Our Agenda is NOW POSTED for the 2012 FORUM!!!

Our annual event brought to you by the Colorado Rural Health Center and ClinicNET is just around the corner. Join us April 11th - 13th at the Sheraton Denver West in Lakewood, Colorado and participate in the numerous education, training and networking opportunities available to you. The agenda is now posted for this years exciting event - check it out and register today!! To register please visit our website or contact Courtnay Ryan at cr@coruralhealth.org. See you there!

AHRQ Announces Free TeamSTEPPS Training Opportunities

AHRQ is offering free trainings for Team Strategies and Tools to Enhance Performance and Patient Safety. To register for a training, please visit http://register.rcsreg.com/r2/hret2012/ga/clear.html.

AHRQ announces free training opportunities for TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), a set of evidence-based, practical tools that helps hospitals and other health care providers strengthen teamwork among caregivers with the goal of improving patient safety. AHRQ and the Department of Defense designed the TeamSTEPPS program specifically for health care providers for use in a variety of care settings.  Free TeamSTEPPS master trainer courses will be offered at six regional training centers throughout the country starting this month. The six regional training centers are NorthShore Long Island Jewish Health System (Roslyn Harbor, NY); Duke University (Durham, NC); Tulane University (New Orleans, LA); University of Minnesota (Minneapolis, MN); Presbyterian St. Luke’s (Denver, CO); and University of Washington (Seattle, WA). Many standard trainings are offered as well as four advanced, special topic trainings on simulation, interprofessional education, and teaching TeamSTEPPS to patients and families. These advanced trainings are designed for individuals who already have a strong background in TeamSTEPPS and an interest in the special topic. All materials, training, and enrollment in the online user support network is free.

To subscribe to email updates from AHRQ click the Subscriber Preferences Page.

Opportunity to Become a Grant Reviewer for Colorado Rural Health Care Grant Program

The Colorado Rural Health Grant Program is intended to support outpatient primary care. The grant applications are for projects that support the health infrastructure in rural Colorado. Infrastructure includes, but is not limited to: equipment, physical plant improvements, information technology, and staff training or education.

Eligibility to be a Reviewer
Individuals who are submitting an application for this grant program this year or who are employed by or on the board of directors of an applicant organization are not eligible to serve as reviewers. We are looking for both urban and rural reviewers. While reviewers will be assigned applications outside their geographic region, they are still expected to notify CRHC – prior to conducting their reviews – if they have a conflict of interest with any application assigned to them.

Time Commitment
Each reviewer will be assigned between five and ten applications, depending upon the number of applications received and the number of reviewers who volunteer. It is expected that each application will take approximately an hour to review and score. Participation as a reviewer will not require travel. Instructions, score sheets, and the assigned applications will be sent to reviewers electronically. Reviewers will then score the applications and return the score sheets electronically.

Reviewers will be sent their applications to review by March 23. Reviewers will have between March 23 and April 13 to complete their reviews.

Interested?
Please contact Shelly Collings at 720.248.2742, 800.851.6782, or sc@coruralhealth.org. You will need to submit the following information: Name (first, middle initial, and last), county, organization (if applicable), email address, and phone number(s).

Proposed Cuts to CAHs in President’s Budget

The President’s budget released this week includes proposed cuts to Critical Access Hospitals (CAHs). According to the budget, “Medicare makes a number of special payments to account for the unique challenges of delivering medical care to beneficiaries in rural areas. These payments continue to be important; however, in specific cases, the adjustments may be greater than necessary to ensure continued access to care.” The Administration proposes to reduce payments from 101 percent to 100 percent of reasonable costs, effective in 2013, and to eliminate the CAH designation for those that are fewer than 10 miles from the nearest hospital, effective in 2014. For more information, click here

Medication Adherence Is Important

To Those You Serve Prescription Resources Are Available
Nearly three out of four Americans report that they do not always take their medicine as directed. Some never fill their prescriptions or don’t follow the instructions – skipping doses or stopping the
medicine early. When people don’t adhere to their medications, especially if they suffer chronic conditions, serious health consequences and significant costs can result. For those without healthcare coverage, medication adherence is particularly challenging, and even more so in a tough economy.

Fortunately, resources are available that can help uninsured individuals save money on their prescriptions so they can manage chronic conditions and, in doing so, better manage overall healthcare costs.   

Together Rx Access®, a free program sponsored by many of the nation’s leading pharmaceutical companies, provides eligible individuals and families with immediate and meaningful savings on prescription products right at their neighborhood pharmacies.

Visit TogetherRxAccess.com to learn more. Additional information and other resources are also available to you in our Resources for Professionals.

