Wednesday, June 29, 2011

National Provider Call on “The ABCs of the Initial Preventive Physical Examination and Annual Wellness Visit”

Thu July 21, 1:30-3pm ETBeginning in 2005, Medicare covers an Initial Preventive Physical Examination (IPPE), commonly known as the "Welcome to Medicare" Visit (WMV); it is provided as a one-time service to newly-enrolled beneficiaries. The IPPE is an introduction to Medicare and covered benefits, with a focus on health promotion and disease detection. Beginning on Sat Jan 1, 2011, the Affordable Care Act allows for coverage of critical new benefits for people with Medicare, including the addition of a free Annual Wellness Visit (AWV). This expanded coverage allows physicians to provide Personalized Prevention Plan Services that consider both age-appropriate preventive services available to all Medicare beneficiaries and additional services that may be appropriate to the patient’s individual needs.
CMS will host a national provider call on “The ABCs of the Initial Preventive Physical Examination and Annual Wellness Visit.” Subject matter experts will discuss basic information about each benefit, when to perform these services, and coding and billing requirements; a question and answer session will follow the presentations. The target audience for this call includes Physicians, physician assistants, nurse practitioners, clinical nurse specialists, health educators, registered dietitians, nutrition professionals, medical billers and coders, and other interested healthcare professionals.
In order to receive the call-in information, you must register for the call. Registration will close at 1:30pm on Wed July 20 or when available space has been filled; no exceptions will be made, so please register early. For more details, including instructions on registering for the call, please visit here

Thanks to all who attended the HRSA Health IT and Quality Webinar last Friday

On Friday, June 24, 2011, HRSA Health IT and Quality hosted a webinar "Tips for the Safety Net Community on Using Health IT within a Patient Centered Medical Home" to provide technical assistance examples of how safety net providers can successfully use health IT in transforming a health center or rural health clinic into a Patient Centered Medical Home (PCMH). Amongst the 1392 participants was Colorado’s very own (Bill Bolt), CIO/Practice Administrator from the Spanish Peaks Regional Health Center, an RHC in Walsenburg, CO, was a presenter. He discussed the experience within his practice of becoming an NCQA recognized PCMH and how “meaningful use” facilitates a PCMH’s objectives.

To view this or other past webinars, or to register for upcoming webinars, please click here (this webinar will not be available until a few days from now):

Rural Telemed Program 'Literally a Life-Saver'

(HealthLeaders Media) Phoenix-based Banner Health is in the midst of rolling out a huge telemedicine program to every critical care hospital in its seven-state hospital system. This so-called eICU technology allows a team of off-site critical care nurses and physicians to remotely monitor ICU patients 24/7 as a backup to existing bedside caregivers. Read more in HealthLeaders Media by clicking here.

Tuesday, June 28, 2011

Facilitating Patient-Centered Medical Home Recognition

September 13-14  2011,  Denver, CO
Taught by the NCQA staff that developed the new standards, NCQA's Facilitating Patient-Centered Medical Home Recognition seminar will give you the tools to help your practice become a recognized patient-centered medical home. Program staff will be available to personally assist with questions participants may have regarding the application process, ISS tools, etc.

Join us for this exciting opportunity to network with colleagues, share ideas and learn new strategies for pursuing recognition. For more information and to register please click here  These seminars will fill quickly. Early registration is highly recommended.

Bill to prevent drug shortages introduced in House

Colorado Representative Diana DeGette (D) introduced legislation last week (H.R. 2245, Preserving Access to Life-Saving Medications Act of 2011) that would give the U.S. Food and Drug Administration (FDA) tools to better manage drug shortages and prevent them in the future. H.R. 2245 would also require drug makers to notify the FDA of any event that could cause a shortage. The FDA says that drug shortages have tripled in the last six years. Please contact Jen Dunn at jd@coruralhelath.org if your hospital, clinic, or community pharmacy is experiencing drug shortages or having difficulties locating appropriate substitutes

Monday, June 27, 2011

Medscape Modules are Available on the CMS EHR Incentive Programs

CMS is pleased to announce that through Medscape Education, you now have the opportunity to achieve CME credits by learning more about the Electronic Health Records (EHR) Incentive Programs.
On Medscape's EHR Learning Center website, leading physician experts in medical informatics provide information, resources, and tools to help providers determine eligibility for the EHR Incentive Programs, understand the requirements for participating, take steps to participate, and recognize the immediate benefits of participation and future consequences of not participating.
By completing the module From Meaningful Use to Meaningful Care, providers can earn CME credit while gaining a better understanding about the purpose of the EHR Incentive Programs, the stages of meaningful use, a timeline of key dates, and most importantly, how patients will benefit.
Providers can also use the Medscape Learning Center to determine their comprehension of the EHR Incentive Programs by taking the Participant Self Assessment: Medicare and Medicaid EHR Incentives: What Do You Know and Do You Know Enough? By completing the assessment, providers can help to shape the content of future CME activities to best address the educational and clinical performance gaps identified. In the next few weeks, new CME modules on meaningful use will be available. Look out for for a listserv message to announce these new learning resources. Want more information about the EHR Incentive Programs? Make sure to visit the EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs

