Volume 10 | October 2018

JOIN OUR WEBINAR: MEDICARE AND MEDICARE ADVANTAGE 101 REIMBURSEMENT PROCESS CHANGES FOR OUT-OF-NETWORK SERVICES CHANGES TO THE HIGHMARK DRUG FORMULARIES

Advocacy Update 10 ways the new opioids bill could help address the epidemic Congress passes bill expanding access for opioid-use disorder treatment and prevention, and authorizes outpatient treatment alternative payment model. How Medicaid expansion has improved care access, outcomes Find out how the Affordable Care Act Medicaid expansion has increased insurance coverage and led to better access to care and patient outcomes.

The 2018 Appalachian Addiction & Prescription Drug Abuse Conference was held at the Embassy Suites in Charleston, WV, October 18-20. Over 300 participants attended from a wide range of disciplines (physicians, social workers, psychologists, lawyers, pharmacists, dentists, and more). The conference speakers,  supporters and exhibitors bring together the best of the best. We wish to thank everyone who participated.    HAVE YOU SEEN THE PHOTOS?

Upcoming Part A Educational Events

Home Health Referrals and Clinical Documentation Requirements Webinar: November 28, 2018 Your Part A/B, Home Health Railroad MACs are excited to announce this webinar collaboration. If you order home health services, this webinar is a great way to assure you are aware of physician roles and Medicare’s coverage criteria! Quarterly Updates Webcast: December 12, 2018 Palmetto GBA will host the Medicare Administrative Contractor Part A Quarterly Updates, Changes and Reminders Webcast at 10 a.m. to 11 a.m. ET on Wednesday, December 12, 2018 Physician's Corner The Physician's Corner is specifically designed for the benefit of physicians and practioners who prescribe DMEPOS items for Medicare beneficiaries. Included in this section is important physician-based information pertinent to both the physician and the supplier that provides the items and services to your patient.     READ MORE

MS-DRG Changes for 2019: New, Deleted and Revised

For discharges occurring on or after October 1, 2018, the MCE selects the proper internal code edit tables based on discharge date. Note that the MCE version continues to match the Grouper version. CMS increased the number of MS-DRGs from 754 to 761 for FY 2019. CMS is implementing 18 new MSDRGs for FY 2019 and deleting 11 MS-DRGs.       READ MORE

INFLUENZA VACCINE INFORMATION 2018-2019 Influenza (Flu) Resources for Health Care Professionals

Provider Types Affected All health care professionals who order, refer, or provide flu vaccines and vaccine administration to Medicare beneficiaries and submit bills for these services to Medicare Administrative Contractors (MACs).       READ MORE ___________________________ Contact Information for Palmetto GBA Part A    READ MORE ___________________________ Updating Calendar Year (CY) 2019 Medicare Diabetes Prevention Program (MDPP) Payment Rates    READ MORE

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