Registration Deadline Approaching for First Time CAH Users of Hospital Compare

CAHs who will be reporting Outpatient measures to Hospital Compare for the first time as a result of participating in MBQIP will need to register with QualityNet in order to complete the Outpatient data reporting online participation pledge by March 31, 2012 in order to submit their data. This deadline also aligns with the Centers for Medicare & Medicaid Services Inpatient/Outpatient CAH quality reporting initiative. For information on registering for QualityNet or to sign the Outpatient pledge, contact Marcy Cameron at CFMC at MCameron@cfmc.org.

CRHC Regional CAH Workshops

Please join us for one of the Colorado Rural Health Center’s (CRHC) upcoming Annual Regional CAH Quality Improvement and Board Workshops. The Quality Improvement Workshops are geared towards CAH Quality Improvement Directors. The CAH Board Workshops are geared towards CAH Boards and CEOs. There is no charge for Colorado CAHs to attend. For more information and to register, click on the links below.
May 1, 2012– Location: Kit Carson County Memorial Hospital, Burlington, CO
CAH Quality Improvement Workshop – 9:00am-3:00pm
CAH Board Workshop – 4:00pm-7:30pm
May 3, 2012– Location: Rio Grande Hospital, Del Norte, CO
CAH Quality Improvement Workshop – 9:00am-3:00pm
CAH Board Workshop – 4:00pm-7:30pm
May 10, 2012– Location: Grand River Hospital and Medical Center, Rifle, CO
CAH Quality Improvement Workshop – 9:00am-3:00pm
CAH Board Workshop – 4:00pm-7:30pm

Rural Provider Opportunity to Let Your Voice be Heard!!

Do you have a family, internal medicine, pediatric or OB/GYN physician in your rural practice that enjoys public speaking, advocating for rural health and LOVES what they do? If so, please let them know we would be honored to host them at this year’s Practice Essentials program put on by COPIC and have them speak about their rural medicine experience. Practice Essentials is a daylong workshop for Colorado’s physician residents to prepare them for work and life after residency. This will be a wonderful opportunity for your providers to motivate residents to ‘go rural’ and give you a chance to plug your own practice’s physician openings. There will be four different dates beginning in April and ending in June. Please email us at cpr@coruralhealth.org for more information. All travel and meal costs will be reimbursed by the Colorado Rural Health Center.

Physical Therapist Assistants Certification

The applications for Certified Physical Therapist Assistant (PTA) are now available on the State Physical Therapy Board’s website at www.dora.state.co.us/physical-therapy. Applicants may now download, complete and submit their applications to the Divisions of Registrations. If you are a licensed Physical Therapist, please notify your Physical Therapist Assistants that have not yet signed up to receive notifications from the Board. Physical Therapist Assistants must be certified by the State Physical Therapy Board by June 1, 2012 in order to work as a PTA in Colorado.

National Medicare Training Program Webinar - Save the date!

When: Tuesday, February 21, 2012; 2:30-3:30 p.m. ET  
Join the Centers for Medicare & Medicaid Services (CMS) National Medicare Training Program (NMTP) monthly webinar. Get the most up-to-date program information for professionals and volunteers who work with seniors and people with disabilities. Topics include: Overview of Accountable Care Organizations, Million Hearts Initiative, 2012 Federal Poverty Levels and Dual Eligibility Standards, Preview of new Medicare Summary Notice.

Call-In Number: (800) 603-1774l; Conference ID: 38927535; Webinar: register here

All Medicare Provider and Supplier Payments To Be Made By Electronic Funds Transfer

Existing regulations at 42 CFR 424.510(e)(1)(2) require that at the time of enrollment, enrollment change request, or revalidation, providers and suppliers that expect to receive payment from Medicare for services provided must also agree to receive Medicare payments through electronic funds transfer (EFT). Section 1104 of the Affordable Care Act further expands Section 1862(a) of the Social Security Act by mandating federal payments to providers and suppliers only by electronic means. As part of CMS’s revalidation efforts, all suppliers and providers who are not currently receiving EFT payments are required to submit the CMS-588 EFT form with the Provider Enrollment Revalidation application, or at the time any change is being made to the provider enrollment record by the provider or supplier, or delegated official.

For more information about provider enrollment revalidation, review the Medicare Learning Network’s Special Edition Article #SE1126, titled “Further Details on the Revalidation of Provider Enrollment Information.”

Revised CMS Swing Bed Fact Sheet

As part of its Rural Health Fact Sheet Series, CMS recently issued a revised fact sheet on swing bed services. Hospitals or critical access hospitals (CAH) that have received approval from CMS to provide swing bed services may, as needed, use their beds to provide either acute or skilled nursing facility (SNF) level care. To access the fact sheet, click here.

