On Nov. 19, 2012, Novitas Solutions took over as the new Texas Medicare Administrative Contractor (MAC) for fee-for-service (FFS). The MAC is the entity that is responsible for paying FFS claims and determining local coverage decisions. Novitas Solutions, Inc., is owned by BlueCross/BlueShield of Florida. For a letter from the Novitas Project Manager introducing Novitas Solutions
Novitas Solutions created a Web page called Jurisdiction H (JH) Transition (JH is our CMS region) so that physicians can prepare for the changeover.
For JH Transition-Frequently Asked Questions
Important information you and your staff need to know
-- It is imperative that any information (mail, email, and fax) that comes to you from Novitas Solutions be treated as priority and be reviewed as soon as possible. Please be sure to advise all your office staff members.
-- Texas physicians received a letter around July 27 from Novitas Solutions requesting that they complete a new Electronic Funds Transfer (EFT) CMS-588 EFT Authorization Agreement. Please read this letter carefully for instructions for completing and returning the EFT agreement. Failure to complete and submit the EFT agreement may result in a delay or interruption of your Medicare payments.
NEWS - PHYSICIAN IMPACTS & TRANSITION
Novitas provides news, updates, webinars, podcasts, educational events, and informationthat will have an impact on Part B Texas physicians.
For FAQs - General
To subscribe to Novitas' JH Transition E-Mail List
To subscribe to Novitas' JH Transition Podcasts
For the Novitas JH Transition Newsletter of November 2012new
For the Novitas JH Transition Newsletter of October 15, 2012
For the Novitas JH Transition Newsletter of September 24, 2012
EDI - ELECTRONIC BILLING & DATA INTERCHANGE
Novitas also provides EDI information, technical support, training tools, and anwers to frequently asked questions concerning EDI for Part B Texas physicians. For FAQs - EDI-related
When calling Novitas concerning the request for a new Electronic Funds Transfer (EFT) Authorization Agreement (version 05/10), be sure to follow the prompts for Provider Enrollment to eliminate unnecessary transfers and to get you to a Provider Enrollment representative that can assist with your EFT Agreement questions. Follow these prompts prior to cutover:
-- Call 1-855-252-8782
-- Part B Providers: Say "Part B' or press 4 from the main menu
-- Say "Other" when prompted to select your state
-- Say "Provider Enrollment" or press 4
For connectivity and boarding opportunities, login ID information, other technical support, please refer to the Novitas Electronic Billing/EDI Web page.
ENROLLMENT - PHYSICIANS & PROVIDERS
Novitas answers frequently asked questions (FAQs) on physician enrollment concerns.
POLICY - LOCAL COVERAGE DETERMINATIONS (LCDs)
Novitas also answers frequently asked questions (FAQs) on issues involving their policy, including local coverage determinations (LCDs).
- Recent News:
-- New Local Coverage Determinations (LCDs) - Novitas has posted the new LCD policies and a crosswalk chart showing the difference between the current TrailBlazer LCDs and the new Novitas LCDs. If your practice has comments/concerns on any of these LCDs, please advise HCMS on the specifics. HCMS will then advocate on your behalf by communicating with Novitas and also sharing your concerns with the Texas Medical Association (TMA).
---JH Local Coverage Determinations (LCDs) That Will Not be Implemented- Issued 08/09/20012
As part of the JH transition activities, Novitas Solutions has become aware that there is some inconsistency between certain Local Coverage Determinations (LCDs) that were not previously analyzed side by side.
As a result, the following LCDs will NOT be implemented:
----L32759, Neurophysiological Studies
----L32713, Paravertebral Facet Nerve Denervation
----L32746, Renal Angiography
----L32724, EPO/Darbepoetin Alfa- Preoperative
----L32725, EPO/Darbepoetin Alfa For Treatment Of Anemia Associated With AZT Therapy
The above LCDs have been removed from the Novitas LCD Web page and are in-process of removal from the Medicare Coverage Database (MCD). Novitas has also removed reference to these LCDs in the JH LCD/Outgoing Contractor Comparison Crosswalks on the JH Transition webpage.
HCMS Educating Members on the Transition
The Harris County Medical Society (HCMS) has been keeping our members advised as the transition unfolds. Be sure to check this Web page and the HCMS Physician Newsletter for updates. HCMS also is holding an educational campaign throughout the summer and fall to prepare our members for the transition.
HCMS Physician Newsletter articles:
-- Novitas is coming to town - HCMS Physician Newsletter, Nov 1, 2012 issue
-- What's new with Medicare? - HCMS Physician Newsletter, Oct 15, 2012 issue
-- Only 24 days left for MAC transition - HCMS Physician Newsletter, Oct 15, 2012 issue
-- STAT Medicare Alert! - HCMS Physician Newsletter, Oct 1, 2012 issue
-- Big change for Medicare claims - HCMS Physician Newsletter, Sept 15, 2012 issue
-- Big change in Nov for Medicare claims administration - HCMS Physician Newsletter, Sept 1, 2012 issue
-- Did you get mail from Novitas Solutions? - HCMS Physician Newsletter, August 15, 2012 issue
-- TrailBlazer out! Novitas Solutions in! - HCMS Physician Newsletter, July 15, 2012 issue
-- Big change in Medicare for Texas - HCMS Physician Newsletter, June 15, 2012 issue
-- TrailBlazer loses contract with Medicare - HCMS Physician Newsletter, March 15, 2012 issue
If you have any questions about the JH transition, please email the HCMS Payment Advocacy Department at email@example.com.
The Texas Medical Association (TMA) and US congressional members from states affected by this change have expressed concern to CMS about the move from TrailBlazer to Novitas and its impact on physicians who care for Medicare patients. Several issues have been raised including physicians having to complete new electronic funds transfer (EFT) agreements and using a new electronic claims filing system. In response to a letter from US Rep. Michael Burgess, MD (R-Texas), CMS Acting Administrator Marilyn Tavenner assured him that CMS is working with Novitas and TrailBlazer to ensure the change does not disrupt services to physicians.
TMA also is working closely with Novitas to make sure Texas physicians are kept informed and have the information they need to make a smooth transition. For more information, please refer to the TMA Novitas Web page.