Revised face-to-face and written order requirements for high cost durable medical equipment (DME)
For certain specified items of durable medical equipment the Affordable Care Act requires that an in-person, face-to-face examination (F2F) documenting the need for the item must have occurred sometime during the six (6) months prior to the order for the item. Click here for a summary of these requirements.
Eligible professionals: Hardship exception applications due July 1, 2014
ODs eligible for hardship exceptions-to avoid the upcoming Medicare payment adjustment for the 2013 report year-must submit their application by July 1, 2014. View complete details.
New Meaningful Use Calculator Helps Providers Attest to Stage 2
April 8, 2014 - Are you a provider participating in Stage 2 of meaningful use? If so, use the new CMS Stage 2 Meaningful Use Attestation Calculator to determine if you will successfully meet Stage 2 requirements.
Information Regarding the Holding of April 2014 Claims for Services Paid Under the 2014 Medicare Physician Fee Schedule
March 28, 2014 - The 2014 Medicare Physician Fee Schedule (MPFS) final rule stipulated a negative update to the MPFS that was to be effective January 1, 2014. That reduction was averted for three months with the passage of the Pathway for SGR Reform Act of 2013, which provided for a 0.5 percent update for services paid under the MPFS through March 31, 2014. View complete update.
CMS: Implementation of National Automated Clearinghouse Association (NACHA) Operating Rules for Health Care Electronic Funds Transfers (EFT)
February 21, 2014 - The Centers for Medicare and Medicaid Services (CMS) released additional information regarding the new payer rules that took effect January 2014. In order to comply with these new requirements, Medicare Administrative Contractors (MACs) have to modify or change the data elements that are currently included in payment information that is transmitted through the Electronic Funds Transfer (EFT) Network. Optometrists and other physicians may notice that the Company Entry Description and the TRN Segment that is transmitted from the physician's financial institution may change in terms of content or length. View complete details.
HHS Issues Model of Notices of Privacy Practices in Spanish
A Spanish version of the Model Notices of Privacy Practices (NPP) has been issued by the U.S. Department of Health and Human Services Office for Civil Rights (OCR) and Office for the National Coordinator for Health Information Technology (ONC). This resource provides patients and health plan subscribers culturally competent information about their rights under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. View complete details.
2014 Joanne Angle Investigator Award—a research grant by Prevent Blindness
The 2014 Joanne Angle Investigator Award provides funding for research investigating public health related to eye health and safety. The application deadline is Monday, March 31, 2014. View complete details and award application.
NGS: Incorrect Denials of Claims for bevacizumab (i.e., AvastinTM) for Ophthalmologic Indications
January 23, 2014 - Some claims with CPT code 67028 (intravitreal injection of a pharmacologic agent) for bevacizumab (i.e., AvastinTM) are denying. This issue is impacting two types of Avastin claims. The first is for Avastin-related claims with dates of service on or after 10/25/13 that are billed with HCPCS code J9035 (bill one unit per eye). View complete details.
CMS: Incorrect Denials of Claims for bevacizumab (i.e., AvastinTM) for Ophthalmologic Indications
January 23, 2014 - CMS began receiving claims on the revised CMS 1500 claim form (02/12) on January 6, 2014. The CMS 1500 claim form is the required format for submitting professional and supplier claims to Medicare on paper, when submitting paper claims is permissible. View complete CMS Reminder (Scroll to page 4, Claims, Pricers, and Codes).
FDA: The Mentholatum Company Issues Voluntary Nationwide Recall of Rohto® Eye Drops Made in Vietnam
January 17, 2014 - The Mentholatum Company announced a voluntary recall of Rohto Arctic, Rohto Ice, Rohto Hydra, Rohto Relief and Rohto Cool eye drops. The recall was initiated due to a manufacturing review at the production facility in Vietnam involving sterility controls. To date, there has been no evidence indicating that product does not meet specifications. View complete recall.