CAHs Encouraged to Participate in MBQIP

The Federal Health Resources and Services Administration’s Office of Rural Health Policy (ORHP) recently kicked off a new CAH initiative, MBQIP, the Medicare Beneficiary Quality Improvement Project. With more national attention on quality and reporting, this initiative takes a proactive and visionary approach to ensure CAHs are well-equipped and prepared to measure and demonstrate quality. Through this program, CAHs agree to give ORHP access to the data their hospital is submitting to CMS. This data will be aggregated to benchmark, demonstrate improvements, share best practices, and to generate reports to aid CAHs and states in quality improvement activities. There is information about MBQIP in this YouTube video from HRSA’s Senior Health Policy Advisor, Paul Moore. To join MBQIP, contact jd@coruralhealth.org or mm@coruralhealth.org.

Version 5010 – Where Are We Now?

 

  

 

 

  

 

 

WHEN: March 6, 2012

TIME: Will vary by region

WHO: Hosted by your Centers for Medicare & Medicaid Services (CMS) Regional Office.

WHAT: Please join CMS staff for an informative webinar for healthcare providers, clearinghouses and vendors on Version 5010. 

 

Version 5010 refers to the standards that HIPAA-covered entities (health plans, health care clearinghouses, and certain health care providers) must use when electronically conducting certain health care administrative transactions, such as claims, remittance, eligibility, and claims status requests and responses.

All covered entities should have been fully compliant with Version 5010 by January 1, 2012.

 In this webinar, we’ll cover:

• Current conversion statistics
• Top 10 concerns impacting the 5010 transition
• Status of current Version 5010 Standard System Maintainer fixes
• Top 10 Version 5010 edits
• Medicaid update
• Resources and contact information

Stay tuned for further information on the time of your region’s session and registration information.

We look forward to seeing you there!

 

 

 

 

 

 

Free TeamSTEPPS Patient Safety Training

Hospitals and other health care providers can register online to attend free master trainer courses for TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), an evidence-based program being implemented nationally by the American Hospital Association's Health Research & Educational Trust under a three-year contract with the Agency for Healthcare Research and Quality. Standard and advanced training sessions are available through Sept. 1 at six regional training centers. For more information, contact the HRET National Implementation Team at AHRQTeamSTEPPS@aha.org or (312) 422-2609.

Commentary: Payment Cuts to Critical Access Hospitals 'Inevitable'

Commentary: Payment Cuts to Critical Access Hospitals 'Inevitable'
By: John Commins, for HealthLeaders Media, February 8, 2012
Many rural hospital leaders lack contingency plans for what one expert in healthcare strategy calls an inevitability—Medicare critical access funding cuts within the next three years.
More Analysis

Last Chance to Apply for Colorado Rural Health Care Grant Program!

There is still time to get your application in for the Colorado Rural Health Care Grant Program! Eligible projects support the rural health infrastructure and strengthen the capacity of rural entities to provide outpatient primary care services now and in the future. Organizations must be located outside of Colorado's urbanized areas and provide outpatient primary care services--including medical, oral, and mental health services. The maximum award amount is $50,000 per applicant. Completing an Intent to Apply form prior to the full application is highly recommended. Applications are due by Noon on Wednesday February 15th.


Important Application Dates
Applications Due: Noon February 15, 2012
Notification of Grant Awards: June 2012

More Information
Read more about this funding opportunity
Fill out an Intent to Apply form
Download the grant guidance
Download the application

130 - Charges Imposed by Immediate Relatives of the Patient or Members of the Patient’s Household

A. General
These are expenses that constitute charges by immediate relatives of the beneficiary or by members of their household. The intent of this exclusion is to bar Medicare payment for items and services that would ordinarily be furnished gratuitously because of the relationship of the beneficiary to the person imposing the charge. This exclusion applies to items and services rendered by providers to immediate relatives of the owner(s) of the provider. It also applies to services rendered by physicians to their immediate relatives and items furnished by suppliers to immediate relatives of the owner(s) of the supplier.

B. Immediate Relative
The following degrees of relationship are included within the definition of immediate relative.
Husband and wife;
Natural or adoptive parent, child, and sibling;
Stepparent, stepchild, stepbrother, and stepsister;
Father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, and sister-in-law;
Grandparent and grandchild; and
Spouse of grandparent and grandchild.

For more information and please see  Section 130

Job Posting for Billing Specialist

Billing Specialist: Full time billing specialist needed for established medical billing service located in Arvada, CO. 2-3 years experience with Rural Health Clinic, FQHC, and/or hospital billing required. CPC a plus but not required. Excellent benefits offered. Please email resume and 3 professional references to jh@rtwelter.com.

