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CMS Quarterly Provider Update Highlights
October 30, 2008

The Centers for Medicare and Medicaid Services (CMS) Quarterly Provider Update distributes new information of interest to a broad array of providers. Below are links to information from the October issue that may be of interest to members.

Transmittal 391, Archiving and Retrieving of the Integrated Outpatient Code Editor and the Medicare Code Editor for Processing Claims affects Community Mental Health Centers, Comprehensive Outpatient Rehabilitation Facilities, Federally Qualified Health Centers, Home Health Agencies, Hospices, Hospitals, Non-Physician Practitioners, Outpatient Physical Therapy, Physicians, Religious Non-Medical Health Care Institutions, Renal Dialysis Facilities, Rural Health Clinics, and Skilled Nursing Facilities. This Change Request (CR) directs the development of a new archiving and call process for the Fiscal Intermediary Shared System to use in accessing archived outpatient code editors and Medicare code editors.

Transmittal 271, Instructions for the Implementation of the Internet-Based Provider Enrollment, Chain and Ownership System (PECOS) affects all providers. This CR incorporates into Pub. 100-08, chapter 10, all of the directives contained in CR 5954. Requirements of CR 5954 are not changed

Transmittal 1610, Fiscal Year (FY) 2009 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, and Inpatient Psychiatric Facility (IPF) PPS Changes affects hospitals (www.cms.hhs.gov/transmittals/downloads/R1610CP.pdf). The IPF PPS is affected only by the ICD-9-CM changes that affect the comorbidity adjustment effective October 1. IPF PPS rate changes occurred on July 1. Refer to Transmittal 1543, CR 6077, published on June 27 for IPF PPS policy changes.

CMS-2229-N, Medicaid Program; Self-Directed Personal Assistance Services Program State Plan Option (Cash and Counseling); Final Rule provides guidance to states that want to administer self-directed personal assistance services through their state plans, as authorized by the Deficit Reduction Act of 2005. The state plan option allows beneficiaries, through an approved self-directed services plan and budget, to purchase personal assistance services. The rule also provides guidance to ensure beneficiary health and welfare and financial accountability of the state plan option. The rule is effective November 3.

MLN Matters MM6212, New 2008 Medicare Physician Fee Schedule (MPFS) Payment Rates Effective for Dates of Service July 1, 2008, through December 31, 2008 is based on CR 6212, which announces the new 2008 MPFS payment rates effective for dates of service July 1 - December 31. Medicare contractors have already implemented the information noted in this article

The complete CMS Quarterly Provider Update is available at www.cms.hhs.gov/quarterlyproviderupdates; select What’s New?

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