Thursday, May 28, 2020
- COVID-19: Adjusting Operations to Manage Patient Surge
- PECOS/NPPES/EHR Identity & Access Management System: Role Renamed
- Medicare Diabetes Prevention Program: Become a Medicare Enrolled Supplier
View this edition as PDF (PDF)
News
COVID-19: Adjusting Operations to Manage Patient Surge
The Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) collaborated with the COVID-19 Healthcare Resilience Task Force on resources:
- Medical Operations Coordination Cells (MOCCs) Toolkit, First Edition: Learn to establish MOCCs to ensure load-balancing across health care facilities and systems
- Establishing MOCCs for COVID-19 Webinar Recording: Features jurisdictions with COVID-19-related experience using the MOCC concept
- Alternate Care Sites (ACS) Funding Summary: Establishment and Operationalization Tip Sheet: Funding options for establishing ACS, including operation, ongoing administration, and direct patient costs
- COVID-19: Healthcare System Operations Strategies and Experiences Webinar Recording: Some of the hardest hit hospitals share their experiences with adjusting operations and logistics to manage patient surge
For More Information:
- ASPR TRACIE Fact Sheet
- ASPR TRACIE website
- ASPR TRACIE Novel Coronavirus Resources webpage
PECOS/NPPES/EHR Identity & Access Management System: Role Renamed
Starting June 8, the role Delegated Official is renamed Access Manager throughout the Identity & Access Management System (I&A) used to manage access to the Provider Enrollment, Chain, and Ownership System (PECOS), National Plan and Provider Enumeration System (NPPES), and the Electronic Health Record (EHR) incentive program:
- No change to requirements, functions, access, or privileges for this role
- No impact on I&A users; no action required
- No change to PECOS, NPPES, or EHR systems
This change will avoid confusion between the Delegated Official in PECOS and the Delegated Official in the I&A System supporting PECOS, NPPES, and EHR. This change has no impact on Delegated Officials listed in PECOS or their titles.
Medicare Diabetes Prevention Program: Become a Medicare Enrolled Supplier
Medicare pays Medicare Diabetes Prevention Program (MDPP) suppliers to furnish group-based intervention to at-risk eligible Medicare beneficiaries:
- Centers for Disease Control and Prevention (CDC)-approved National Diabetes Prevention Program curriculum
- Up to 2 years of sessions delivered to groups of eligible beneficiaries
Find out how to become a Medicare enrolled MDPP supplier:
- Obtain CDC preliminary or full recognition - Takes at least 12 months to obtain preliminary recognition and up to 24 additional months to achieve full recognition: See the Supplier Fact Sheet and CDC website
- Prepare for Medicare enrollment: See the Enrollment Fact Sheet and Checklist
- Apply (PDF) to become a Medicare enrolled MDPP supplier (existing Medicare providers must re-enroll): See the Enrollment Webinar Recording and Enrollment Tutorial Video
- Furnish MDPP service: See the Session Journey Map
- Submit claims to Medicare: See the Billing and Claims Webinar Recording, Billing and Claims Fact Sheet, and Billing and Payment Quick Reference Guide
For More Information:
- MDPP Participants: CMS Flexibilities to Fight COVID-19 (PDF)
- MDPP Expanded Model (PDF) Booklet
- from Medicare Learning Network call on June 20, 2018
- MDPP webpage
- CDC - CMS Roles Fact Sheet
- Contact
Claims, Pricers & Codes
Medicare Diabetes Prevention Program: Valid Claims
For a claim to be valid under the Medicare Diabetes Prevention Program (MDPP), you must have both:
- Centers for Disease Control and Prevention (CDC) preliminary or full recognition; see the Supplier Fact Sheet and CDC website for more information
- Separate Medicare enrollment as an MDPP supplier (Specialty D1); see the Enrollment Fact Sheet and Checklist
Important:
If you do not have a separate Medicare enrollment as an MDPP supplier and you submit a claim for MDPP services, your claim will be rejected.
Medicare enrolled MDPP suppliers: See the Quick Reference Guide to Payment and Billing and Billing and Claims Fact Sheet for information on valid claims:
- MDPP Medicare beneficiary eligibility data is returned via the HIPAA Eligibility Transaction System (HETS) on the 271 response; use this data to determine if a beneficiary meets the criteria to receive MDPP services
- Submit claims when a performance goal is met, and report codes only once per eligible beneficiary (except G9890 and G9891)
- List each HCPCS code with the corresponding session date of service and the coach’s National Provider Identifier
- List all HCPCS codes associated with a performance payment (including non-payable codes) on the same claim
- Include Demo code 82 in block 19 (Loop 2300 segment REF01 (P4) and segment REF02 (82)) to identify MDPP services
- Do not include codes for other, non-MDPP services on the same claim
For More Information:
- MDPP Expanded Model (PDF) Booklet
- MDPP webpage
- For trouble with MDPP billing and claims, contact your Medicare Administrative Contractor
Events
COVID-19: Lessons from the Front Lines Call — May 29
Fridays from 12:30 to 2 pm ET
These weekly calls are a joint effort between CMS Administrator Seema Verma, Food and Drug Administration (FDA) Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians: Share your experience, ideas, strategies, and insights related to your COVID-19 response. There is an opportunity to ask questions.
To Participate:
- Conference lines are limited; we encourage you to join via audio webcast
- Or, call 877-251-0301; Access Code: 6350189
For More Information:
- Coronavirus.gov
- CMS Current Emergencies website
- Podcast and Transcripts webpage: Audio recordings and transcripts
Target Audience: Physicians and other clinicians.
MLN Matters® Articles
Medicare Continues to Modernize Payment Software
A new MLN Matters Special Edition Article SE20019 on Medicare Continues to Modernize Payment Software (PDF) is available. Learn about efforts to modernize payment grouping and code editing software for inpatient rehabilitation facilities and skilled nursing facilities
Publications
Acute Care Hospital Inpatient Prospective Payment System — Revised
A revised Acute Care Hospital Inpatient Prospective Payment System Medicare Learning Network Booklet is available. Learn about:
- Payment rates
- Payment adjustments
Like the newsletter? Have suggestions? Please let us know!
Subscribe to MLN Connects. Previous issues are available in the archive.
This newsletter is current as of the issue date. View the complete disclaimer.
Follow the MLN on Twitter #CMSMLN, and visit us on YouTube.
The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).
