 |
| Medicare Part B Drugs Competitive Acquisition Program (CAP) - Reminder about CAP Claims Submission Deadlines and Unused CAP Drugs The following is a reminder about upcoming CAP deadlines. It is very important that participating CAP physicians understand and comply with these deadlines because failure to do so will affect physicians' ability to be reimbursed. CAP Drugs Administered during 2008CAP drug claims must be submitted on or before January 30, 2009. CAP drug claims and corresponding physicians' drug administration claims must have a date of service on or before December 31, 2008.CAP drugs that have not been administered by December 31, 2008 are the property of the Approved CAP Vendor.Do not submit CAP claims for dates of service after December 31, 2008 because they will be denied. CAP Drugs NOT Administered by December 31, 2008 CAP physicians must return any unused CAP drugs to the Approved CAP Vendor by February 28, 2009. CAP drugs are the property of the Approved CAP Vendor. Therefore, physicians who have not returned these drugs to the Approved CAP Vendor on or before February 28, 2009 will be liable for the cost of drugs. Please note that CAP physicians may contact the Approved CAP Vendor to discuss the option of purchasing unused CAP drugs. Emergency Restocking of CAP Drugs for Dates of Services on or before December 31, 2008 When permitted under the emergency restocking provision, physicians may submit a prescription order for a CAP drug to replace what they used from their own stock (the emergency restocking provision). Physicians may request replacement drugs ONLY if the date of service is on or before December 31, 2008, AND the corresponding drug administration claim has been submitted on or before January 30, 2009.Physicians must request replacement drugs by January 30, 2009.The Approved CAP Vendor will not send replacement products under the CAP emergency restocking provision (J2 modifier claims) after February 28, 2009.CAP physicians who have not submitted a prescription order and a request for replacement drugs under the emergency restocking provision as described above will not be able to bill Medicare under the ASP system for the CAP drugs that they administered on or before December 31, 2008 from their private stock. For more informationPhysicians who participated in the CAP during 2008 are encouraged to contact the Approved CAP Vendor and reconcile their inventories as soon as possible. Contact information for the Approved CAP Vendor, BioScrip, is available on their website at www.bioscrip.com. Additional information on the 2009 CAP Postponement is available on the Centers for Medicare and Medicaid Services website at: http://www.cms.hhs.gov/CompetitiveAcquisforBios/01_overview.asp Review of Negative Pressure Wound Therapy (NPWT) DevicesThe Centers for Medicare and Medicaid Services (CMS) has partnered with the Agency for Healthcare Research and Quality (AHRQ) to commission a review of Negative Pressure Wound Therapy (NPWT) devices. The purpose of this review is to provide information to CMS for consideration in Healthcare Common Procedure Coding System (HCPCS) coding decisions. Section 154(c) (3) of the Medicare Improvements for Patient and Providers Act of 2008 (MIPPA) calls for the Secretary of Health and Human Services to perform an evaluation of the HCPCS codes for NPWT devices. The HCPCS Level II coding system is a comprehensive, standardized system that classifies similar products that are medical in nature into categories for the purpose of efficient claims processing. Products are classified based on similarities in function and whether the products exhibit significant therapeutic distinctions from other products. This review will facilitate CMS' evaluation of HCPCS coding for NPWT by providing CMS with relevant studies and information for use in consideration of coding changes, as required by the MIPPA legislation. CMS will use this review in its assessment of whether existing HCPCS codes adequately represent the technology and comparative benefits of NPWT devices. This review is one of several that are being conducted for the AHRQ Technology Assessment Program. It will include a review of all available literature on the topic and a solicitation from all interested stakeholders including health care professionals, scientific researchers, wound care organizations, biotech industry, and the patient wound care community for studies and other compelling clinical evidence regarding clinical outcomes associated with NPWT devices. We are particularly interested in those well-conducted clinical trials that describe the comparative benefits of these devices. The solicitation for studies and evidence was made available to industry stakeholders on December 30, 2008, and requested stakeholders provide this information to AHRQ by February 06, 2009. Stakeholders who would like to provide information about studies or other compelling evidence related to comparative benefits and outcomes of NPWT devices should refer to http://www.ahrq.gov/clinic/ta/npwtrequest.htm. For the full HCPCS web page see http://www.cms.hhs.gov/medhcpcsgeninfo/ on the CMS website. |
| Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you! CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message. To unsubscribe/change profile: click here. |
Email list management powered by http://MailerMailer.com
Posts