HRSA Health IT and Quality Webinar



"Mobile Health Clinics: Opportunities and Challenges"
Friday, July 8, 2011 – 2:00-3:30 PM EDT This informational webinar will explore how mobile health clinic vans can be used to deliver cost-effective, preventive health care in an efficient way.
These clinics represent an innovative way to potentially reduce health care disparities by moving care settings closer to the homeless and other underserved populations who may not have access to transportation or other resources to obtain care. Mobile health clinics are typically located in self-contained motorized vehicles, and may either make regularly scheduled visits to specific locations or locations where marginalized potential patients congregate. Mobile health clinics may also facilitate preventive screenings and immunizations, as well as decrease the use of emergency departments.
Several factors should be considered when adopting mobile outreach services, such as performing a detailed needs analysis of the intended service population, the clinic’s perception of the problems, and the community’s cultural preferences and health beliefs.
Webinar presenters will share their experiences as mobile health care providers, as well as research findings on the scope and cost effectiveness of this care delivery model. The potential impact of mobile health clinics on avoided emergency room visits, disease prevention, and chronic disease management in the underserved will also be discussed. Presenters include:
Nancy E Oriol, M.D., Founder, The Family Van, Harvard Medical School
Anthony Vavasis, M.D., Clinical Director of Medical Services, Callen-Lorde Community Health Center
Sandy Ortiz, M.B.A., Program Director, S.H.O.W. Mobile Program, Southeast Missouri State University
Registration Link

NQF Releases Updated Serious Reportable Events

The National Quality Forum (NQF) Board has recently approved for endorsement a list of 29 serious reportable events in healthcare as outlined in the forthcoming report Serious Reportable Events in Healthcare–2011 Update: A Consensus Report. Of the events submitted, 25 were updated from their earlier endorsement in 2006, and 4 new events were added to the list:
Death or serious injury of a neonate associated with labor or delivery in a low-risk pregnancy
Patient death or serious injury resulting from the irretrievable loss of an irreplaceable biological specimen
Patient death or serious injury resulting from failure to follow up or communicate laboratory, pathology, or radiology test results
Death or serious injury of a patient or staff associated with the introduction of a metallic object into the MRI area.

The full list of events will be available for a 30-day public appeals process closing July 12, 2011. For more information, click here.

Friday, June 24, 2011

Plan, Do, Study, Act!!

Our program assists providers by teaching them the PDSA Cycle, which is used to test and implement changes for improvement.  For more inforamation on this service or for other services that the Colorado Rural Health Center can assist you with please visit our website or click here and view our resources page. 

Thursday, June 23, 2011

Agrisafe Webinar: Developing Instructional Designs to Educate Hispanic Agricultural Workers

June 23, 2011 12-1pm CDT
Presenter: Cesar Asuaje, Regional Specialized Extension Agent, Farm Labor Education/Pesticides and Farm Safety, Palm Beach County Extension Office, University of Florida. At the end of the webinar, participants will be able to:

1. Understand the occupational communication needs of Hispanic agricultural workers
2. Identify program design strategies to educate Hispanic agricultural workers
3. Understand the importance of program instructional design
4. Develop program evaluation indicators

To participate in the webinar, click here Enter your name in the guest login box and click on 'Enter Room'

Wednesday, June 22, 2011

AMA to reconsider support of requiring Americans to purchase health insurance

The AMA's House of Delegates is to vote in the coming days on whether to withdraw its support of the mandatory health insurance requirement in the Affordable Care Act. The resolution comes from three surgery groups, representing a minority of AMA physician members, that say the mandate will "likely undermine the innovations and improvements in health care financing that can evolve in a free market" and call for the AMA to support making health insurance an individual responsibility that can be aided by noncompulsory measures. Chicago Tribune (6/17)

Top 4 Obstacles to ACO formation

SAN DIEGO – Healthcare facility administrators and physicians report that the most serious obstacle they face in forming accountable care organizations (ACOs) is physician interest, according to a new survey.
The survey, conducted by AMN Healthcare, a healthcare staffing and workforce solutions organization, asked hospital executives and physicians about their participation in ACOs, and whether or not they think the model will deliver significant cost and quality benefits.
Fifty-eight percent of 882 administrators and physicians responding to the survey indicated their facilities are either in the process of forming ACOs or are considering doing so, while 42 percent said their facilities will not form ACOs in the foreseeable future.
Of those who are moving toward ACOs, 42 percent said physician alignment is the most serious obstacle to their efforts, followed by:
  • lack of capital (38 percent);
  • lack of integrated IT systems (31 percent);
  • and lack of evidence-based treatment protocol data (25 percent).
The survey found that of those who are not moving toward ACOs, 40 percent cited physician alignment as a reason they are not, followed by:
  • lack of capital (31 percent);
  • lack of integrated IT systems (26 percent);
  • and lack of evidence-based treatment protocol data (23 percent).

According to AMN Healthcare president and CEO Susan Salka, the survey underscores what is the central issue regarding both ACO formation and the industry-wide effort to enhance quality of care and reduce costs.
"While capital and data are essential to forming ACOs, the success of this emerging model turns on people," Salka said. "Health facility leaders and physicians must align their interests, communicate and cooperate for this model to work."
The survey further suggests that the majority of healthcare facility administrators and physicians still hold out hope that ACOs will deliver significant cost and quality benefits over time.
Fifty-nine percent of those surveyed either strongly agreed or somewhat agreed that ACOs will deliver benefits and that they are a key to enhancing quality and reducing costs. However, a significant minority (41 percent) either strongly disagreed or somewhat disagreed with that statement, the survey found.