Upcoming CRHC CAH Webinars

Click on the links below for more information and to register.
Utilization Management for CAHs – February 28, 2012
CAH Swing Beds Part I – March 20, 2012
CAH Swing Beds Part II – April 3, 2012

QHi Benchmarking Tool – Back to Basics Webinar

The next Quality Health Indicators (QHi) Back to Basics Training Session is scheduled for Wednesday, February 22, 2:00-3:00 Central Time. During this session QHi will review the basics of using the system. Additionally, they will review new enhancements to the site and upcoming measure changes. QHi is a benchmarking tool geared towards CAHs and rural hospitals under 50 beds. All Colorado CAHs can participate in QHi at no cost. Over 200 hospitals in 14 states use the tool. For more information contact jd@coruralhealth.org.

Medicare System to Include ‘Rendering Provider’ Field to Allow Correct Physician NPI Reporting for PCIP for CAHs Reimbursed Under Optional Method

Change Request (CR) 7686 instructs Medicare contractors to implement a system update to include the “Rendering Provider” field to allow correct physician National Provider Identifier (NPI) reporting for the Primary Care Incentive Program (PCIP) for CAHs reimbursed under the optional method. Upon implementation of CR 7686, CAHs reimbursed under the optional method should use the 837I version 5010A2 “Rendering Provider” field (loop 2310D) instead of the “Other Operating Physician” field (loop 2310C). The “Rendering Provider” field on the 837I must be populated by the eligible primary care practitioner’s NPI for the primary care services to qualify for the incentive bonus. Providers should continue to use loop 2310C, as well as the information that is required in loop 2310B defined as “operating physician,” for purposes of PCIP reporting until implementation of CR 7686. Effective July 1, 2012, providers should begin using loop 2310D. For more information, click here.

OSHA Respiratory Protection Videos

The OSHA Respiratory Protection Videos web page includes nine short videos that cover key compliance points for the Respiratory Protection Standard, 1910.134. The free videos, while not specific to healthcare settings, allow safety officers and trainers to access sections of the standard that apply to general industry, including healthcare. There is also an OSHA video specific for healthcare workers available on the Department of Labor website here that covers elements of the standard listed above.

CAH Conditions of Participation

The updated version of CMS’ State Operations Manual Appendix W “Regulations and Interpretive Guidelines for CAHs” has been updated with the latest updates to the conditions of participation regarding credentialing and privileging for telemedicine, advance directives, as well as patient visitation rights. The updated language is listed in red throughout Appendix W. To access the updated Appendix W, click here.

Determining Eligibility for the Medicare HPSA Physician Bonus Payment

Physicians who may be eligible for the Medicare Health Professional Shortage Area (HPSA) bonus payment should be aware of the following information and educational resources regarding determining eligibility, in order to minimize errors during the post-payment review process.


Information on the HPSA bonus, including the list of zip codes eligible for automatic payment, can be found at on the CMS website  here.
Two MLN Matters articles are available which go into further detail:
“2012 Annual Update for the HPSA Bonus Payments” (MM7517): here and
“HPSA Bonus Payment Policy Reminders” (SE1202): here.
Websites to help determine existing designations and eligibility for the Medicare HPSA physician bonus include: HPSA Find  – to identify designations within a state,
FFIEC– to identify census tracts by entering an address, and
Data Warehouse HPSA– to see if an area is listed as being in an eligible area.

Multiple Procedure Payment Reduction for Physician Services for Certain Diagnostic Imaging Procedures in CAHs

CMS Change Request (CR) 7684 informs Medicare contractors about the changes necessary to implement Multiple Procedure Payment Reduction (MPPR) for physician services for certain diagnostic imaging procedures in CAHs that have elected the optional method for outpatient billing. Payment is made to the CAH for physician services (revenue code 096X, 097X or 098X) on Type of Bill (TOB) 85X based on the Medicare Physician Fee Schedule (MPFS) supplemental file. Additional information is available on the CMS website here.

CMS Rural Health Open Door Forum

The next CMS Rural Health Open Door Forum is scheduled for Tuesday, March 13, 2012 from 2:00pm-3:00pmET. To participate, dial 1-800-837-1935 Conference ID 27273952. The Rural Health ODF addresses RHC, CAH and FQHC issues, as well as some inclusion of other questions and concerns that occur in clinical practice pertaining to other CMS payment systems that also extend into these settings. For more information, click here

Register Now for the ICD 10 - Keys to Successful Transition Workshop near you

• February 22nd in Rifle, Colorado
• February 23rd in Yuma, Colorado
• March 27th in Alamosa, Colorado
• March 28th in Lamar, Colorado

To register, please click on the location nearest you! Your registration confirmation is your ticket to the workshop. For more information or for assistance with registration, please contact Courtnay Ryan at 303.309.6807 or cr@coruralhealth.org. See you there!

