**Updated June 1, 2011- Special Open Door Forum: The Advance Payment Initiative; Tuesday, June 14, 2011 2pm-3:30pmET.The CMS Innovation Center is considering an Advance Payment Initiative for those ACOs entering the Medicare Shared Savings Program to test whether and how pre-paying a portion of future shared saving could increase participation in the Medicare Shared Savings Program. More information is available on the Innovation Center website at www.innovations.cms.gov. This Special ODF is Conference Call Only. To participate, dial 1-866-501-5502 Conference ID 71725238. Please see the Download section below for the full participation announcement. Thank you for your continued support of the CMS Open Door Forums.
**Updated May 25, 2011- Special Open Door Forum: The Pioneer ACO Model: A Review of the Application - Tuesday, June 7, 2011, 12:00 PM – 1:30 PM ET. This Special Open Door Forum will focus on the request for applications for the Pioneer Accountable Care Organization (ACO) Model released on May 17, 2011. The RFA, application, and other background materials are available on the Innovation Center website at www.innovations.cms.gov. If you wish to participate via conference call, dial 1-800-837-1935 Conference ID 70961782. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
** Update May 20, 2011- The next Physician, Nurses and Allied Health Professionals Open Door Forum is scheduled for Tuesday, June 28, 2011 from 2pm-3pmET. If you wish to participate dial 1-800-837-1935 Conference ID 59680265. This call will be Conference Call Only. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums.
**Updated May 3, 2011- Special Open Door Forum: 2011 Physician Quality Reporting System (previously known as the Physician Quality Reporting Initiative or PQRI) and Electronic Prescribing (eRx) Incentive Programs: ICD-10 Conversion and E-Prescribing (eRx) Incentive programs - Thursday, May 26, 2011; from 2:30pm- 3:30pm ET. This Special Open Door Forum will focus on ICD-10 Conversion. Following the presentation, the telephone lines will be opened to allow participants to ask questions of the CMS subject matter experts. This agenda is subject to Change. If you wish to participate, dial 1-800-837-1935 Conference ID 44767414. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
**Updated March 31, 2011- Effective April 1, 2011, the Centers for Medicare & Medicaid Services (CMS) expects home health agencies and hospices have fully established internal processes to comply with the face-to-face encounter requirements mandated by the Affordable Care Act (ACA) for purposes of certification of a patient's eligibility for Medicare home health services and of recertification for Medicare hospice services.
Section 6407 of the ACA established a face-to-face encounter requirement for certification of eligibility for Medicare home health services, by requiring the certifying physician to document that he or she, or a non-physician practitioner working with the physician, has seen the patient. The encounter must occur within the 90 days prior to the start of care, or within the 30 days after the start of care. Documentation of such an encounter must be present on certifications for patients with starts of care on or after January 1, 2011.
Similarly, section 3131(b) of the ACA requires a hospice physician or nurse practitioner to have a face-to-face encounter with a hospice patient prior to the patient's 180th-day recertification, and each subsequent recertification. The encounter must occur no more than 30 calendar days prior to the start of the hospice patient's third benefit period. The provision applies to recertifications on and after January 1, 2011.
On December 23, 2010, due to concerns that some providers needed additional time to establish operational protocols necessary to comply with face-to-face encounter requirements mandated by the Affordable Care Act (ACA) for purposes of certification of a patient's eligibility for Medicare home health services and of recertification for Medicare hospice services, CMS announced that it will expect full compliance with the requirements, beginning with the second quarter of CY2011.
Throughout the first quarter of 2011, CMS has continued outreach efforts to educate providers, physicians, and other stakeholders affected by these new requirements. CMS has posted guidance materials including a MLN Matters article, questions and answers documents, training slides, and manual instructions which are available via CMS' Home Health Agency Center and Hospice webpages. CMS' Office of External Affairs and Regional Offices contacted state and local associations for physicians and home health agencies and advocacy groups to ensure awareness about the face-to-face encounter laws, and to distribute the educational materials.
CMS will continue to address industry questions concerning the new requirements, and will update information on our Web site at http://www.cms.gov/center/hha.asp and http://www.cms.gov/center/hospice.asp.
******
Physicians Nurses & Allied Health Professionals Open Door Forum Overview
The Physicians, Nurses, and Allied Health Professionals Open Door Forum addresses the concerns and issues of Medicare and Medicaid physicians, non-physician practitioners, nurses, and other allied health care specialists. This diverse group of providers serves Medicare and Medicaid beneficiaries in almost all service settings, ranging from independent physician offices to specialized departments within larger facilities. The types of issues that come up during this forum are as varied as the providers who participate, but some frequent topics include the Physician Fee Schedule, Stark regulations, care plan oversight, payment and documentation rules, Provider Enrollment Chain Ownership System (PECOS), as well as the roles and responsibilities of different allied health professional staff under CMS regulations. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the forums.
Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.
**Updated May 25, 2011- Special Open Door Forum: The Pioneer ACO Model: A Review of the Application - Tuesday, June 7, 2011, 12:00 PM – 1:30 PM ET. This Special Open Door Forum will focus on the request for applications for the Pioneer Accountable Care Organization (ACO) Model released on May 17, 2011. The RFA, application, and other background materials are available on the Innovation Center website at www.innovations.cms.gov. If you wish to participate via conference call, dial 1-800-837-1935 Conference ID 70961782. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
** Update May 20, 2011- The next Physician, Nurses and Allied Health Professionals Open Door Forum is scheduled for Tuesday, June 28, 2011 from 2pm-3pmET. If you wish to participate dial 1-800-837-1935 Conference ID 59680265. This call will be Conference Call Only. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums.
**Updated May 3, 2011- Special Open Door Forum: 2011 Physician Quality Reporting System (previously known as the Physician Quality Reporting Initiative or PQRI) and Electronic Prescribing (eRx) Incentive Programs: ICD-10 Conversion and E-Prescribing (eRx) Incentive programs - Thursday, May 26, 2011; from 2:30pm- 3:30pm ET. This Special Open Door Forum will focus on ICD-10 Conversion. Following the presentation, the telephone lines will be opened to allow participants to ask questions of the CMS subject matter experts. This agenda is subject to Change. If you wish to participate, dial 1-800-837-1935 Conference ID 44767414. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
**Updated March 31, 2011- Effective April 1, 2011, the Centers for Medicare & Medicaid Services (CMS) expects home health agencies and hospices have fully established internal processes to comply with the face-to-face encounter requirements mandated by the Affordable Care Act (ACA) for purposes of certification of a patient's eligibility for Medicare home health services and of recertification for Medicare hospice services.
Section 6407 of the ACA established a face-to-face encounter requirement for certification of eligibility for Medicare home health services, by requiring the certifying physician to document that he or she, or a non-physician practitioner working with the physician, has seen the patient. The encounter must occur within the 90 days prior to the start of care, or within the 30 days after the start of care. Documentation of such an encounter must be present on certifications for patients with starts of care on or after January 1, 2011.
Similarly, section 3131(b) of the ACA requires a hospice physician or nurse practitioner to have a face-to-face encounter with a hospice patient prior to the patient's 180th-day recertification, and each subsequent recertification. The encounter must occur no more than 30 calendar days prior to the start of the hospice patient's third benefit period. The provision applies to recertifications on and after January 1, 2011.
On December 23, 2010, due to concerns that some providers needed additional time to establish operational protocols necessary to comply with face-to-face encounter requirements mandated by the Affordable Care Act (ACA) for purposes of certification of a patient's eligibility for Medicare home health services and of recertification for Medicare hospice services, CMS announced that it will expect full compliance with the requirements, beginning with the second quarter of CY2011.
Throughout the first quarter of 2011, CMS has continued outreach efforts to educate providers, physicians, and other stakeholders affected by these new requirements. CMS has posted guidance materials including a MLN Matters article, questions and answers documents, training slides, and manual instructions which are available via CMS' Home Health Agency Center and Hospice webpages. CMS' Office of External Affairs and Regional Offices contacted state and local associations for physicians and home health agencies and advocacy groups to ensure awareness about the face-to-face encounter laws, and to distribute the educational materials.
CMS will continue to address industry questions concerning the new requirements, and will update information on our Web site at http://www.cms.gov/center/hha.asp and http://www.cms.gov/center/hospice.asp.
******
Physicians Nurses & Allied Health Professionals Open Door Forum Overview
The Physicians, Nurses, and Allied Health Professionals Open Door Forum addresses the concerns and issues of Medicare and Medicaid physicians, non-physician practitioners, nurses, and other allied health care specialists. This diverse group of providers serves Medicare and Medicaid beneficiaries in almost all service settings, ranging from independent physician offices to specialized departments within larger facilities. The types of issues that come up during this forum are as varied as the providers who participate, but some frequent topics include the Physician Fee Schedule, Stark regulations, care plan oversight, payment and documentation rules, Provider Enrollment Chain Ownership System (PECOS), as well as the roles and responsibilities of different allied health professional staff under CMS regulations. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the forums.
Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.
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