CMS Proposes New Standards for Community Mental Health Centers

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that is designed to improve the quality and safety of treatment provided to Medicare beneficiaries who receive care at Community Mental Health Centers (CMHCs). The notice of proposed rulemaking would establish conditions of participation (CoPs) for CMHCs for the first time. The proposed rule includes health and safety standards for CMHCs that participate in the Medicare program. In particular, the proposed new conditions focus on a client-centered, outcome-oriented approach. CMS will accept public comments on the proposed rule until August 16, 2011. For more information and to access the proposed rule, click here.

Agricultural Medicine Training: Occupational and Environmental Health for Rural Health Professionals

Provides basic information and skills to enable the health care professional to function in the anticipation, diagnosis, treatment, and prevention of occupational illnesses and injuries in the farm community. Successful completion of this course allows participants to join AgriSafe® as a Provider Member. The target audience is: nurses, nurse practitioners, physicians, physician assistants, physical therapists, veterinarians, and other interested health care professionals. For more information, please click here

Tuesday, June 21, 2011

Health IT Workforce Development Opportunity

College of Nursing, University of Colorado Anschutz Medical Campus
The U.S. Department of Labor has identified Health IT as a high growth and emerging industry sector. A recent study from the University of California San Diego Extension listed Health IT as the number one career opportunity in 2010. As the nation moves toward a more technologically advanced health care system, providers are going to need highly skilled health IT experts to support them in the adoption and meaningful use of electronic health records. Health IT professionals are in demand, and there is estimated to be a shortage of as many as 200,000 Health IT workers by 2015.

This shortage is critical because it may impact organizations’ ability to demonstrate meaningful use of electronic health records and obtain the financial incentives promised. The Office of the National Coordinator (ONC) is trying to address this shortage by funding Health IT Workforce Development programs for both Community Colleges and Universities. These programs are graduating high-caliber health information technology professionals interested in supporting the growing and evolving health IT industry.

One of the most important workforce shortage needs to address is providing Health IT education to rural and medically underserved communities. The University of Colorado Denver has received a grant from the ONC to provide graduate-level Health IT education to 132 healthcare professionals. This grant covers the tuition and fees up to $10,000, which covers most of the costs for the student.

Rural and medically underserved communities are given first priority for this funding. This brochure and website provide more information about the program. Applications are being accepted until July 10, 2011, for fall admission. Please forward this information to anyone in your organization that might be interested in this opportunity. These funds will only be available until the positions are filled, which is anticipated to occur within the next 6 months. If you have questions about the program, please contact Donna DuLong, Colorado HITEC Program, at 303.724.5515 or send an email to HITEC@ucdenver.edu.

TrailBlazer Bank of America Accounts Closing

In August 2010, TrailBlazer changed from issuing Medicare payments from accounts with Bank of America/Merrill Lynch to JP Morgan Chase Bank. Providers were notified in July 2010 of this change to JP Morgan Chase Bank via TrailBlazer’s Web site. As a result of this banking transition, TrailBlazer is in the process of closing the former bank accounts at Bank of America, effective June 30, 2011. To minimize the impact of closing the bank accounts on providers’ cash flow, providers are encouraged to deposit any checks dated from June 20, 2010, through August 4, 2010, written on a TrailBlazer Bank of America account, before June 30, 2011. For more information, click here

Accepting Nominations for Rural Health Excellence Award

CRHC is now accepting nominations for the 2011 Rural Health Excellence Award. This prestigious award is given annually by Colorado Rural Health Center to honor those who have made a notable contribution to health, healthcare, or a healthcare delivery system in rural Colorado. For 2011, the award will be presented during the 20th Annual Colorado Rural Health Conference August 11-12th, at the Denver Tech Center Hyatt Regency.

To be eligible for the award, a candidate must have made a significant contribution to the health, healthcare, or a healthcare delivery system in a rural Colorado community, area, or region. Healthcare providers, board members, administrators, volunteers and others are eligible for nomination. Despite their enormous contributions, CRHC Board Members are not eligible for nomination while serving on the Board.

To nominate someone, simply complete the entry form. The 2011 deadline for entries is July 15, 2011.

Questions? Contact Nadine Gressett.

