Medicare Compliance & Reimbursement

CMS' Medicare manuals get a makeover - and they'll soon be online - only. 

Provider-specific Medicare manuals are going the way of the dodo - and health care organizations that don't want to do the same had better take notice.

The Centers for Medicare & Medicaid Services is phasing out provider-specific, paper-based manuals in favor of eight new Internet-only manuals grouped into functional areas, CMS explains in a Sept. 12 transmittal.

So instead of separate manuals for hospitals, skilled nursing facilities, home health agencies, etc., and for carriers and intermediaries, CMS now will have eight manuals that providers must look to for subject-specific information: Pub. 100-01-Medicare General Information, Pub. 100-02-Medicare Benefit Policy, Pub. 100-03-Medicare National Coverage, Pub. 100-04-Medicare Claims Processing, Pub. 100-05-Medicare Secondary Payer, Pub. 100-06-Medicare Financial Management, Pub. 100-08-Medicare Program Integrity, and Pub. 100-09-Medicare Contractor Beneficiary and Provider Communications.

But providers can't automatically switch to the new manuals, many of which are still under development. Instead, when CMS issues new information, it will update the Internet-only manuals and delete information from the paper-based manuals.

"We will continue this phase-out/phase-in process until all manual instructions are included in the CMS Manual System" (i.e., the Internet-only manuals), CMS says on its new manual Web site. "In the meantime, you should check both sets of manuals for current policy and procedures."

In addition to the manual changes, CMS will adjust how it distributes program instructions. Currently, it uses program memoranda to issue instructions to carriers and intermediaries. After Sept. 30, it will switch to using new "one-time notifications." It will also use manual revisions, "business requirements" and "confidential requirements" to communicate changes, CMS says in its notification.

Other Internet only manuals will include: Pub 100-10 - Medicare Quality Improvement Organization, Pub 100-07 - Medicare State Operations and Pub. 100-16 - Medicare Managed Care.

To see the CMS manual notification, go to http://cms.hhs.gov/manuals/pm_trans/R2OTN.pdf.