Thursday, October 31, 2013

CMS Stakeholder & Partner Education Series Webinar

Remember to join us for the November 5, 2013
CMS Stakeholder & Partner Education Series Webinar 

The CMS Stakeholder & Partner Education Series monthly webinar will be held on Tuesday, November 5, 2013 from 2:30 – 3:30 pm ET.

This month we’ll feature an overview of the 2014 Medicare premiums, and updates on the Plan Finder tool, Medicare Open Enrollment, and 1-800-MEDICARE.

To participate in the webinar please join both the audio and webinar portion of the meeting.

Audio: Please dial: 1- 800-603-1774, conference ID: 69736004
Webinar: https://webinar.cms.hhs.gov/edseriesnov2013/

LTC Culture Change to Reduce Hospitalizations Using Person-Centered Care Webinar

LTC Culture Change to Reduce Hospitalizations Using Person-Centered Care 

Webinar: November 14th, 12:00-1:00 MT
Hosted by the Colorado Health Care Association

Hospitalizations can be a detriment to long-term care residents, impacting their quality of life and resulting in earlier mortality, immobility, or cognitive decline. Assisted living must think about addressing both acute and chronic care while remaining a social model. Now is the time to seek out partnerships with other providers to provide distance monitoring to support the care provided in assisted living so residents can be cared for and not unnecessarily transferred to the hospital. These interventions can be person-centered and individualized.

Learning Objectives:
  • Understand the importance of safely reducing hospital readmissions. 
  • Learn about how the tools from the INTERACT™ program, POLST, and others can be used in continuing education. 
  • Examine attitudes and individual beliefs about caring for the elderly and the impact these have on culture change 

Click Here for Free Registration

ICD-10 Back to School: Create a Project Plan

With less than a year to go, you should be getting ready now for the October 1, 2014 transition to ICD-10. You can help guide your practice through a smooth transition with a project plan that maps out your practice’s ICD-10 prep from start to finish.

Your project plan should identify each task to be completed, when tasks should begin and end, and who should be responsible for each task. At a minimum, your organization should consider the following activities:
  • Ensure senior leadership understands the breadth and significance of the ICD-10 change. Download free ICD-10 fact sheets and background information from the CMS website and share trade publication articles on the transition. 
  • Assign overall responsibility and decision-making authority for managing the transition. This can be one person or a committee depending on the size of the organization. 
  • Plan a comprehensive and realistic budget. This should include costs such as software upgrades and training needs. 
  • Ensure involvement and commitment of all internal and external stakeholders. Contact vendors, physicians, affiliated hospitals, clearinghouses, and others to determine their plans for ICD-10 transition. 
  • Take advantage of free webinars and implementation materials. 
  • Share best practices with peers. 
  • Schedule software/hardware testing. 
  • Review internal policies to support the transition. 
  • Adhere to a well-defined timeline. 

Here are some tasks that should be included in the project plan.
  • Identify commonly used ICD-9 codes and begin to explore related ICD-10 codes. 
  • Identify and update paper and electronic forms to accommodate the ICD-10 code structure. 
  • Schedule ICD-10 training for clinicians, office managers, billers, coders, and other key staff. 

For more information, check out the resources on implementation planning on the Provider Resources page of the CMS ICD-10 website.

WEDI ICD-10 Status Survey
The Workgroup for Electronic Data Interchange (WEDI) is currently hosting their October ICD-10 Status Survey. The survey will assess the ICD-10 readiness of vendors, clearinghouses, health plans, and providers. If you fall into one of these categories, your participation will help CMS and industry update the progress of the ICD-10 transition. The survey closes on Friday, November 1.

Want more information about ICD-10?
Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, deadline. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.

CREATE Tip of the Week - Reimbursement

Required Supporting Documentation for Reimbursement Submittal

You received a CREATE grant, completed your course and now you’re ready to submit for reimbursement. To ensure that your reimbursement is granted and the process is smooth, be sure to include the required supporting documentation in addition to the CREATE Reimbursement Forms.

Your reimbursement will not be processed without the appropriate, required documentation. The required documentation includes:

  • Receipts for all expenses. The CREATE grant does not pay off of invoices or verbal agreements. The receipt must have a date, list a balance and show that the balance was paid off.
  • Maps from Google or MapQuest that show mileage. The mileage shown on the maps is used as the basis for mileage reimbursed. Without the map CREATE cannot grant reimbursement for mileage.
  • Accommodations (Housing/Hotels) Be sure to include the hotel receipt in your documentation, NOT the hotel invoice. Your receipt must include the dates of your stay and show that you paid off the balance.
As stated in the Grant Guidelines, you cannot make purchases before you receive confirmation of the approval of your grant. Your reimbursement will be denied. This includes, but is not limited to, the purchasing of books, class supplies, paying any deposits (accommodations, car and equipment rental, etc.).

The best way to ensure a speedy and smooth reimbursement process is to start collecting the supporting documentation that you received for the course and additional expenses associated with the course from the day your CREATE grant is approved. By collecting these documents from the beginning, you can avoid a last minute scramble to recover them.

If there are questions about supporting documents, or if an entity needs assistance in supplying replacement documents, please contact Lakesha Jones, Grant Manger, at lj@couralhealth.org. For more information on CREATE, visit our web page at http://coruralhealth.org/programs/create/.



CMS Open Payments Sunshine Rule Webinar

CMS Regions 5, 6, 7 & 8 Webinar on 
Open Payments Sunshine Rule 

The Centers for Medicare & Medicaid Services (CMS) invites you to attend the Open Payments Sunshine Rule Webinar on Wednesday, November 20, 2013, from 12 Noon until 1 PM Central Time.

The webinar will include an overview of the Physician Payments Sunshine Rule. Section 6002 of the Affordable Care Act requires the establishment of a transparency program, now known as Open Payments. The program increases public awareness of financial relationships between drug and device manufacturers and certain health care providers.