Monday, June 20, 2011

Doctors seek standardized patient records

(Reuters) - The country's largest physicians' group adopted policies on Tuesday calling for easier-to-use electronic patient records and better nutrition in prisons, but put off recommending a tax on sugary soft drinks.
Delegates to the American Medical Association, which has 216,000 members, considered resolutions ranging from urging advertisers to stop altering photographs of models to advocating for the standardization of computerized records.  Physicians reported having a hard time accessing information in the brave new world of Electronic Medical Record systems (EMRs), the group said, so it will lobby hospitals and health care systems to make changes.
"Standardized EMR interface designs will help physicians working at multiple facilities with different EMR systems better navigate and use EMRs to help their patients," said AMA board member Dr. Steven Stack.
The AMA also weighed in on menu planning for the nation's 2.3 million prison inmates, who it said could benefit from more nutritious foods to help avoid chronic diseases.  "Various challenges exist in providing affordable, palatable and low security-risk foods for inmates that will also meet their nutritive needs," said the AMA's Dr. Barbara McAneny.  The resolution recommended implementing dietary guidelines in prisons and jails.  Advertisers were reprimanded by the group for creating unrealistic body image expectations among impressionable children by altering photographs.  "In one image, a model's waist was slimmed so severely, her head appeared to be wider than her waist," said McAneny.  A resolution that would have the AMA lobby for a 1 cent per ounce tax on sugar-sweetened beverages -- aimed at lowering the 50 gallon per capita U.S. consumption of soft drinks -- was put off for further study

Kinship Care Brochure

 
The Colorado Department of Human Services has released a Kinship Care brochure outlining the resources available. Kinship caregivers include but are not limited to grandparents, aunts, uncles, siblings, and persons not related to the child/youth, but have a family-like relationship and provide care to them in a safe environment when their parents are unable to. The brochure describes the types of kinship care, basic requirements for families caring for a child/youth placed by a county department of human/social services, and services that may be available to the family.

If you would like copies of this brochure sent to your facility, please contact Jeannie Berzinskas, MSW, Non-Certified Kinship Care Program Administrator at 303.866.4617 or jeannie.berzinskas

Friday, June 17, 2011

Health People 2020 Community Innovations

A Bidders Conference will be held on Monday, June 27, 2011 ( see below for times and links to register)
We are pleased to announce a call for proposals for the Healthy People 2020 Community Innovations Project.  This project, administered by John Snow, Inc. (JSI) as part of a contract it has with the Office of Disease Prevention and Health Promotion (ODPHP), will fund non-profit, community-based organizations with budgets less than $750,000 to implement projects that address Healthy People 2020 overarching goals, topic areas and objectives and integrate at least one of the following Healthy People 2020 Community Innovation Project priorities: environmental justice, health equity, and healthy behaviors across all life stages. As many as 170 projects will be given between $5,000 to $10,000 to conduct projects between December 1, 2011 and May 31, 2012.

The deadline for submitting an application in response to this Request for Proposal (RFP) is Friday, August 5, 2011. More details are included in the attached Healthy People 2020 RFP, which is also available online  here
Eligible applicants in Eastern and Central time zones:  12:00 p.m. EDT/11:00 a.m. CDT 
Please  to register: click here
Dial: 1.877.223.6135; Conference I.D.: 628.55.112

Eligible applicants in Mountain and Pacific time zones:
12:00 p.m. MDT/11:00 a.m. PDT
Please  to register: click here
Dial: 1.877.223.6135; Conference I.D.: 705.32.378

Eligible applicants in Hawaii-Aleutian and Alaska time zones:
10:00 a.m. HAST/12:00 p.m. AKDT
Please  to register: click here
Dial: 1.877.223.6135; Conference I.D.: 705.32.501

During this one hour conference call and webinar, JSI and ODPHP will describe the Healthy People 2020 initiative, review the Healthy People 2020 Community Innovations Project Request for Proposal (RFP), and address any questions that bidders may have.   Thank you for your time. We hope you will work with your staff and partners to apply for this important funding opportunity.

CMS Seeks Comments on Quality Measures

CMS has contracted with Yale New Haven Health Services Corporation/Center for Outcomes Research and Evaluation (YNHHSC/CORE) to develop quality measures for the following:
 
  • 30-day all cause readmission following vascular procedures – comments due June 30
  • 30-day, all-cause mortality following hospitalization for acute exacerbation of COPD – comments due July 8
  • 30-day, all-cause readmission following hospitalization for acute exacerbation of COPD – comments due
July 8CMS is requesting stakeholder review and public comment of these measures currently under development. The measure specifications are outlined in the Measure Information Forms (MIFs) which are available at http://www.CMS.gov/MMS/17_CallforPublicComment.asp. The CMS public comment system, including links and instructions on comment submission, can be found at http://www.CMS.gov/MMS/17_CallforPublicComment.asp

CMS IPPE FAQ’s

CMS has recently posted new FAQs about the Medicare Initial Preventive Physical Exam (IPPE). To access the FAQ’s click here and search for IPPE.

Thursday, June 16, 2011

Feel like you're struggling day to day to keep your practice alive?

With the ever-changing healthcare environment, it is crucial to have up-to-date and accurate financial management strategies. We offer an array of support services from coding, operations and credentialing management to contract negotiations, start-up assistance, and a total access billing and revenue service. We offer rural practices an unparalleled level of experience, support, reporting, and client access to real-time data. We understand that cash flow is crucial and the life line of your practice and we are ready to assist you with strategies that ensure you the best chance at success and profitability.

We also offer regional and customized billing, coding and documentation workshops at your facility, or via teleconference or webinar. These educational activities are geared toward both clinicians and billing and coding staff, and provide comprehensive review and update of accurate billing, coding and documentation practices to assist rural facilities in maximizing reimbursement and assuring timely receipt of revenues from the patient encounter though claims submission and accounts receivable follow-up.

