CMSRELEASESINITIAL GUIDANCEFORMEDICAREDRUGPRICENEGOTIATION

CMShas released information about the 27 Part B drugs and biological products with reduced coinsurance beginning April 1, 2023 under the Medicare Prescription Drug Inflation Rebate Program in the quarterly ASP public file:

Further information can also be found on the Medicare Part B Drug Average Sales Price webpage: Medicare Part B Drug Average Sales Price | CMS https://www.ngsmedicare.com/web/ngs/events?lob=96664&state=97244&rgion=93624

CorroHealt h rem inds our readers t hat Medicare Adm inist rat ive Cont ract or Nat ional Governm ent Services (NGS) has m any upcom ing t raining sessions, free of cost , for Part A and Part B providers.

Topics Available bet w een April 10 t o April 21, 2023:

Part A

- Submitting Revalidation via CMS-855A Paper Application for Pt A Providers

- Counseling to Prevent Tobacco Use

- Over-the-Counter COVID-19 Tests

- Let?s Chat About Provider Enrollment Revalidation

- PECOS: Manage Signatures and Additional Information Requests

- Let?s Chat about Medicare Secondary Payer for Part A Providers

Part B

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Part B Appeals, Clerical Error Reopenings, ADRs and Prior Auth Requests

- Submitting Revalidation via CMS-855I Paper Application for Pt B Providers

- Introduction to Medicare Part I and II

- End of the PHEand Billing Telehealth Services

- NCCI Edits

- How to Avoid Duplicate Claims

NGSalso offers computer-based training through its Medicare University portal. To access these sessions, you must register and create a login. Once logged in, registrars have access to hundreds of courses

According to an MLN Fact Sheet published in December, 2022, Medicare will require all 340(B) entities, including Critical Access Hospitals, which submit claims for separately payable Part B drugs and biologicals to report modifier ?JG?or ?TB?on claim lines for drugs acquired through the 340(B) discount program.

The MLN is available at the following website: www cms gov/files/document/mln4800856-medicare-part-b-inflation-rebate-guidance-use340b-modifier pdf