FDA: Acetaminophen Prescription Combination Drug Products with more than 325 mg: FDA Statement—Recommendation to Discontinue Prescribing and Dispensing
January 14, 2014 - FDA is recommending health care professionals discontinue prescribing and dispensing prescription combination drug products that contain more than 325 milligrams (mg) of acetaminophen per tablet, capsule or other dosage unit. View complete FDA alert.
CMS: 2013 Physician Quality Reporting System (PQRS): 2015 PQRS Payment Adjustment
Along with attestation for meaningful use, members need to report at least one PQRS measure for a patient in 2013 to avoid a penalty in 2015. Follow "criteria 2" to avoid a penalty. 2013 registry reporting can be done in the first quarter of 2014. View complete CMS reminder.
CMS: Medicare EPs Must Attest by February 28 at 11:59 pm ET to Receive 2013 Incentive
If you are an eligible professional (EP), the last day you can register and attest to demonstrating meaningful use for the 2013 Medicare EHR Incentive Program is February 28, 2014. You must successfully attest by 11:59 p.m. Eastern Standard Time on February 28 to receive an incentive payment for your 2013 participation.
EPs participating in the Medicaid EHR Incentive Program need to refer to their state deadlines for attestation information. Payment adjustments for EPs will be applied beginning January 1, 2015, to Medicare participants that have not successfully demonstrated meaningful use. Visit the payment adjustment tipsheet for EPs.
ICE: Federal agencies warn against counterfeit decorative contact lenses
October 23, 2013 - With Halloween rapidly approaching, federal officials are warning the public about the dangers associated with counterfeit decorative contact lenses. Decorative and colored lenses are becoming increasingly popular, especially around this time of year. View complete ICE warning.
CMS: Updated Medicare Remit Easy Print (MREP) software now available for free download
October 21, 2013 - The latest edition of the Medicare Remit Easy Print (MREP) software to view and print the Health Insurance Portability and Accountability Act (HIPAA) compliant 835 for professional providers and suppliers is now available for free download. View annual enhancement details. Download updated MERP software.
Reminder: Practitioners must respond to returned Medicare claims within 45 days
October 17, 2013 - Health care practitioners who have claims denied or otherwise returned for additional information must respond within 45 days or those clams will be rejected. View complete reminder.
CMS: Medicare to correct improper ophthalmology code denials
September 19, 2013 - Medicare Administrative Contractors (MACs), as the result of a systems error, have been inappropriately denying claims when eye care services were reported using general ophthalmology service codes 92012 and 92014 with modifiers 24, 25, or 57, according to the U.S. Centers for Medicare & Medicaid Services (CMS). View complete CMS update (Scroll to page 5-6, Claims, Pricer, and Codes Updates).
FDA: Altaire Pharmaceuticals, Inc. Carboxymethylcellulose Sodium 0.5% Ophthalmic Solution recall
September 06, 2013 - Altaire Pharmaceuticals, Inc. issues voluntary nationwide recall of 9 lots of Carboxymethylcellulose Sodium 0.5% Ophthalmic Solution sold under several brands because the preservative may not be effective through expiry. View complete FDA recall.
FDA: NuVision Pharmacy sterile products alert
August 16, 2013 - The U.S. Food and Drug Administration is reminding health care providers about safety concerns with all sterile drug products made and distributed by NuVision Pharmacy of Dallas, Texas. View complete FDA alert.
FDA: Fluoroquinolone antibacterial drug label safety announcement
August 15, 2013 - The U.S. Food and Drug Administration (FDA) has required the drug labels and Medication Guides for all fluoroquinolone antibacterial drugs be updated to better describe the serious side effect of peripheral neuropathy. View complete FDA safety announcement.
FDA: Laser toy safety announcement
August 6, 2013 - When operated unsafely, or without certain controls, the highly-concentrated light from lasers—even those in toys—can be dangerous, causing serious eye injuries and even blindness. View complete FDA safety announcement.