Don't forget to 'Save The Date' for our upcoming Billing & Coding Workshops and Webinars.  The are scheduled for September 13th, 14th, and 15th.  Please stay tuned for times and locations in your area.  For more information on our Financial Revenue Management program and other services or on these workshops please contact Courtnay Ryan at cr@coruralhealth.org

Wednesday, June 15, 2011

WIPFLI CAH and RHC Conference

September 20-22, 2011, Spokane, WA
Conference sessions include: Basic and advanced cost reporting, RHC documentation and billing, cost-based reimbursement strategies, hospital operational improvement, hospital/physician alignment, meaningful use/EHR, and strategic financial reporting. For more information on pricing and registration, click here.

Tuesday, June 14, 2011

Open for Applications: Outreach and Enrollment Grant Opportunity

Applications are due to the Department by June 27, 2011 at 3pm MST.
Does your organization plan to do outreach and enrollment for the newly eligible adults without dependent children?  If so, a new grant opportunity from the Department of Health Care Policy and Financing, called the MORE Grant is ready for applicants!  Applications are now online!

The MORE Grant funds community organizations who wish to maximize their outreach, retention, and enrollment activities for all the Medicaid expansion populations. To read more about this grant, go to our post about this.  If your organization has applied before and is interested in applying again, you can apply via the BIDS website.   If your organization is new to this application, please register your organization here first. If you are a political subdivision (e.g., county, city, school district, etc.), you will need to contact Lee Joseph first.

If you have any questions, please contact Cinda Terra with the Department at (cindi.terra@state.co.us). For more information about the grant program, please visit HCPF's website

DORA Regulatory Notice - State Board of Health - Ch.IV General Hospitals & Ch.IX Community

The Colorado Department of Public Health and Environment (CDPHE) has submitted a draft proposed rule or amendment to Chapter IV and Chapter IX. Specifically, the proposed amendments to Chapter IX - Community Clinics and Community Clinics and Emergency Centers: 1) authorize certain types of community clinics to become off-campus locations of a general hospital; 2) amend provisions regarding inpatient care; 3) exempt federally qualified health centers and rural health clinics from licensure requirements in accordance with state statute; 4) clarify services to be provided by community clinics and emergency centers; and 5) make technical changes including but not limited to updating obsolete references, changing terminology, and reorganizing provisions. The proposed amendments to Chapter IV - General Hospitals: 1) authorize community clinics added to the hospital license as off-campus locations to meet either "existing" or "new" occupancy requirements under the Life Safety Code; 2) exempt off-campus locations from plan review if added to the hospital license by a specified date; and 3) make conforming amendments to align with changes made in Chapters IV and IX regarding off-campus locations. The proposed amendments are available here under "Notices of Upcoming Public Rulemaking Hearings and Draft Proposed Rules" and may also be found by: clicking here. A hearing on the proposed amendment is set for Wednesday, August 17, 2011 at 10:00 am at CDPHE, Bldg. A, Sabin-Cleere Conference Room, 4300 Cherry Creek Drive, South, Denver CO 80246. For more information, contact Lorraine Dixon-Jones, Policy Analyst at 303-692-2889 at CDPHE. To provide feedback on the proposed amendment, please email opr@dora.state.co.us before July 24, 2011.

Monday, June 13, 2011

Should Mobile Health Apps Be Regulated By FDA?

With the growing popularity of tablets and smartphones--and the explosion of E-health record products for clinicians and patients--we're seeing lots of useful, innovative mobile health tools hit the market. Will the threat of increased fedetal regulation stifle this rush of innovation? That's a question a lot of developers are probably asking themselves as they hear the latest news from the FDA.   Until fairly recently, most mobile health apps have been geared to consumers, including those who want handy access to information online about a health topic of interest--or to track details about their own health and wellness. But a growing number of mobile health apps are also aimed at patients with chronic conditions, measuring parameters like blood glucose, blood pressure, and the like.   These readings are often compiled for the consumer's own informal tracking, but sometimes they're shared with doctors or other clinical third parties.
Increasingly sophisticated applications allow the data to be transmitted to clinicians for more intensive monitoring. Such monitoring allows caregivers to provide invaluable preventative advice when a patient is showing early signs of trouble.   As these apps become increasingly more sophisticated--some can send data to patients' health records or help clinicians make diagnoses or treatment decisions--experts worry that some devices and applications may do more harm than good, especially if they don't meet basic standards of reliability, safety, and security.  These considerations have prompted the Food and Drug Administration to take a closer look at mobile health devices and applications. To date, the FDA hasn't gotten too deep into making rules or enforcing regulations as they relate to mobile health app development. But that's likely to change soon

CAH Optional Method Election for Outpatient Services: CMS MLN Article

Prior to a change made in the Fiscal Year (FY) 2011 Inpatient Prospective Payment System (IPPS) final rule, if a CAH chose to be paid under the optional method (Method II), it was required to make that election on an annual basis. However, the FY 2011 IPPS final rule changed the regulations for electing and/or terminating participation in Method II. This Medicare Learning Network article explains those changes. To access the article, click here.