This call is intended for association/medical society staff, physicians, practitioners, and practice managers located in CMS Regions 5, 6, 7 & 8. Associations/medical societies are encouraged to invite member providers.

CMS Speaker: Louisa Carey, CMS. Presentation will be followed by questions and answers.

Below is the dial-in telephone number and link to webinar.
Webinar Link (URL): https://webinar.cms.hhs.gov/r05-8openpayment/
Dial-In: 1-877-267-1577; Meeting ID Number: 997 589 431

This meeting does not require a password.



Wednesday, October 30, 2013

PEAK Campaign and FAQs

PEAK Campaign

Beginning in mid-October, the Department of Health Care Policy and Financing launched a targeted marketing campaign for PEAK. The campaign includes English and Spanish radio spots, billboards and online media. Keep your eyes and ears open for the advertisements through November. If you have specific questions regarding the campaign please contact Raina.Paisley@state.co.us.

Applicants and community partners can now find additional guidance on the PEAK application at Colorado.gov/Health. On the Colorado.gov/Health FAQ page, you can find answers to your general application questions as well as question and answers specific to the online PEAK application. The FAQs can also be accessed directly from the PEAK site by clicking on Quick Links, then Client FAQs. We will continue to add to these FAQs as well as others about health care reform regularly, so check back often.



Tuesday, October 29, 2013

Medicare Program: Conditions of Participation (CoPs) for Community Mental Health Centers

This final rule establishes, for the first time, conditions of participation (CoPs) that community mental health centers (CMHCs) must meet in order to participate in the Medicare program. These CoPs focus on the care provided to the client, establish requirements for staff and provider operations, and encourage clients to participate in their care plan and treatment. The new CoPs enable CMS to survey CMHCs for compliance with health and safety requirements.

For more information, click here

Medicare Open Enrollment Begins

Medicare Open Enrollment is underway and will continue through December 7! CMS would appreciate your help in making the Medicare beneficiaries you assist aware of some of important information for this year’s open enrollment.

Please consider sharing the attached information with your members. You could:
  • post on your website, 
  • include as a drop-in-article in a publication, 
  • insert into an upcoming newsletter, or 
  • share with your affiliates/chapters that work directly with beneficiaries. 
Additional information about Medicare’s open enrollment period is available at the Medicare Open Enrollment Center at http://www.cms.gov/Center/Special-Topic/Open-Enrollment-Center.html. Promotional materials including posters, conference cards and stickers also are available from the product ordering site at http://productordering.cms.hhs.gov.

A message from the Center for Medicare & Medicaid Services

CMS Opens Public Comment on Influenza Immunization

The Centers for Medicare and Medicaid Services (CMS) has contracted for the retooling of NQF #1659, Influenza Immunization, as an electronic clinical quality measure (eCQM), to be derived from electronic health record data. Abt Associates, in collaboration with the Oklahoma Foundation for Medical Quality (OFMQ), are the measure developers leading the retooling of NQF 1659, Influenza Immunization.

The measure has been specified using the Measure Authoring Tool (MAT). Abt is requesting stakeholder review and public comment on the draft specifications. This email serves as a call for public comment on these specifications. The 30-day public comment period will begin October 25, 2013 and end November 25, 2013.

All comments are welcome, but we are particularly interested in feedback in the following areas:
  • Representation of the legacy measure constructs in the logic
  • Value sets
  • Implementation considerations
There are three sets of files included in this posting for public comment, which include:

  • The Measure Information Form (MIF), which outlines the specifications for the NQF-endorsed legacy measure
    • The eCQM Health Quality Measures Format (HQMF) MAT generated artifacts:
    • An XML Stylesheet for Transformation (XSLT): The XSLT file allows the eCQM XML file to open directly in a web browser. When opened this way, the eMeasure XML file displays in the same human-readable format as the eMeasure human-readable HTML file. 
    • An XML file: An XML document (.xml) based on the HQMF. Its major components include a Header and a Body. The Header identifies and classifies the document and provides important metadata about the measure. The HQMF Body contains eMeasure sections, e.g., data criteria, population criteria, and supplemental data elements. 
    • A SimpleXML file: The SimpleXML extension allows easier manipulation and use of the XML data
    • The “Human Readable” Rendition: A HyperText Markup Language (HTML) file (.html) that displays the eCQM content in a human‐readable format directly in a web browser. This file does not include the underlying HQMF syntax. 
    • An Excel spreadsheet listing all value sets for the measure
  • A “Read Me” file with additional information about the value sets

Comments will be logged through Jira. If you do not have a Jira account please utilize the link below to register http://jira.oncprojectracking.org/secure/Signup!default.jspa

Questions and comments regarding the specifications may be submitted through Jira between October 25 – November 25th at: http://jira.oncprojectracking.org/browse/PCQM

Lastly, please use the following link to access the public comment system where you may access the documents described above and find additional instructions on comment submission: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/CallforPublicComment.html.

Please contact Sara Galantowicz (CMS_Hospital_eMeasures@abtassoc.com or 617-520-2510) should you have any questions.

Earn CEUs for the IHI Global Trigger Tool White Paper

You can now receive continuing education units (CEUs) for the IHI Global Trigger Tool White Paper.

The IHI Global Trigger Tool for Measuring Adverse Events is an invaluable tool that can help you better understand when a patient suffers harm, what the harm was, and what the rate of harm is over time.

