. Some of the highlighted changes include waiving the Medicare Part B deductible for this service, expanding the benefit for a period of 12 months (previously 6 months) from date of Medicare eligibility and eliminating the requirement of a screening EKG. The benefit has also been expanded to include end -of-life planning and body mass measurement as part of the physical exam components.

As a benefit to physicians, Medicare has created a quick reference guide titled, “The ABCs of Providing the Initial Preventive Physical Examination” to assist in capturing all necessary documentation to bill for this one-time Medicare service. An additional separate brochure is also included that summarizes the expansion of the IPPE.

NEWSMAKERS

Marshfield Clinic’s EHR use featured in New York Times

Marshfield Clinic was featured recently in the New York Times. The December 27 article, “Health care that puts a computer on the team” was part of a series titled “The Evidence Gap,” focusing on the benefits and potential of electronic health records (EHR).

“The Marshfield Clinic, a large doctors’ group in Wisconsin, shows that computerized records can indeed improve the quality and efficiency of medicine,” states the article. Click here to read more.

CAPITOL INSIDER

State Senate and Assembly Committee rosters announced

2009-2010 biennium is underway, with all legislators sworn in on Monday. Rosters are now set for committee membership; here are health-related committees and rosters:

Senate
Committee on Health, Health Insurance, Privacy, Property Tax Relief, and Revenue
Committee on Public Health, Senior Issues, Long-Term Care, and Job Creation

Assembly
Committee on Health and Healthcare Reform
Committee on Public Health

If you'd like more information about these or any other legislators, go to the Legislature's Web site. To find out who represents you, click here.

QUALITY CORNER

Quality tools available from Innovations Exchange

The Health Care Innovations Exchange is an AHRQ program designed to support health care professionals in sharing and adopting innovations that improve the delivery of care to patients. Explore this site to find innovative strategies and quality-related tools, learn how to improve your organization’s ability to innovate and adopt new ideas, and interact with innovators and adopters.

FAQ

Question:
My physician delivers a baby that requires neonate critical care. Our facility does not have the ability to provide these services, so after 3 hours the newborn is transferred to a facility with a Neonatal Intensive Care Unit (NICU). How does my provider bill for the 3 hours of critical care services provided if the new CPT codes (99468-99476) are global, per-day codes?

Answer:
The physician that delivers the baby and personally spends 3 hours providing critical care services will report time-based critical care codes 99291-99292. The first 30-74 minutes will be reported with 99291 and 99292 for each additional 30 minutes. The receiving facility will bill for the global, per-day, neonate critical care codes 99468-99476 as appropriate.

For answers to other Frequently Asked Questions about coding matters and more, click here to review our Education Department’s FAQ archive, or e-mail efaq@wismed.org.