Friday, June 10, 2011

Materials from the AAPC-CMS ICD-10 Code-a-thon Have Been Posted to the ICD-10 Website

If you weren't able to join us for the AAPC-CMS ICD-10 Code-a-thon held on April 26, 2011, or if you just want a closer look at all the materials from the presentation, they are now available on the CMS website in the Latest News section.

Posted materials include:
Presentations from AAPC and CMS on ICD-10 and Version 5010
A transcript and audio of the presentations given during the webinar

These materials should be helpful in getting informed and learning about the transitions to Version 5010 and ICD-10. Feel free to share this information with colleagues, staff, or anyone interested in learning more about these important transitions.

Keep Up to Date on Version 5010 and ICD-10.

Please visit www.cms.gov/icd10 for the latest news and resources to help you prepare!

Thursday, June 9, 2011

Need help with your CMS Enrollment or Change of Ownership forms?

The process to obtain enrollment in Medicare or change enrollment status can be time consuming and frustrating. We will coordinate and facilitate enrollment with all state and federal forms including Centers for Medicare and Medicaid ( CMS) Form 855A for prospective RHC's and CMS Form 29 for existing RHC change of ownership needs. Return submissions of the CMS Form 855A is included.  For more information on these services and how the Colorado Rural Health Center can assist you with these processes please contact Courtnay Ryan @ cr@coruralhealth.org  or by phone 303.309.6807. 

Nearly 70,000 Americans die needlessly each year because they are not given optimal heart failure therapy

Nearly 70,000 Americans die each year because they do not receive optimal therapy as called for in guidelines promoted by national health authorities, researchers said Monday. Physicians have been slow to implement many of the procedures called for in the guidelines, according to the first national study of adherence to the treatment goals, the team reported in the June edition of the American Heart Journal.

Dr. Gregg D. Fonarow of UCLA's Geffen School of Medicine and his colleagues studied six evidence-based therapies for heart failure, using data from clinical trials, in-patient and out-patient registries for heart failure patients, quality-of-care studies and other published sources. To read more about their findings, click here.

Patient Self-Management Tools: COPD, Diabetes, Heart Failure

The latest issue of AHRQ’s Innovations Exchange includes links to several quality tools including Patient Self-Care Workbooks from the TMF Health Quality Institute to assist clinicians with patient self-management education for patients with COPD, Diabetes, or Heart Failure. For more information, click here.

Important 5010/D.0 Implementation Items

Versions 5010 & D.0 FAQs are now available online! Click here to get your questions answered.

Trading partners should make it a priority to test early during calendar year 2011 with their Medicare Administrative Contractors (MACs) for the implementation of versions 5010 and D.0 transactions so as not to impact future Medicare claim processing. Do you know what you need to have in place to test with your MAC? Find out here.

HIPAA version 5010 has new Erratas for the certain transactions. Compliance with the Errata must be achieved by the original regulation compliance date of January 1, 2012. View the transactions affected by the Errata version online here.

CMS, in conjunction with the Medicare FFS Program, announces two National 5010 Testing Days to be held June 15 and August 24, 2011. National 5010 Testing Days are an opportunity for trading partners to come together and test compliance efforts that are already underway with the added benefit of real-time help desk support and direct and immediate access to MACs.

Click here to find out more about testing readiness and upcoming events.

TrailBlazer Rural Health Ask-the-Contractor Teleconference

Date: July 13, 2011
Time: 11:00-12:00pm CST

ACTs provide a forum for providers to ask TrailBlazer specific questions concerning Medicare billing policies and procedures, identify provider issues and share information. TrailBlazer is conducting a Rural Health ACT to discuss agenda items received from providers, Medicare updates and enhancements to the TrailBlazer Web site specific to CAHs, FQHCs and RHCs. For more information and to register, click here.

TrailBlazer eBulletin – May 2011

The TrailBlazer eBulletin – May 2011 is now available on the TrailBlazer Newsletters Web page. The TrailBlazer eBulletins are posted monthly to ensure providers are kept abreast of national and local policies, program updates, new initiatives and significant changes to the Medicare program. For more information, click here.

QHi Benchmarking Tool - Back to Basics Webinar

Date: July 13, 2011
Time: 1:00-2:00pm MST

Quality Health Indicators (QHi) is a benchmarking tool geared towards CAHs and rural hospitals under 50 beds. QHi will hold its next Back to Basics Webinar on July 13. This webinar will provide a program overview and walk through the basics of using the system. QHi is available to all Colorado CAHs at no charge. For more information, contact Jen Dunn at jd@coruralhealth.org.

Tuesday, June 7, 2011

Application by the Joint Commission for Continued Deeming Authority for CAHs

CMS has posted a notice informing the public of the Joint Commissions application for continued recognition as a national accrediting organization for CAHs that wish to participate in the Medicare or Medicaid programs. CMS is accepting public comments about the Joint Commission’s application until 5 p.m. on June 13, 2011. To access the notice, click here.

CMS special open door forum: The Pioneer ACO model: A review of the application

The Centers for Medicare & Medicaid Services will host a special open door forum on the request for applications for the Pioneer Accountable Care Organization model released on May 17.  The RFA, application and other background materials are available on the Innovation Center web site.

