Alerts, recalls and updates

Now Available: 2013 Quality and Resource Use Reports
On September 30, CMS made 2013 Quality Resource Use Reports (QRURs) available to group practices and physician solo practitioners nationwide. View complete details.

Save the date: 2015 Third Party Conference and State Government Relations Committee meeting
November 24, 2014 - The 2015 State Legislative and Third Party National Conference and State Government Relations Committee meeting will be held October 22-25, 2015, at the Hyatt Regency in Denver, Colorado. Demonstrate your commitment to advocacy and advancing our profession by attending.

CMS Releases 2015 Physician Fee Schedule Final Rule
November 14, 2014 - On October 31, 2014, CMS issued the final rule that updates the payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2015. For more information about participating in PQRS in 2015, visit the CMS PQRS website.

CMS Announces Distribution of 2012 PQRS Supplemental Incentive Payments has Begun
November 14, 2014 - CMS is pleased to announce that the 2012 Physician Quality Reporting System (PQRS) Supplemental Incentives have begun to be distributed to eligible professionals who submitted data for the reporting period of January 1, 2012 through December 31, 2012 and met criteria for satisfactory reporting. View more information.

Open Payments data correction period begins
Open Payments data correction period began on September 15, 2014, and will last for a minimum of 15 days. Applicable manufacturers and group purchasing organizations have the opportunity to acknowledge and resolve disputes initiated by physicians and teaching hospitals. View complete details.

Final EHR rule
Revised Medicare regulations fail to adequately address the AOA's longtime request for more flexibility in electronic health record (EHR) programs. The AOA states the changes don't go far enough to assist most users of certified EHRs. View complete details.

New PQRS Remittance Advice Codes now effective

PQRS-eligible professionals participating in claims-based reporting this year will now have to use the updated Remittance Advice Remark Codes (RARCs) for PQRS claims-based reporting that went into effect on April 1, 2014. View complete details.

HHS finalizes Oct. 1, 2015 as the new compliance date

The U.S. Department of Health and Human Services issued a rule finalizing Oct. 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. View complete details.

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.