June 2016
4 steps to prepare for Medicare's new payment systems

While the details of the Medicare Access and CHIP Reauthorization Act (MACRA) regulations still are being hammered out, physicians should start preparing for the new payment systems now. Make sure you're on track by taking four important steps from the American Medical Association. 

The lengthy proposed rule released by the Centers for Medicare and Medicaid Services outlines the draft regulations the agency is considering for implementation. This is just the beginning of the official rulemaking process, but what is known for sure is that physicians will have a choice in whether to participate in the Merit-based Incentive Payment System (MIPS) or meet requirements for an  alternative payment model (APM).

Here are the steps you can take to prepare your practice for one of the two new Medicare paths:
 
1. Review your quality measurement and reporting. 
2. Understand your patient data and benchmarks. 
3. Check on your electronic health record (EHR). 
4. Stay informed. 
 
For more details, read the full story from the AMA
June 30 registration deadline for PQRS group practice reporting option approaching

Providers and group practices must satisfactorily report PQRS quality measure data either as individuals or as a group practice in 2016 to avoid potential Medicare penalties of up to 6 percent in 2018. The Physician Value - PQRS (PV-PQRS) Registration System is open through June 30.

Avoiding the CY 2018 PQRS payment adjustment by satisfactorily reporting via a PQRS GPRO is one of the ways groups can avoid the automatic downward payment adjustment under the Value Modifier (-2.0% or -4.0% depending on the size and composition of the group) and qualify for adjustments based on performance in CY 2018. Alternatively, groups that choose not to report via the PQRS GPRO in 2016 must ensure that the EPs in the group participate in the PQRS as individuals in 2016 and at least 50 percent of the EPs meet the criteria to avoid the CY 2018 PQRS payment adjustment.

Attention Colorado Medicaid and CHP+ Providers - Coming soon! Big changes to the Provider Portal, MMIS and PBMS

As part of the Colorado Medicaid Management Innovation and Transformation (COMMIT) project, the Department of Health Care Policy and Financing will be launching several new provider-facing systems on Oct. 31, 2016.

Two of these new systems will affect the way providers submit claims and receive payment. These are the Colorado interChange (a new claims processing and eligibility verification system) and the Pharmacy Benefits Management System (a new pharmacy point of sale system).

Over the next several months, the Department will be working to inform and prepare the Colorado Medicaid and CHP+ provider networks for these changes. In addition to the updates mentioned below, the Department will also be hosting a series of live webinars to answer any questions you may have. Both webinar and training schedules will be released mid/late July 2016.

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Other ways to stay informed
The Department will keep you informed and help prepare you for the coming changes. Look for general information and updates to be posted in the Provider Bulletins, At a Glance, and on the Department's website.
Modernizing patient payment collection

Collections of patients' outstanding bills, those charges not covered by health insurance plans, challenge most medical practices across the country. In this article by a senior director of NACHA - The Electronic Payments Association, the author stresses the need for physicians to migrate toward other methods to collect patient payments, including offering online payment portals and accessibility for patients to make a single or series of electronic funds transfer (EFT) payments via ACH. This is particularly relevant as more employers offer high-deductible plans to employees.

NOVITAS NEWS

Cycle 2 revalidations have begun

The Centers for Medicare and Medicaid Services initiated Cycle 2 revalidations in March 2016. Novitas Solutions issued the first set of revalidation notification letters, via hardcopy, on March 18.
 
Revalidation is required under the Affordable Care Act. Providers/suppliers are required to revalidate their entire Medicare enrollment record, including all assigned National Provider Identifiers (NPIs) and Provider Transaction Access Numbers (PTANs). Individual providers who reassign benefits to more than one group or entity must include all organizations to which benefits are reassigned on one revalidation application. The processing status of Cycle 2 revalidation applications can be obtained using the Provider Enrollment Status Inquiry Tool located on Novitas' website, www.novitas-solutions.com.
 
Click here for the cycle 2 revalidation summary, key points and available education.

Self-service feature added to IVR

In the next few months, Novitas will implement an enhanced self-service feature that will be introduced to the Interactive Voice Recognition (IVR) unit allowing providers to conduct an unlimited number of claim corrections for select Medicare Part B claims via the IVR. This IVR self-service tool will be enhanced to allow providers to conduct an unlimited number of claim corrections and eliminate the need to speak to an agent for select claims corrections. Click here to read more.
 