Following the presentation, participants will be able to ask questions of the CMS subject matter experts.
Participation instructions:
Dial: 1-866-501-5502
Conference ID: 70961782

Monday, June 6, 2011

Top 10 Tips for Helping Patients Get Disability Benefits

Hospitals today have an extremely diverse patient populations, especially when it comes to disabilities. Case managers, social workers and other patient advocates must navigate an increasingly complex system to determine if a patient’s condition is severe enough – or will become severe enough – to qualify for Social Security Disability Insurance (SSDI) benefits. You rarely have ample time or information to properly assess their condition before discharge. Too often, that same patient will return months or even years later to be readmitted – this time without health insurance, unable to pay for his or her treatment.
This scenario often can be avoided if healthcare professionals encourage patients to consider applying for SSDI benefits. Congress created the SSDI program in 1956 to protect Americans who became disabled and could no longer work. SSDI beneficiaries become eligible for Medicare after a waiting period, so even though they are out of work and still sick, they receive medical coverage.
The challenge now facing the SSDI system is that the population of Americans with disabilities is growing rapidly, in part due to the aging baby boomers, putting enormous strain on workers who review claims and make benefit determinations. Many applicants wait months or even years to find out if they qualify.

That’s why disability representatives are working to raise awareness of the challenges involved in successfully filing for federal disability benefits. My organization, Allsup, helps individuals get through the disability review process more quickly so they can receive income and come a step closer to Medicare eligibility. We work with hospitals and healthcare facilities to support their patients, without contracts and at no cost to their organizations. We also offer continuing education to healthcare providers, again at no cost, to equip patient advocates with the information their patients need to determine if their condition is eligible for benefits.

Healthcare professionals often are the first people patients turn to for advice. As a result, we have developed a list of top 10 tips that we encourage you to share:

1. Determine eligibility. Claimants must have been disabled before reaching full retirement age (65-67) and meet the Social Security Administration's definition of disabled, which generally means being unable to work due to a medically determinable mental or physical impairment expected to result in death or last for at least 12 months. Applicants must have worked and paid into the program for five of the last 10 years.

2. File immediately. If an initial claim is denied, the wait for an appeals hearing now takes an average of 371 days. There is no time to lose.

3. Obtain doctor's agreement. Claimants need written medical confirmation of their qualifying conditions when they apply. Otherwise, they may face delays.

4. Get help. Filing for disability benefits is a complicated process akin to preparing a difficult income tax return. The earlier applicants seek help, the more support they have to put them on the right track.

5. Prepare an accurate medical record. A comprehensive factual record is required to prove your disability.

6. Establish work history. Compile records of dates and tenure of previous employment. Individuals must have worked five of the previous 10 years to qualify for benefits.

7. Meet deadlines. If benefits are denied at any stage, claimants have only 60 days to file an appeal. If the deadline is missed, the process starts over from the beginning.

8. Reduce spending. The long wait for benefits means that people lose their savings, cars and sometimes homes. Cut out unnecessary spending as quickly as possible and prepare for the long haul.

9. Maintain health insurance. There will be a temptation to cut spending on insurance, but even after individuals begin receiving disability benefits there is a two-year waiting period for Medicare eligibility.

Don't give up. The Social Security Administration denies more than 60 percent of all initial applications, but two-thirds of the people who appeal eventually will receive their benefits.

Accountable Care Collaborative

All seven Regional Care Collaborative Organizations‟ contracts have been awarded and program implementation has begun. This map illustrates the RCCOs and their corresponding counties. The Department sent enrollment letters to 521 Medicaid clients in Weld County (RCCO 2- Colorado Access) in April notifying them of their enrollment in the ACC program effective May 1. Only five clients chose to opt-out of the program.
For a June start date, the Department sent letters to approximately 4,000 more clients living in Northeast Colorado (RCCO 2- Colorado Access); approximately 5,000 thousand clients on the Western Slope and in Larimer County (RCCO 1- Rocky Mountain Health Plan); and approximately 5,900 clients in Southern Colorado, including Pueblo, Huerfano and Las Animas Counties (RCCO 4- Integrated Community Health Partners).

If you would like more information, please contact Sarah Roberts at sarah.roberts@state.co.us

Friday, June 3, 2011

Advancing Health in Rural America

Monday, June 13, 2011 | 9:00 – 11:30 a.m. ET
An AARP Solutions Forum in Collaboration with the National Rural Health Association and the Robert Wood Johnson Foundation focusing on how can we improve health care in rural America, where a shortage of providers limits access to primary and preventive services, reduces consumer choice and can raise costs?

Join policy experts, thought leaders and key stakeholders to examine important opportunities to improve rural health found in the recommendations of the recent Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health.

We will discuss problems facing rural health care, highlight cutting-edge rural health models that are making a difference, explore state and national nursing-based solutions, and discuss policy implications for state and federal policymakers.
Click here to register to attend in person. or Click here to register for the live webcast.

Important new Update on Remittance Advice from CMS

CMS has identified an institutional remittance advice problem where claim adjustment reason code A7 is being used to explain adjustments where other appropriate codes that better explain the adjustments are available. Be assured that we are working to resolve this problem and we will inform providers when this issue has been resolved. We regret any inconvenience this issue may have caused.

For more information on Remittance Advice, please contact your local Medicare Administrative Contractor (MAC). A Provider Call Center Toll-Free Numbers Directory can be found by clicking here, in the ‘Downloads’ section of the webpage.