Click the image to start the free lesson and get step-by-step instructions for using the tool:


CEU_IHIGlobalTriggerToolWhitePaper2009-(1)-1

Monday, October 28, 2013

ORHP ACA Office Hours and Updates

ORHP ACA Office Hours
Wednesday, October 30, 2013
3-4 pm Eastern
Call-in Number: (800) 857-3749
Passcode: ORHPACA
Adobe Connect Session: https://hrsa.connectsolutions.com/orh1/

ACA Updates 
  1. Americans will have an extra six weeks to buy health care coverage: Due to all the website glitches, the White House announced that individuals can sign up for coverage up until the last day of enrollment (March 31) before incurring any penalty.
  2. Paper applications: Serco, the contractor processing paper applications, reported that application rates are up and there is minimal backlog. The address to which consumers should send paper applications is:
Health Insurance Marketplace
Dept. of Health and Human Services
465 Industrial Blvd.
London, KY 40750-0001

The first few steps to enrolling in the Marketplace are to create an account, fill out and submit an application, and receive your eligibility notice. As the Administration continues to improve HealthCare.gov, consumers can still fill out applications over the phone, on paper, and in-person. Once consumers receive their eligibility notice, they can go online to compare plans and enroll. We also encourage you to keep trying on HealthCare.gov, as more people are getting through each day. We appreciate your patience and the work that you are doing.

Please also note that an incomplete paper application will slow down the eligibility determination process, as Serco will have to follow up with each applicant and complete the missing information. We encourage Navigators and CACs to take an extra moment with applicants to ensure that all applications are complete prior to submission. A list of the most common mistakes Serco is seeing on the paper application is below.

HCPF's ACA Implementation News

The latest issue of the Department of Health Care Policy and Financing’s ACA Implementation News is now available online here. Please feel free to forward this along to your colleagues that may find the content of interest.

If you would to sign up to receive ACA Implementation News or our ACA Communication Updates please click here.

Friday, October 25, 2013

Medicaid Resources for Parents

Beginning in January 2014, more Coloradans may qualify for Medicaid or for new financial assistance to help buy health care coverage through Connect for Health Colorado. We know that most of those newly eligible Medicaid will be parents and adults without children. The Department of Health Care Policy and Financing has developed a brochure to help Coloradans learn about their options as well as a flyer that can help get the attention of parents who may be newly eligible in January for Medicaid.

Medicaid brochure (English) (Spanish)
Parent flyer (English) (Spanish)

Help us get the word out about the changes in health insurance coverage options in Colorado by using the materials available for download at Colorado.gov/HCPF/ACAResources.

Drop-in article for your publications or website:


Thursday, October 24, 2013

Lean Six Sigma - Three Part Webinar Series

CRHC has partnered with SigmaMed Solutions to present a three part webinar series about Lean Six Sigma. In this three part webinar series SigmaMed Solutions will present they keys to a highly successful LSS roll-out in a rural CAH and demonstrate the use of several LSS tools that participants may immediately take back to their work to make rapid improvements. In this training, participants will gain a solid understanding of how the LSS methodology may help them more effectively initiate and manage improvement projects and an idea of how to begin the process at their institution in an affordable and highly effective manner. The format will be highly interactive and participants will be asked to complete activities that are then discussed with the audience to enable them to learn from each other and leave the training with an action list of possible projects.


Part one - 11/5/2013 
12:00-13:00 
Overview and Results in Rural Hospitals and Clinics Click Here to register 

Part two - 11/12/2013 
12:00-13:00 
Project Selection and Definition Click Here to register 

Part three - 11/19/2013 
12:00-13:00 
Lean Tools and DMAIC Project Management Click Here to register

Synagis and Influenza Vaccine provider bulletin

Please click on the link below to go to the Synagis® and Influenza Vaccine provider bulletin.
Synagis® and Influenza Vaccines (B1300343 - 10/13)

Or you may go to the Bulletins page at http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1246972411343, click on B1300332 - Current (next to 2013). Then click on Synagis® and Influenza Vaccines (B1300343 - 10/13).

Are You Contracted with a RCCO?

The RCCO connects Medicaid clients to Medicaid providers and also helps Medicaid clients find community and social services in their area. The RCCO helps providers to communicate with Medicaid clients and with each other, so Medicaid clients receive coordinated care. A RCCO will also help Medicaid clients get the right care when they are returning home from the hospital or a nursing facility, by providing the support needed for a quick recovery. A RCCO helps with other care transitions too, like moving from children's health services to adult health services, or moving from a hospital to nursing care.

For more information on who the contact is for your region and how to become involved, please click here

The Aging of the Rural Primary Care Physician Workforce - Study


As the aging primary care provider population retires, rural provider shortages will be further exacerbated. Identifying states and counties that are at particularly high risk for primary care physician (PCP) attrition through retirement can help inform policy and planning decisions in an effort to avoid PCP shortages in these vulnerable locations. This study identified rural locations with high proportions of generalist physicians nearing retirement age using data from the American Medical Association and American Osteopathic Association 2005 Masterfiles.

Contact Information:
Sue Skillman
WWAMI Rural Health Research Center
skillman@uw.edu

Now available on-demand: ICD-10 Discussion with Government Payers webinar

Representatives from Colorado's Medicare contractor Novitas, Colorado's Health Care Policy and Finance Department and the Colorado Division of Workers' Compensation answered your questions about the ICD-10 transition during the coalition's October webinar on Oct. 15.

Click here to view the on-demand recording. Click here to download the program slides.

And mark your calendars for the next ICD-10 webinar on Tuesday, Nov. 19. More details will be sent out soon.

What Practice Managers Need to Know about Connect for Health Colorado: Webinar

What practice managers need to know about Connect for Health Colorado 

Oct. 29, 12 - 1 p.m. MDT 

As of Oct. 1 Coloradans have a new way to shop for health insurance, and odds are you have already received a few questions from patients. Connect for Health Colorado, the state's new health insurance marketplace, is the only place where new federal financial assistance will be available to make insurance more affordable.

As a practice manager, what does this new marketplace mean to your patients and your practice? Who is eligible and what resources are available? How might it affect health insurance benefit decisions in your practice?

Get answers to these questions and more by attending an engaging and informative webinar, "Connect for Health Colorado: What practice managers need to know about the new health insurance exchange," Tuesday, Oct. 29, 12 - 1 p.m. Featured guests are Marcia Benshoof from Connect for Health Colorado, Andrea Levine from COPIC Financial Services and Marilyn Rissmiller from the Colorado Medical Society.

This free webinar is sponsored by the Colorado Medical Society. Click here to register today!