2012 Colorado Rural Credentialing Network – Register Today!

This peer learning network for rural hospitals and clinics offers educational webinars facilitated by a credentialing specialist, access to tools and resources, access to a credentialing specialist for your general credentialing questions, and group discounts on more in-depth credentialing consultations. Membership in the 2012 Credentialing Network is $250 for CRHC members and $375 for non-members. Webinars begin in February. For more information click here.

Utilization Management for CAHs – Webinar

February 28, 2012 11:00am-12:30pm
Join CRHC for this webinar on Utilization Management (UM) and Utilization Review (UR) for CAHs. All hospitals, including CAHs, must have a UM/UR Plan that describes the process used to review all services provided by the institution and by the members of the medical staff. In addition to assuring optimal healthcare delivery and positive patient outcomes, sound UM/UR practices are integral to achieving successful results during activities such as RAC audits. During this webinar, experts from the Joffit Group, will discuss the components involved in setting up an efficient UM/UR process and will review CRHC's Utilization Management Resource for Critical Access Hospitals: a concise, easy-to-use tool for hospital providers and staff that explains the role of UM/UR in various CAH settings including: Inpatient, Outpatient, Observation, and Swing Bed. This webinar is FREE for all CRHC-member Colorado CAHs; $79 for all non-member Colorado CAHs, and $99 for all others. For more information click here.

Register Now for the 2012 Forum - Essential Perspectives for the Safety Net Providers

Our annual event brought to you by the Colorado Rural Health Center and ClinicNET is just around the corner. Join us April 11th - 13th at the Sheraton Denver West in Lakewood, Colorado and participate in the numerous education, training and networking opportunities available to you. For more information on this event or to register please visit our website or contact Courtnay Ryan at cr@coruralhealth.org. See you there!

New Policy Brief from the Flex Monitoring Team: Relevant Quality Measures for CAHs

Dear Colleagues,

The Flex Monitoring Team is pleased to announce the release of a new Policy Brief on rural relevant quality measures for Critical Access Hospitals (CAHs). The purpose of this study is to provide rural health care providers and policymakers with an up-to-date set of relevant quality measures for CAHs.
Relevant Quality Measures for Critical Access Hospitals 

Key Findings:  
A comprehensive set of quality measures are relevant for Critical Access Hospitals (CAHs), including measures addressing appropriate care for inpatients with specific medical conditions, global measures addressing appropriate care across multiple medical conditions, and Emergency Department measures.
Although CAHs have low volumes of patients for some measures, the measures are relevant because they address serious conditions, are based on strong evidence, and reflect the standard of care that all hospitals should aim to provide for every patient.
Many relevant quality measures are now ready for reporting. Other measures need specifications to be finalized and/or a data reporting mechanism to be established; these could be reported starting in January 2013.
It would significantly reduce the reporting burden for CAHs if all entities involved in regulation, accreditation, and payment would agree to accept a single set of quality measures with common specifications. Implementation of a common set of CAH quality measures and a unified data reporting structure will require coordinated actions by multiple organizations.
To motivate improvement in the quality of careand help patients make informed decisions in selecting health care providers, all CAHs should publicly report on relevant quality measures.

For more information, contact Michelle Casey, mcasey@umn.edu

Update to the Primary Care Incentive Payment Program for Critical Access Hospital Providers Paid Under Optional Method

On Tue Nov 15, 2011, CMS issued a listserv message with billing instructions for Critical Access Hospitals (CAHs) paid under the Optional Method regarding the Primary Care Incentive Payment (PCIP) Program. The message instructed CAH providers to continue submitting their National Provider Identifiers (NPIs) using the “other provider” field located in loop 2310C on the current electronic claim format.

After further research, CMS has determined that, in addition to reporting the NPI in loop 2310C, CAH providers will need to report the same NPI as well as the information that is required in loop 2310B defined as “operating physician.” This will ensure CAH claims submitted using the Accredited Standards Committee (ASC X12) version 5010A2 will continue to receive their PCIP bonus without any interruption.

 Change Request 7686 has been created and will be implemented by contractors to update the Medicare systems to assign the PCIP bonus payments based on the NPI from loop 2310D, “rendering physician.” However, until the successful implementation of CR7686 – expected to take place in July – the reporting of the NPI for the PCIP bonus payments should continue as described above.