Provider Payment Delay Update from the Department of Health Care Policy and Financing

The proposed provider payment delay was not in the FY 2010-11 budget and was not in the FY 2011-12 budget. There will not be payment delays this fiscal year and they are not planned for the next fiscal year beginning July 1, 2011. There is always a possibility of changes in the budget based on the economy.

For more information, please contact Joanne Lindsay at joanne.lindsay@state.co.us.

Thursday, June 2, 2011

Author in the Room Teleconference coming soon!!

June 15 Author in the Room® Teleconference Join the Institute for Healthcare Improvement (IHI) and The Journal of the American Medical Association (JAMA) on Wednesday, June 15, 2011, from 2:00 to 3:00 PM Eastern Time for the Author in the Room® teleconference. The topic for this call is the JAMA article:

Finances in the Older Patient With Cognitive Impairment:
“He Didn't Want Me to Take Over”

by Dr. Eric Widera

Many patients with cognitive impairment and their families seek guidance from their primary care clinician for help with financial impairment, yet most clinicians do not understand their role or know how to help. Dr. Widera will discuss his JAMA article on the role of the primary care clinician in educating older adult patients and their families about the need for advance financial planning, recognizing signs of possible impaired financial capacity, assessing financial impairments in cognitively impaired adults, recommending interventions to help patients maintain financial independence, and knowing when and to whom to make medical and legal referrals.

To help launch this unique collaboration between IHI and JAMA, former IHI President and CEO Don Berwick, MD, MPP, and JAMA Editor Catherine D. DeAngelis, MD, MPH, co-authored a JAMA editorial.
Enrollment
There is no fee for this innovative initiative but enrollment is required. Enrollment grants you one telephone connection and unlimited participation at your site. Please note there are limited lines available for this call so early enrollment is encouraged.
A free audio recording of the call will be posted to the "Archive" tab of the program web pages after the call.

Enroll now for the June 15 "Author in the Room®" call.

Reminder: CCPD Review Committee Vacancies - June 7 Deadline!!!

The Cancer, Cardiovascular Disease and Pulmonary Disease (CCPD) Grant Program, on behalf of the Colorado Board of Health, is currently seeking applicants for four (4) positions on the statutorily-mandated grant program Review Committee (“Review Committee”):

1) Cardiovascular disease professional
2) Cancer professional
3) Recognized expert in health disparities
4) Public health professional

The Review Committee is a 16-member advisory committee created by legislation (C.R.S. 25-20.5-303) to oversee program strategies, review grant applications and make funding recommendations to the Colorado Board of Health for a competitive grants program established with a portion of the state’s tobacco excise tax revenue. The purpose is to fund competitive grants that provide a cohesive approach to cancer, cardiovascular disease and chronic pulmonary disease prevention, early detection and treatment in Colorado.
The Review Committee is a working advisory board that meets monthly. Meetings are held on the second Friday of each month, from 12:30 to 4:30 p.m. and are open to the public. Additional time is required during the grant review process between January and April of each year. In addition, ad hoc committee assignments related to major components of the program may be needed during the term of office. A committee Chair and Co-Chair, responsible for setting agendas and working with state health department staff, are elected by the committee members. Members serve without compensation but will be reimbursed for travel expenses.

All those interested in becoming a member of the Review Committee must submit 1) a signed application form, 2) current resume, and a 3) statement of interest (why the applicant would like to serve on this committee), by Tuesday, June 7, 2011. The term of office for new appointments will be a full three-year term, from August 1, 2011 – July 31, 2014.

The application form and more information about the Review Committee are available for review if you click here

Wednesday, June 1, 2011

Please join us for this interactive Web Forum on Community Transformation Grants

Monday, June 6, 201111:30 a.m. to 1:00 p.m. Pacific Daylight Time
2:30 p.m. to 4:00 p.m. Eastern Daylight Time

Putting the “Transformation” in Community Transformation Grants: Building Momentum for Equity and Prevention
Please join us for this interactive Web Forum:

Click here to register

New Information Regarding Medicare Enrollment for Providers

Medicare Enrollment Guidelines for Ordering/Referring Providers Fact Sheet – This new publication is now available in downloadable format. It is designed to provide education on the Medicare enrollment requirements for eligible ordering/referring providers, and includes information on the three basic requirements for ordering and referring and who may order and refer for Medicare Part A home health agency, Part B and DMEPOS beneficiary services.

Medicare Shared Savings Program and Rural Providers Fact Sheet – View, print or download this new fact sheet that is designed to provide education on how the Medicare Shared Savings Program (as proposed in the Notice of Proposed Rulemaking) impacts rural providers.
The following fact sheets are now available in print format from the MLN General Information Web page by scrolling to Related Links Inside CMS and selecting MLN Product Ordering Page:

Clinical Laboratory Fee Schedule (revised February 2011) – Designed to provide education on the
Clinical Laboratory Fee Schedule including background information, coverage of clinical laboratory services and how payment rates are set.

Ambulance Fee Schedule (March 2011) – Designed to provide education on the Ambulance Fee Schedule including background, ambulance providers and suppliers, ambulance services payments and how payment rates are set.