PLEASE NOTE: This webinar is designed specifically for practice managers. A different webinar, geared for physicians, will be held later that day, Oct. 29 at 6 p.m. For more information on the webinar for physicians, click here.

HCPF Resource Page for ACA

The Department of Health Care Policy and Financing has developed a new Affordable Care Act (ACA) resource page for health care providers. The Department’s ACA Resources for Health Care Providers page is designed to deliver key information about health care reform, the Medicaid expansion and the Connect for Health Colorado marketplace. The resource page will be updated as new information becomes available and additional resources are developed for health care providers.

We also invite all nurses to view a recorded webinar hosted by the Department’s Executive Director Susan Birch, MBA, BSN, RN regarding the ACA. The webinar can viewed on the ACA Resources for Health Care Providers page here.

Additionally, we encourage all partners to review the frequently asked questions section on Colorado.gov/Health. We are adding new FAQs to this page regularly—so check back often!

For the latest information on Colorado’s efforts to implement the health reform law, check out the Department’s ACA Implementation News. The newsletter also often features content from Connect for Health Colorado, PEAK and other agency partners. Click here for all issues.

To sign up for ACA Implementation News or our ACA Communication Updates click here.

Wednesday, October 23, 2013

Part B Webinar Handout: "Medicare Updates"

Part B Webinar Handout: "Medicare Updates"  
October 29, 2013 (10:00am - 11:30am CT)

http://www.novitas-solutions.com/webcenter/spaces/MedicareJL/page/pagebyid?contentId=00024785

Join us as we discuss changes in the Medicare program. You will gain a clear understanding of the changes that will help you remain compliant with the new guidelines. We will explain the Comprehensive Error Rate Testing (CERT) Program and provide tips in preventing the most frequent errors. You will learn to identify and promote the use of self service options and preventive services. This is a must attend event! Register today!

Tuesday, October 22, 2013

Got Telemedicine - Benefits of a Comprehensive Resource Training Manual: Telehealth Webinar

“Got Telemedicine? 
Benefits of a Comprehensive Resource Training Manual”
Telehealth Webinar
Thursday, October 24, 2013~ 11:00am PDT

This is an opportunity to learn about:
  1. The moving parts to developing a telemedicine program
  2. The challenges of developing a telemedicine program
  3. The benefits of developing a comprehensive telemedicine resource training manual
For more information and registration instructions go to  http://www.telemedicine.arizona.edu/upcomingworkshops.cfm

This webinar is made possible through funding provided by Health Resources and Services Administration, Office for the Advancement of Telehealth

Improving Access to Quality Medical CareThe practice and delivery of healthcare is changing, with an emphasis on improving quality, safety, efficiency, & access to care. Telemedicine can help you achieve these goals! The Arizona Telemedicine Program, Southwest Telehealth Resource Center and UnitedHealthcare invite you to a free webinar on the implementation and practice of telemedicine.

Monday, October 21, 2013

Looking for a cost effective non-biased peer review service?

CRHC offers specialty - matched, confidential, medical opinions from a rural provider, for a rural provider, based on objective review of medical records. The program is a collaborative effort among Colorado's rural providers, and not only provides a cost effective way to manage peer review requirements, but also provides an effective means to improve patient care through identifying opportunities for a process improvement.

For more information on our Peer Review Network, please contact Samantha Hiner at sh@coruralhealth.org.



All Vials Are Not Created Equal - Single-Dose or Multi-Dose

Single-dose and multi-dose vials can come in any shape and size; you shouldn't assume a vial is a single or multi-dose vial based on size or volume. Always check the label! Single-dose vials are for use on only one patient.

In recognition of Infection Prevention Week (October 20-26th), the Premier Safety Institute® is reminding all healthcare providers about the importance of proper identification and use of medication vials. We are also sharing the new and dynamic infographic about the use of single and multi-dose vials being released by the One & Only Campaign for educating providers and patients.

Ongoing outbreaks - evidence of harm 
Since 2001 at least 50 outbreaks involving unsafe injection practices were reported to CDC, with hundreds of patients being infected. Many of these outbreaks were related to improper use of both single and multi-dose vials. A single dose vial typically lacks an antimicrobial preservative and can become contaminated and serve as a source of infection. Multi-dose vials can be used on more than one patient if aseptic technique is followed. However, the CDC recommends that multi-dose vials be assigned to one patient whenever possible.

CMS enforces policy for single-dose vials for only one patient.
CMS issued a memorandum maintaining its existing policy that a citation will be issued if single-dose vials are re-entered and used for multiple patients. CDC also issued a position statement reaffirming its position that vials labeled by manufacturers as "single-dose" or "single-use" should only be used for one patient to protect against life-threatening infections.

Infographic for provider and patient education
The new dynamic infographic from the One & Only Campaign is available in two user-friendly formats:
Additional resources:

Policy Briefs on Perinatal Health

Perinatal Health in the Rural United States, 2005
This series of briefs examine perinatal outcomes in rural areas across the United States in 2005. Low birth weight, a key indicator of the health of the U.S. population, and adequacy of prenatal care, a critical indicator of access and quality of health care, are explored to discover how they are related to rural or urban location, race, and ethnicity.

Contact information:
Laura-Mae Baldwin, MD, MPH
WWAMI Rural Health Research Center
Phone: 206-685-4799
lmb@fammed.washington.edu

Undergradute Pre-Health Internship - University of Colorado Anschuitz

The University of Colorado Anschutz Medical Campus | Office of Diversity and Inclusion and Kaiser Permanente Health Plan of Colorado | Diversity Development Department partner to provide summer internships for undergraduate students interested in pursuing careers related to health care. Both organizations are committed to helping increase the number of historically underrepresented individuals within health care professions for the purpose of reducing health disparities among underserved communities in Colorado. Students will enroll in a 13-month Undergraduate Pre-Health Program. Topics will include health disparities in underserved communities and career and educational opportunities in health care. The session will be lead by distinguished University of Colorado faculty, staff, and students and will consist of lectures, demonstrations and professional development. The program will start in April with an orientation and students will participate in lectures, demonstrations and a 10-12 week summer internship. After the summer
program the participants will be required to attend Saturday Academies once a month from September 2014- May 2015.

