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November 25, 2020

MLN Connects® for Wednesday, November 25, 2020

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Hospital Price Transparency Webcast on 12/8

News

  • CMS Announces Historic Changes to Physician Self-Referral Regulations
  • Policy Will Increase Number of Lifesaving Organs by Holding OPAs Accountable through Transparency and Competition
  • Prescription Drug Payment Model to Put American Patients First
  • DMEPOS Competitive Bidding Program: Contract Suppliers for Round 2021
  • Quality Payment Program APMs: Extended Deadline to Update Billing information – December 13
  • Clinical Laboratory Fee Schedule: CY 2021 Final Payment Determinations
  • Hospice Quality Reporting Program: November Refresh
  • November is Home Care & Hospice Month
  • World AIDS Day is December 1

Compliance

  • Polysomnography Services: Bill Correctly

Claims, Pricers & Codes

  • Medicare Diabetes Prevention Program: Valid Claims

Events

  • Long-Term Services and Supports Open Door Forum – December 1
  • Hospital Price Transparency Webcast – December 8
  • Interoperability and Patient Access Final Rule Call – December 9

MLN Matters® Articles

  • Changes to the End-Stage Renal Disease (ESRD) PRICER to Accept the New Outpatient Provider Specific File Supplemental Wage Index Fields, the Network Reduction Calculation and New Value Code for Time on Machine
  • Claim Status Category and Claim Status Codes Update
  • Implementation of Two (2) New NUBC Condition Codes. Condition Code "90", "Service provided as Part of an Expanded Access Approval (EA)" and Condition Code "91", "Service Provided as Part of an Emergency Use Authorization (EUA)"
  • Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE
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