Novitas will offer "Novitasphere Claim Correction Overview" webinars prior to each implementation date to provide practices with the information needed to successfully transition to the IVR claim corrections self-service tool for Medicare Part B claims.  Remaining webinar dates are: June 21, June 23, July 6, July 7, July 21, July 22, Aug. 2, Aug. 9, Aug. 23 and Aug. 25. Visit the Novitas website to register for one of these webinars.

2016 Medicare Symposium: Colorado Springs - Aug. 17

Novitas invites you to their signature educational event: 2016 Medicare Symposiums. One symposium will be held in Colorado Springs on Aug. 17. This event is for Part A and B Medicare providers and their billing and compliance representatives. Attendees will benefit from a wide variety of education based on data-driven content and the latest Medicare changes that practices need to know to bill Medicare the right way, the first time.

Register today at www.novitas-solutionslearning.com.
Time is running out: 2015 EHR Meaningful Use hardship exemption

Don't forget: The deadline to apply for a Meaningful Use (MU) hardship exemption was extended to July 1, 2016. The AMA encourages ALL physicians who participated in the 2015 Medicare MU program to apply for the hardship.

The application and additional instructions are available on the federal CMS EHR Incentive Programs website. The AMA has made available step-by-step instructions for completing the hardship exception application; click here to access it. 

Submission of a hardship exception application does not prevent providers from attesting and receiving an incentive payment if meaningful use requirements are met. In essence, the hardship exemption will act as a safety net. Therefore, physicians who believe that they met the MU requirements for the 2015 reporting period should still apply for the hardship protection. 

Note that the program operates on a two-year look-back period, meaning that physicians who are granted an exception for the 2015 program will avoid a financial penalty for 2017. The federal CMS has stated that it will broadly accept hardship exemptions.
Physician Compare Initiative call: Thursday, June 16, 11:30 a.m.

Do you want to learn more about Medicare's Physician Compare website and what it might show about your practice? Physician Compare provides information to consumers to help them make informed health care decisions and provides incentives to physicians to maximize their performance. Experts from the Centers for Medicare and Medicaid Services will walk you through the information currently available, upcoming plans, and the future of Physician Compare under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). A question-and-answer session will follow the presentation. To register, visit MLN Connects Event Registration. Learn more on the Physician Compare Initiative page.
Webinar: Learn about the new name for Colorado Medicaid, Health First Colorado

Colorado Medicaid is changing its name to Health First Colorado (Colorado's Medicaid Program) this summer. Join the Colorado Department of Health Care Policy and Financing to learn about why Colorado Medicaid is changing its name, and how this change affects your patients and your practice. They will also direct you to resources to help educate your patients about this change.

There are four dates for the webinar: Wednesday, June 22; Thursday, June 23; Tuesday, June 28; and Wednesday, June 29. All are 12 - 1 p.m. except the June 23 webinar, which will be held 12:30 - 1:30 p.m.
In This Issue
Sponsors

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Important! What your practice needs to know about switching to EMV: Click here.
 



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Events
Healthy Transitions Colorado webinar: Dementia-Friendly Communities of Northern Colorado - June 17

Join Healthy Transitions Colorado for a free webinar on Friday, June 17, 11 a.m. -12 p.m. MT, "Dementia-Friendly Communities of Northern Colorado." In this webinar, Cyndy Luzinski, MS, RN, CDP, will share her own experience as a catalyst for building and sustaining dementia-friendly communities. She will answer the questions: Why now for dementia-friendly communities? What are dementia-friendly communities? What is going on in Northern Colorado? What are some practical steps to start the initiative in other communities? Register here. 
 

CPT workshop - June 25

Register for a hands-on, interactive CPT workshop with CHIMA on June 25, 8 a.m. - 5 p.m. MT. Bring your 2016 CPT book to walk through each individual chapter in CPT, review the pertinent guidelines, talk about coding caveats and do some actual coding examples for each chapter.

Attendees will spend the day thoroughly discussing the different sections, things to tab and remember, as well as how to look up the codes. Attendees will finish out the day with an overview of how to use the HCPCS books, look up supplies, drugs and how the chapters are built in the HCPCS book. Learn more and register here. 
 

Webinar: New phase of HIPAA audits - June 28

As a part of their continued efforts to assess compliance with the HIPAA Privacy, Security and Breach Notification Rules, the HHS Office for Civil Rights (OCR) has begun its next phase of audits of covered entities and their business associates. The 2016 Phase 2 HIPAA Audit Program will review the policies and procedures adopted and employed by covered entities and their business associates to meet selected standards and implementation specifications of the rules.

In an article for CORHIO, David Ginsberg, president of PrivaPlan Associates, discusses phase two. Click here to read the article on the CORHIO website and register for their June 28 webinar. 
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