Students are selected on the basis of academic and professional achievement, and an interest in the Healthcare Professions. We encourage students from underrepresented groups or categories (first generation college attendee, low-income, or ethnic minorities such as Black or African American, Hispanic, American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander or Asian) to apply. Applicants must have completed at least one year of college by June 2013 (30 or more credits). Applicants must hold a sophomore or junior status and must be enrolled as a fulltime student for the duration of the program (Fall 2014 and Spring 2015).

Applicants must be U.S. Citizen or U.S. Permanent Resident. For more information on applying, please click here.

Friday, October 18, 2013

Novitas Service Impact Due to System Changes

As a result of recent system changes at Novitas customers may experience the following temporary operational difficulties, which they are working to fix:

Long Wait Times for Customer Service 
Receipt of a high volume of calls in our Customer Contact Center is causing longer than usual wait times.

We understand this is causing an inconvenience for you, our customers, and we are working diligently to correct this issue.


Busy Signal When Faxing
Receipt of a high volume of documents being transmitted via fax which results in receiving a busy signal when attempting to transmit documents.

An additional fax server was recently added and we are working on adding additional servers in the very near future to increase our fax capacity.


Appeal is not in Appeals Status Tool 
Appeals received after September 23, 2013 may not be entered in the Appeals Status Tool as expected. Therefore, this may not be an accurate method to determine if an Appeal request has been received by Novitas.

We are working diligently to correct this issue with a goal that all requests are available for viewing within the next two weeks.


Novitas appreciate your patience as they work through these issues. They will continue to provide updates as appropriate.



New Report Demonstrates Critical Role of Health IT in Managing Population Health

In response to increasing collaborations among traditional medical providers and community organizations, the PCPCC released a new report to support primary care clinicians in their efforts to adopt a population health approach that leverages health IT solutions. The report titled, “Managing Populations, Maximizing Technology: Population Health Management in the Medical Neighborhood,” was released at the PCPCC’s Annual Fall Conference (October 14 – 15) in Bethesda, MD.

The report offers a comprehensive view of health IT-enabled population health management that is built on a foundation of the patient-centered medical home, and extends into the medical neighborhood. A relatively new term, the medical neighborhood is an all-inclusive primary care model that connects traditional primary care providers across the medical and non-clinical, including community organizations that encourage healthy living, wellness, and safe environments.

The report provides an overview of the population health approach and provides a number of health IT tools that are embedded in the five key attributes of the PCMH and medical neighborhood. It also includes a recommended “Top Ten List” of health IT-based population health management tools, and a series of case studies from practices throughout the country, including Twin City Pediatrics, a small practice in Winston-Salem, NC, Union Health Center, a community health center in New York, NY, and Bon Secours Medical Group, an Accountable Care Organization (ACO) in Richmond, VA.

The report will be released at the PCPCC Annual Conference on October 14th, and will be the focus of a panel session on Tuesday, October 15th from 10 AM to 11 AM, and 11AM to 12:15 PM at the Hyatt Regency Bethesda.

Download the report.
Download the press release.


Tuesday, October 15, 2013

Colorado's Reducing Readmissions and Safe Transitions Collaborative: Webinar

Colorado's Reducing Readmissions and Safe Transitions Collaborative 
Webinar: Tuesday, October 15th, 12:00-1:00 MT 

Hosted by the Colorado Hospital Association

Join Healthy Transitions Colorado's Webinar October 15th to learn about Colorado Hospital Association and UnitedHealthcare's Reducing Readmissions and Safe Transitions Collaborative.

In year one of this two-year initiative, the program has seen double-digit decreases in hospital readmissions and savings of nearly $3 million. With goals of improving inpatient and outpatient safety, increasing patient preparedness for self-care, and reducing avoidable readmissions through enhanced patient-provider relationships, the initiative consists of two phases geared towards reengineering the hospital discharge process. Phase One utilizes Boston University School of Medicine's Project RED (Re-Engineered Discharge) as its foundation to improve the discharge process within the inpatient setting. Phase Two focuses on improving care transitions from hospital to the post-acute care setting by building partnerships with medical homes, long-term care facilities, nursing facilities and other transition organizations in the community.

Click Here For Free Registration

Southwest Memorial Hospital Recognized as October Member of the Month

Congratulations to Southwest Memorial Hospital for being recognized as CRHC's October Member of the Month!

From CRHC's Special Delivery 
Southwest Memorial Hospital is an affiliate of Southwest Health System, Inc., a not-for-profit corpo­ration that is governed by a volunteer Board of Directors. The hospital has been a member of Colorado Rural Health Center (CRHC) for many years. The hospital is one of CRHC’s highly engaged sites, participating in numerous programs, including; iCARE (Improving Communications and Readmissions), REC (Regional Extension Center) services, SHIP (Small Rural Hospital Improvement Program), and is contracted with CRHC’s Colorado Provider Recruitment program. In addition, the hospital’s affiliated rural health clinic has completed a healthy clinic assessment. Staff and leadership from the hospital and clinics actively participate in numerous CRHC educational opportunities, including regional workshops, conferences and webinars. CRHC is proud to recognize Southwest Memorial Hospital for their many accomplishments and for the outstanding level of care they provide in Cortez and the surrounding area. To learn more about Southwest Memorial Hospital, visit their website or check them out on Facebook.

For the full article, including a history of Southwest Memorial Hospital, please click here

Thursday, October 10, 2013

Annual Colorado Rural Health Conference - Not too Late!

It's Not Too Late!
The 22nd Annual Colorado Rural Health Conference will be held October 17-18, 2013. This year’s conference will provide participants with a wide range of educational topics, networking, resource opportunities and much more.

