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Physicians, Nurses and Allied Health Professionals Open Door Forum

**Updated January 7, 2009- Special Open Door Forum: PECOS date & time changed to Tuesday, January 13, 2009 from 3:30pm-5pmET. The participation information has not changed (see the Special Open Door Forum web page). Date changed as not to conflict with the Physicians Quality Reporting Initiative (PQRI) National Provider Call on January 14, 2009.

**Updated January 5, 2009- Medicare Billing Information for Rural Providers, Suppliers, and Physicians

The publication titled Medicare Billing Information for Rural Providers, Suppliers, and Physicians (revised October 2008), which consists of charts that provide Medicare billing information for Rural Health Clinics, Federally Qualified Health Centers, Skilled Nursing Facilities, Home Health Agencies, Critical Access Hospitals, and Swing Beds, is now available in print format from the Medicare Learning Network. To place your order, visit the Medicare Learning Network Ordering page. The link is provided in the "Related Links Inside CMS" section below.

**Updated December 31, 2008-

January 8, 2009- Special Open Door Forum: DMEPOS Accreditation. Please see the Special Open Door Forum page under the Downloads section for participation information. 

**Updated December 19, 2008: January 13th ODF participation information, PQRI Program updates.

 

The next Physicians, Nurses, and Allied Health Professionals Open Door Forum (ODF) is Tuesday, January 13, 2009 from 2pm-3pmET. Please see the Downloads section for the participation information.

The Physicians, Nurses, and Allied Health Professionals Open Door Forum addresses the concerns and issues of Medicare and Medicaid physicians, non-physician practitioners, nurses, and other allied health care specialists. This diverse group of providers serves Medicare and Medicaid beneficiaries in almost all service settings, ranging from independent physician offices to specialized departments within larger facilities. The types of issues that come up during this forum are as varied as the providers who participate, but some frequent topics include the Physician Fee Schedule, Stark regulations, care plan oversight, payment and documentation rules, Provider Enrollment Chain Ownership System (PECOS), as well as the roles and responsibilities of different allied health professional staff under CMS regulations. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the forums.

***2009 Physician Quality Reporting Initiative Program Updates*** 

2009 Physician Quality Reporting Initiative Measure Specifications is Now Available

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the release of the detailed specifications for the 2009 Physician Quality Reporting Initiative (PQRI) measures and the 2009 PQRI measures groups.  The following resources have been posted to the PQRI webpage on the CMS website:    

*2009 PQRI Quality Measure Specifications Manual and Release Notes- Contains the detailed specifications (including codes and reporting instructions) for the153 2009 PQRI quality measures for claims or registry-based reporting and a summary of the changes from the 2008 PQRI Measure Specifications (in the form of release notes delineated by measure number). 

*2009 PQRI Implementation Guide - Provides guidance about how to implement 2009 PQRI claims-based reporting of measures to facilitate satisfactory reporting of quality data codes by eligible professionals for the 2009 PQRI.

*2009 PQRI Measures Group Specifications Manual and Release Notes- Contains the detailed specifications and instructions for the seven(7) 2009 PQRI measures groups and a summary of the changes from the 2008 PQRI Measures Groups Specifications (in the form of release notes). 

*Getting Started with 2009 PQRI Reporting of Measures Groups - Provides guidance about implementing the 2009 PQRI measures groups.

To access the 2009 PQRI Quality Measure Specifications Manual and Release Notes, the 2009 PQRI Implementation Guide, the 2009 PQRI Measures Group Specifications Manual and Release Notes, or the Getting Started with 2009 PQRI Reporting of Measures Groups, visit the PQRI webpage and click on Measures/Codes on the left. Once on the Measure/Codes page, scroll down to the "Downloads" section and click on the appropriate link.

Please note that the 2009 PQRI quality measure specifications for any given quality measure may be different from specifications for the same quality measure used in 2008. Therefore, specifications for all 2009 PQRI quality measures, whether or not included in the 2008 PQRI program, must be obtained from the 2009 PQRI Quality Measure Specifications Manual. 

In addition, measures groups specifications are different from the specifications for individually reported measures that form the group.  Therefore, the specifications and reporting instructions for the 2009 PQRI measures groups must be obtained from the 2009 PQRI Measures Group Specifications Manual. 

Reporting for the 2009 PQRI begins January 1, 2009. Please note there is no need to sign up or pre-register in order to participate.

New Section Page on the Physician Quality Reporting Initiative Web Page

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce a new section page on the Physician Quality Reporting Initiative web page. The "Spotlight" section page can be accessed on PQRI web page (see Related Links Inside CMS for PQRI link) and click on the Spotlight tab.The "Spotlight" page is updated frequently and was created to alert eligible professionals to the newest program information available on the PQRI web page.

Detailed information on the 2009 PQRI may be found in the 2009 Medicare Physician Fee Schedule final rule with comment period (73 FR 69817 through 69847) that was published in the Federal Register on November 19, 2008.  The final rule with comment period can be found in the "Related Links Outside of CMS" section of the Physician Quality Reporting Initiative website. 

Reporting for the 2009 PQRI begins January 1, 2009. Please note there is no need to sign up or pre-register in order to participate.

 

Downloads

January 13, 2009- Physicians, Nurses & Allied Health Professionals (PDF, 26KB)

Carrier/FI Directory (PDF, 338KB)

Quality Improvement Organization Program's 9th Scope of Work (pdf, 24KB)
Related Links Inside CMS

Physicians Open Door Forum Mailing List Sign-Up

CMS Physician Center

Physician Quality Reporting Initiative (PQRI)

Physicians Regulatory Issues Team (PRIT)

Medicare Learn Network (MLN) Product Ordering Page

Details for Post Acute Care Payment Reform Demonstration (PAC-PRD)

Health Care Consumer Initiatives

Therapy Services Overview

Skilled Nursing Facilities Consolidated Billing Information

Medicare Prevention Benefits
Related Links Outside CMSExternal Linking Policy

Government Printing Office Federal Register

September 19, 2007- Care Giver Broadcast Archive

CMS Internet Streaming

 

 

Page Last Modified: 01/07/2009 2:23:16 PM
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