CMS Notices

Carter L. Alleman, J.D.

 

CDC Issues Action Alert on Vitamin K-Dependent Antagonist Coagulopathy

The Centers for Disease Control and Prevention (CDC) recently sent an action alert to help health care professionals address potentially life-threatening vitamin K-dependent antagonist coagulopathy in patients with a history of synthetic cannabinoid use. According to the CDC all high-risk patients, such as synthetic cannabinoid users, regardless of their presentation, should be screened for vitamin K-dependent antagonist coagulopathy by checking their coagulation profile (that is, international normalized ratio and prothrombin time). Trauma, general, orthopaedic, oral, and plastic surgeons; obstetrician-gynecologists; dentists, interventional cardiologists and radiologists; and nephrologists should be aware that patients with a history of synthetic cannabinoids use may be anti-coagulated without clinical signs of coagulopathy. These patients should be screened for vitamin K-dependent anti-coagulant coagulopathy before their procedure. Patients who are hemorrhaging should receive urgent treatment pending the results of their coagulation profile.

The CDC encourages providers to take the following actions:

  • Ask all patients about their history of illicit drug use and all high-risk patients should be screened for coagulopathy by checking their coagulation profile.
  • Maintain a high index of suspicion for vitamin K-dependent antagonist coagulopathy in patients with a history of synthetic cannabinoids use and who present with clinical signs of coagulopathy, bleeding unrelated to an injury, or bleeding without another explanation; or with complaints unrelated to bleeding (such as appendicitis) that may lead to a surgical procedure.
  • Check a coagulation profile on any high-risk patient prior to performing invasive/surgical procedures.
  • Be aware that patients with vitamin K-dependent antagonist coagulopathy associated with synthetic cannabinoids use may have friends or associates who have used the same synthetic cannabinoids product but are asymptomatic and unaware of their numerical coagulopathy.
  • Report possible cases of vitamin K-dependent antagonist coagulopathy associated with synthetic cannabinoids use to your local health department or your state health department, if your local health department is unavailable.
  • Contact your local Poison Information Center (1-800-222-1222) for questions on diagnostic testing and management of these patients.

Read the full action alert for more details.

CMS Releases 2018 MIPS Eligibility Tool

You can now use the updated CMS MIPS Participation Lookup Tool to check on your 2018 eligibility for the Merit-based Incentive Payment System (MIPS). 

Just enter your National Provider Identifier, or NPI, to find out whether you need to participate during the 2018 performance year.

Changes to Low-Volume Threshold

To reduce the burden on small practices, we’ve changed the eligibility threshold for 2018. Clinicians and groups are now excluded from MIPS if they:

  • Billed $90,000 or less in Medicare Part B allowed charges for covered professional services under the Physician Fee Schedule (PFS) 

OR

  • Furnished covered professional services under the PFS to 200 or fewer Medicare Part B -enrolled beneficiaries

This means that to be included in MIPS for the 2018 performance period you need to have billed more than $90,000 in Medicare Part B allowed charges for covered professional services under the PFS AND furnished covered professional services under the PFS to more than 200 Medicare Part B enrolled beneficiaries. 

Note: The 2018 Participation Lookup Tool Update for Alternative Payment Model (APM) participants will be updated at a later time.

Find Out Today

Find out whether you’re eligible for MIPS today. Prepare now to earn a positive payment adjustment in 2020 for your 2018 performance.

CMS WILL NOT BE MAILING ELIGIBILTY NOTICES FOR THE 2018 PERFORMANCE YEAR. YOU WILL NEED TO USE THE MIPS PARTICIPATION TOOL ONLINE TO CHECK YOUR ELIGIBILITY FOR 2018.

CMS Begins Implementation of the New Medicare Card Project

The Centers for Medicare & Medicaid Services (CMS) has begun mailing new Medicare cards to beneficiaries as of April 1. The cards include the new Medicare Beneficiary Identifier (MBI) that has replaced the Social Security Number-based Health Insurance Claim Number (HICN). The mailing is set to happen in waves based on states where beneficiaries reside; CMS has said that all old cards will be replaced by April 2019.

April 1 also marked the beginning of the 21-month transition period, set to end December 31, 2019, during which providers will be allowed to submit either an HICN or MBI when billing Medicare. After the 21-month transition period, CMS will not accept any claims that include HICNs, unless the claims meet the approved claim exceptions outlined by CMS. It is recommended that all providers who submit or receive Medicare transactions containing HICNs modify their processes and electronic systems to ensure readiness to accept MBIs by the start of the transition period.

More information about the New Medicare Card Project can be found on the CMS website.