Opportunities to sponsor and exhibit at this conference are now available. Visit www.coruralhealth.org/events/annual.htm for more information and to register.

Register before September 18, and CRHC members will pay only $220, non-members will pay $370. After September 18 prices increase! Register now!

BHbusiness: Mastering Essential Business Operations Opportunity

The behavioral health field is rapidly broadening and evolving, rife with challenges and opportunities. How is your organization responding?

If you are an executive or leader in the mental health and/or substance use disorder field and are looking to position your agency for success in the new environment, BHbusiness: Mastering Essential Business Operations can help your agency improve critical business skills in:
  • Strategic Business Planning 
  • Third-party Billing and Compliance 
  • Third-party Contract Negotiations 
  • Eligibility and Enrollment 
  • Meaningful Use of Healthcare Technology 
BHbusiness courses are funded by SAMHSA and provided to participants at no cost. The project is led by State Associations of Addiction Services (SAAS) in partnership with the National Council for Behavioral Health (National Council), NIATx, and Advocates for Human Potential (AHP).

Apply as an individual provider and BHbusiness will add you to a network of other providers. Or take advantage of BHbusiness’ collaborative learning platform and join a group of providers in your state or region to form your own learning network. Each learning network is equipped with an expert coach, online tools and resources, and a dedicated convener to support this interactive learning process. You may also consider convening your state’s learning network or encourage your Single State Authority (SSA) or provider association to convene your group. Learn more about this powerful business opportunity for your organization and how to apply at BHbusiness.org.

Still have questions? Feel free to contact me at (202) 684-7457 ext. 230 or MohiniV@thenationalcouncil.org.

CREATE Application Tip of the Week

When submitting for both a Financial Waiver and General Application, be sure to include the following required three financial documents with the application:
By including these documents, the Review Committees will better be able to understand the need an entity has for receiving a CREATE match.

If there are questions about these documents, or if an entity needs assistance in supplying replacement documents, please contact Lakesha Jones, Grant Manger, at lj@couralhealth.org. For more information on CREATE, visit our web page at http://coruralhealth.org/programs/create/.

Washington County Trains 10 New EMT-Basics Through CREATE Grant Funding

“CREATE is kind of a God sent for small rural communities”, Tony Wells, Director of Washington County Ambulance Services boasted when asked what CREATE funding means to their organization. He, like many rural counties across Colorado depend on the 50% reimbursement grant program to increase emergency and trauma education in their communities and meet personnel needs.

Washington County was awarded a grant to train new EMTs, by which 10 students are on track to complete the course by the end of the month. It has been over 6 years since Washington County Ambulance was able to organize an EMT course due to limited financial resources, by which many rural communities face. CREATE is slated to be a part of the Washington County Ambulance Services’ education and training goals over the next five years as they are planning to incorporate a I/99 Intermediate to Paramedic Bridge course among other required emergency and trauma trainings that will continue to help them meet the needs of Washington County.

To learn more about CREATE, contact Lakesha Jones, Grants Manager at (720) 248-2742 or by email at lj@coruralhealth.org. Grant guidelines and general information can be found at http://www.coruralhealth.org/programs/create/ 



Two-Midnight and 96-Hour Reg Updates

96-Hour Medicare Condition of Payment and CAH Condition of Participation
According to The American Hospital Association (AHA), since 1997, as part of a CAH condition of payment, physicians must certify that there is a reasonable expectation that a Medicare patient admitted to an acute inpatient bed will be discharged or transferred within 96 hours of admission to the CAH, if this is the best care strategy for the patient. This is not the same as the CAH Condition of Participation for average annual length of stay of 96 hours, but they go hand in hand. According to the State Operations Manual, Appendix W, §485.620(b) Standard: Length of Stay, “The CAH provides acute inpatient care for a period that does not exceed, on an annual average basis, 96 hours per patient.”

According to 42 CFR Chapter IV Subchapter B – Medicare Program, Part 424 – Conditions for Medicare Payment, Section 424.15 Requirements for Inpatient CAH services, Medicare Part A pays for inpatient CAH services only if a physician certifies that the individual may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the CAH, and that the services are provided in accordance with § 412.3. Certification begins with the order for inpatient admission and must be completed, signed, and documented in the medical record prior to discharge. Certification is required no later than 1 day before the date on which the claim for payment for the inpatient CAH services is submitted.

For more information, visit these documents from The Federal Register and the Government Printing Office.

Two-Midnight Rule
The Two Midnight Inpatient Admission Guidance and Patient Status Review for Admission, commonly called the “two-midnight rule” will be reviewed by The Centers for Medicare & Medicaid Services (CMS), and part of the enforcement of Inpatient Prospective Payment System (IPPS) admission will be delayed. This stems from a “Dear Colleague” letter written to CMS, signed by Members of the U.S. House of Representatives and supported by National Rural Health Association (NRHA), urging a 6-month delay of a new policy established in the 2014 IPPS final rule.

This rule does apply to CAHs. In essence, the rule went into effect on October 1, 2013, but will not be enforced by the Medicare Administrative Contractors (MAC) for 90 days (after December 31, 2013). During the implementation period of October 1, 2013 until December 31, 2013, CMS will instruct the MACs and Recovery Auditors not to review claims spanning more than two midnights after admission for appropriateness of patient status. MACs and Recovery Auditors will not review any claims related to Critical Access Hospitals. In addition, during this period, CMS will not permit Recovery Auditors to review inpatient admissions of one midnight or less that occur on or after October 1. If an issue is identified by A MAC during this 90-day period, the MAC will conduct education to the hospital and follow-up as necessary.

For more information, visit frequently asked questions on this topic from CMS.

Wednesday, October 9, 2013

Orphan Drugs Exclusion

Orphan Drugs Exclusion

340B hospitals subject to the orphan drug exclusion (critical access hospitals, free-standing cancer hospitals, sole community hospitals and rural referral centers) are responsible for ensuring that any orphan drugs purchased through the 340B Program are not transferred, prescribed, sold, or otherwise used for the rare condition or disease for which the orphan drugs are designated under section 526 of the Federal Food, Drug, and Cosmetic Act.

For more information or to read the final rule Click Here to access the HRSA.Gov website.

Colorado's Reducing Readmissions and Safe Transitions Collaborative: Webinar

Colorado's Reducing Readmissions and Safe Transitions Collaborative 
Webinar: Tuesday, October 15th, 12:00-1:00 MT 

Hosted by the Colorado Hospital Association

Join Healthy Transitions Colorado's Webinar October 15th to learn about Colorado Hospital Association and UnitedHealthcare's Reducing Readmissions and Safe Transitions Collaborative.

In year one of this two-year initiative, the program has seen double-digit decreases in hospital readmissions and savings of nearly $3 million. With goals of improving inpatient and outpatient safety, increasing patient preparedness for self-care, and reducing avoidable readmissions through enhanced patient-provider relationships, the initiative consists of two phases geared towards reengineering the hospital discharge process. Phase One utilizes Boston University School of Medicine's Project RED (Re-Engineered Discharge) as its foundation to improve the discharge process within the inpatient setting. Phase Two focuses on improving care transitions from hospital to the post-acute care setting by building partnerships with medical homes, long-term care facilities, nursing facilities and other transition organizations in the community.

Click Here For Free Registration

Got Telemedicine? Benefits of a Comprehensive Resource Training Manual: Telehealth Webinar

“Got Telemedicine? 
Benefits of a Comprehensive Resource Training Manual”
Telehealth Webinar
Thursday, October 24, 2013~ 11:00am PDT

This is an opportunity to learn about:
  1. The moving parts to developing a telemedicine program
  2. The challenges of developing a telemedicine program
  3. The benefits of developing a comprehensive telemedicine resource training manual
For more information and registration instructions go to  http://www.telemedicine.arizona.edu/upcomingworkshops.cfm

This webinar is made possible through funding provided by Health Resources and Services Administration, Office for the Advancement of Telehealth

Improving Access to Quality Medical CareThe practice and delivery of healthcare is changing, with an emphasis on improving quality, safety, efficiency, & access to care. Telemedicine can help you achieve these goals! The Arizona Telemedicine Program, Southwest Telehealth Resource Center and UnitedHealthcare invite you to a free webinar on the implementation and practice of telemedicine.

2014 HPP RHC Funding Information

Is your clinic ready for an emergency?


The information on the 2014 HPP funding for Rural Health Clinics has been released. The total amount of funding allocated for each Rural Health Clinic for this cycle is $4,000, separated among three activities. Completion of the NIMS/ICS activity is required to receive reimbursement for the other activities. Clinics can elect to participate in either or both of the remaining activities for additional reimbursement funds.

The grant period is currently open and will carry through to the reimbursement deadline of April 15, 2014. Be aware that after the deadline, an opportunity to receive additional funding will be presented to those who participate in this grant cycle. Just prior to the April 15th deadline, there will be a procedure laid out to submit for this funding in which a proposal and approval process will be followed. Further details regarding this opportunity will be forthcoming sometime in early April.

For more information, please click here for a flyer. Further activity descriptions and reimbursement documentation can be found at:
http://coruralhealth.org/programs/rhc/emergency.htm.

For more information or questions, contact Ron Seedorf at 920-302-9021 or rs@coruralhealth.org.

Tuesday, October 8, 2013

School-Based Telemedicine Webinar

School-Based Telemedicine Webinar: 
Come Learn What's Involved, How to Get Started and the Secrets to Success 


AMD Global Telemedicine, MY Health-e-Schools and The Children's Partnership invite you to attend a webinar to learn how to implement, run and sustain an effective school-based telemedicine program. Attendees will have the opportunity to hear first hand from MY Health-E-Schools about how they started their program, lessons learned along the way and how they have managed to sustain success.

In addition, attendees will be able to hear from The Children's Partnership about school-based telemedicine programs from across the country, lessons learned and the benefits of school-based telemedicine.

School-Based Telemedicine Programs: Learn the Secrets to Success

Date: November 5, 2013
Time: 2:00 PM (Eastern Standard Time)
Duration: 30 minutes, plus Q &A session

>> Register for the webinar today!



Monday, October 7, 2013

Building Skills for Effective Teams (BSET) – Team Development Training


October 25-27, 2013; December 5-7, 2013; February 27-March 1, 2014; May 15-17, 2013

The 2013-2014 BSET training will occur over a 12-month period, and will strengthen teams within health centers. The BSET will include four 2.5 day workshops focused on providing and practicing in real-time an expanded set of skills and abilities needed to develop, lead and be part of effective interprofessional teams. These workshops will be combined with ongoing coaching by trained coaches and a capstone project. The first day of the workshop will be a half-day, from 5PM to 9PM (including dinner). The 2nd and 3rd days will run from 8AM to 5PM. Project outcomes include: 1. Significant acquisition of essential team-focused skills such as role-definition/negotiating, conflict resolution, shared decision making; 2. Increased levels of trust and communication between team members; 3. Assessment of personal and team operating styles (before and after) and performance based on national norms/testing instruments; 4. The implementation of a team-selected and team-implemented capstone project; and 5. A well-developed understanding of what are the best practices in team operations, based on current team effectiveness research

Registration Deadline: October 18, 2013 - Contact Angela Rose at 303-867-9511 or at Angela@cchn.org and register here: http://events.r20.constantcontact.com/register/event?llr=5q6upyeab&oeidk=a07e80qcemxeb780fec

For: Clinical and administrative teams of 3-6 participants; such as advanced managers, supervisors, RNs, NPs physicians, PAs, clinicians, and leadership and executive teams.

Where: Goddard Middle School, 3800 West Berry Avenue, Littleton, CO

Cost: $200 per participant



Please contact Angela Rose at Angela@cchn.org or at 303-867-9511 if you’d like to register or have questions.

Thursday, October 3, 2013

MAC Operations Continue During Shutdown

During the time that the partial government shutdown is in effect, Medicare Administrative Contractors will continue to perform all functions related to Medicare fee-for-service claims processing and payment.

Wednesday, October 2, 2013

The Center Releases CAH Blueprint for Performance Excellence

With funding from the Federal Office of Rural Health Policy, the National Rural Health Resource Center (The Center) is pleased to announce the release of the Critical Access Hospital Blueprint for Performance Excellence. Please feel free to distribute the Blueprint, found at: http://www.ruralcenter.org/tasc/resources/critical-access-hospital-blueprint-performance-excellence, and the attached press releases to your rural stakeholders and critical access hospitals. Please see below for additional information about this useful Blueprint and critical success factors for managing the complexities of the changing healthcare environment in critical access hospitals.


Job Opportunity - Cavity Free at Three

The Colorado Department of Public Health and Environment, The Prevention Services Division is recruiting for a Cavity Free at Three Education Coordinator - Health Professional III. All Colorado residents may apply. The announcement is scheduled to be posted through October 7, 2013.However, applicants are encouraged to apply early as these positions may close early due to quantity and the quality of applications received.

Please follow the above link for the job announcement and instructions on how to apply. Please forward this email to interested parties. Thank you in advance for your interest in this career opportunity!

September Edition of At a Glance

Please find the link to the September edition of At a Glance below. This Department of Health Care Policy and Financing publication provides information on major initiatives including policy changes and program updates. Please feel free to share it with your colleagues.

At a Glance







CMS Proposes Regulatory Relief for RHCs

The Centers for Medicare & Medicaid Services (CMS) has issued a new proposed rule recommending a change in the RHC regulations governing employment of PAs & NPs working in the RHC setting. The proposed change was published in the September 23rd Federal Register.

CMS has for some time taken the position that ALL PAs and NPs working in RHCs must be employees of the RHC as evidenced by the issuance of a W-2. NARHC has long argued that this was an overly narrow reading of the RHC statute and has, instead, recommended that RHCs have greater flexibility in their employment relationships. More specifically, we have urged CMS to allow PAs and NPs to be “independent contractors” to the RHC rather than exclusively “employees.”

In a compromise intended to move closer to the Association’s position, CMS has proposed that in situations where the RHC “employs” multiple PAs and/or NPs, only one of those PAs or NPs must be an employee (i.e. W-2). Once the RHC has met the “employ” requirement with one individual, the RHC would be free to establish whatever employment relationship is acceptable to the PA/NP and the RHC and permissible by state law.

If adopted, this proposed change would not remove the requirement that RHCs have a PA or NP on-site & available to see patients at least 50% of the time the clinic is open. It would simply allow more flexibility in the employment relationship between the RHC and the PAs/NPs the clinic “employs”.

The proposed rule is available for public comment for 60 days. At that time, CMS will review all of the comments submitted & then move to issue a final rule on this topic. Absent any opposition, we anticipate that the new policy could be in place by Spring of 2014. Please do not hesitate to contact NARHC if you have any questions about this proposed policy change.

By Bill Finerfrock from NARHC

Vaccines and Immune Response Provider Education Presentation

Back by Popular Demand: Vaccines and the Immune Response
Thurs., Oct. 10, 2013
11 a.m.-12:30 p.m.
Register by Thurs., Oct. 3, 2013

CCIC members and providers know that immunizations are key to preventing vaccine-preventable diseases, but can you explain the concepts behind how immunity and vaccines work?

This provider education presentation will address:

  • Innate and adaptive immunity
  • Passive and active immunity
  • Antigens and the capacity of the immune system
  • Case studies of the immune response to four different vaccines
  • A review of herd immunity
  • The efficacy of vaccination compared to the risks of non-vaccination


Whether you are new to immunology or just need a refresher, Vaccines and the Immune Response will convey concepts to help better address the importance of immunizations with providers, patients and parents.

Presented by Aimee Pugh Bernard, PhD
Immunologist and Senior Instructor of Biology
Department of Integrative Biology
University of Colorado at Denver

Location:
Children's Hospital Colorado
13123 E. 16th Ave.
Aurora, CO 80045
2nd Flr, Mt. Harvard
Get directions

Light snacks and beverages will be provided.

Register by Thurs., Oct. 3
To attend in person:
Please email your name, credentials, institution, work phone, mailing address and email address.

To participate via webinar: For an optimal learning experience, we recommend attending this presentation in person. However, if distance or time does not allow, we welcome you to
register for web and audio access.

AHIMA Foundation to Offer Webinars for Rural Healthcare Providers

A new free webinar series, National Rural Health Webinars, will focus on health information technology for rural healthcare providers by addressing current topics in information governance and informatics including opportunities in mHealth, health information technology, health information management workforce, ICD-10 implementation, and health analytics. The webinars will be offered by the AHIMA Foundation.

The National Rural Health Webinars will address:
  • the affect of the health information technology on patient quality and access
  • educational offerings related to legal and regulatory requirements of care
  • best practices related to operational management within the rural healthcare environment.
The first webinar will focus on the role of mHealth in rural areas. This webinar will be presented Wednesday, Oct. 9 at 2 p.m. ET, and will feature nationally renowned speakers discussing:
  • mHealth in rural communities
  • sensor-based solutions for asthma and COPD management
  • mHealth/wireless health

Speakers will include:
  • Mark Gerhring, co-founder and president, Propeller Health, Madison, Wis.
  • Robert Jarrin, JD, senior director of government affairs, Qualcomm Incorporated, Washington, D.C.
  • Jonathan Katz, CEO, MedAdherence LLC, New York
  • Alan Portela, CEO, AirStrip Technologies, San Antonio
  • Brian Russell, CEO and founder, Zephyr Technology Limited, Annapolis, Md.
To register and find out more about the “Role of mHealth in Rural Areas,” 
visit http://www.ahimafoundation.org/about/FoundationEvents.aspx