Weekly Update: October 2014

Thursday, October 30, 2014

Medicare Part A and B News- Jurisdiction H for October 28th, 2014

Medicare News

New Fees for Procedure Code 75946
Please take a minute to review information regarding local contractor pricing of procedure code 75946.

New Medicare Insights Weekly Podcasts now Available!
In this week's Medicare Insights Weekly podcast, we interview a member of our Electronic Data Interchange area on the new Novitasphere Portal. Learn about everything Novitasphere has to offer. Listen today!

Medicare Learning Network (MLN) Articles from CMS

Revised:

Phase 3 Revalidation (requests dated after September 20, 2013) Mailing Address:

Novitas JH Provider Enrollment
P.O. Box 44137
Jacksonville, FL 32231

Note that although Internet-based PECOS instructs providers to send hardcopy certification statements/supporting documentation to a specific Novitas address, please mail all Phase 3 revalidation documents to the address immediately above.

ACA Implementation News- October 23rd, 2014

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 like to receive ACA Implementation News or our ACA Communication Updates please click here.

Webinar: Choosing a Telehealth Service Provider

The National Telehealth Webinar Series Presented by the National Network of Telehealth Resource Centers Presents:

Choosing a Telehealth Service Provider

When:

Thursday, November 20, 2014

9:00 AM HST, 10:00 AM AKST, 11:00 AM PST, 12:00 PM MST, 1:00 PM CST, 2:00 PM EST

Presented by:

Elizabeth A. Krupinski, Ph.D.

The use of Telemedicine Service Providers is increasing dramatically as the need for providers increases. It is a competitive & bewildering market. How do you decide which vendor is the best for your needs? What are some of the steps you can take to protect yourself, your institution and your patients while still getting the best services possible? This webinar will provide some useful tips and strategies for choosing a telemedicine service provider.

To join the webinar, click here.

MLN Connects Provider eNews for October 23rd

MLN Connects™ Provider eNews for October 23, 2014

View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

• CMS 2014 Certified EHR Technology Flexibility Rule — Last Chance to Register
• Transitioning to ICD-10 — Register Now
• New MLN Connects™ National Provider Call Audio Recordings and Transcripts

CMS Events

• Webinar for Comparative Billing Report on Podiatry: Debridement of Ulcers and Wounds

Announcements

• Protect Your Patients Against Influenza and Pneumonia
• Updated CDC Resource Available on Ebola
• New Affordable Care Act Initiative to Support Care Coordination Nationwide
• Extension of Shared Savings Program Fraud and Abuse Waivers Interim Final Rule
• IRF Quality Reporting Program: NHSN Quality Data Submission Deadline Extended to November 15
• LTCH Quality Reporting Program: NHSN Quality Data Submission Deadline Extended to November 15
• Open Payments Search Tool Now Available
• Open Payments: Start Preparing for the 2014 Reporting Year
• Comparative Billing Report on Podiatry: Debridement of Ulcers and Wounds
• EHR Incentive Programs: Protect Electronic Health Information Core Objective

Claims, Pricers, and Codes

• FQHC PPS Issue with Claims Containing Both Preventive and Non-Preventive Services
• Hold on FQHC Medicare Advantage PPS Claims — Update
• Use of HCPCS X Modifiers for Distinct Procedural Services
• Mass Adjustment of Selected SNF Inpatient Claims
• October 2014 Outpatient Prospective Payment System Pricer File Update

Medicare Learning Network® Educational Products

• "Medicare Quarterly Provider Compliance Newsletter [Volume 5, Issue 1]” Educational Tool – Released
• Medicare Learning Network® Web-Based Training Programs
• Updated MLN Matters® Search Indices

Phase 3 Revalidation (requests dated after September 20, 2013) Mailing Address:
Novitas JH Provider Enrollment
P.O. Box 44137
Jacksonville, FL 32231

Note that although Internet-based PECOS instructs providers to send hardcopy certification statements/supporting documentation to a specific Novitas address, please mail all Phase 3 revalidation documents to the address immediately above.

2014 Certified Electronic Health Record Technology (CEHRT) Flexibility Rule, Webinar

November, 19th at 12:00PM CT / 11:00AM MT

Register now by clicking: https://www.eventbrite.com/e/cms-2014-cehrt-flexibility-rule-overview-registration-13847832239

The CMS Regional Offices in Dallas, Denver, and Kansas City and are pleased to announce a new EHR webinar focused on the EHR Incentive Payment Program – 2014 Certified Electronic Health Record Technology (CEHRT) Flexibility Rule. We will cover instructions on how eligible professionals who have been unable to fully implement 2014 Edition CEHRT for an EHR reporting period in 2014 due to delays in 2014 Edition CEHRT availability can use the rule’s flexibility to report for 2014.

Agenda

· Overview of CEHRT – David Nilasena, M.D., Chief Medical Officer, CMS, Region VI
· Q & A Session

What You Need To Do Now

Register for the webinar at: https://www.eventbrite.com/e/cms-2014-cehrt-flexibility-rule-overview-registration-13847832239

1. You will receive an appointment which will include information on how to connect to the 11/19/14 webinar.
2. Submit your CEHRT questions to Ceceilia Robl at ceceilia.robl@cms.hhs.gov by COB November 18th. Please use “November CEHRT Webinar” in the subject line of your email.

What You Need To Do On November 19th

Join the live webinar by following the instructions in the Eventbrite appointment that will be emailed to you following registration. We have 500 lines available on a first-come first-served basis. If several people are calling from the same location, please use one line. Presentation materials will be available for viewing upon your entrance into the webinar.

Meaningful Use: Audits, Opportunities, and Roadmaps

Date & Time:
November 4, 2014
12:00 - 1:00 PM MT

Speaker:

Michael Orr and Travis Skinner
BKD, LLP

Description:

This presentation will cover the different types of EHR audits, the nature and scope of the different EHR audits, best practices, common pitfalls as well as mitigation strategies. This topic focuses on an area that is receiving a high degree of scrutiny from regulatory authorities and MACs. A good deal of press has been focused on the significant paybacks resulting from the Meaningful Use Compliance Audits and their "all or nothing" results - failure on one minor measure could result in recoupment of both Medicare and Medicaid funding for the program year under audit as well as trigger audits for other program years. The program will be discussing audit preparedness as well as focusing on a few key areas that appear to be common problems at many facilities. The mechanics of handling a failed audit and submission of a final appeal to CMS will be addressed. There are 3 primary types of audits occurring - The meaningful use compliance audits referenced above, state Medicaid meaningful use compliance audits and HiTech payment audits. The program will be addressing charity care interaction with the HiTech audits and its effect on settlements. It should be noted that the EMR attestation process covers multiple years, with multiple reimbursement scenarios per year and criteria that evolve as the program progresses. The program will touch on the "road map" concept to help hospitals develop a strategy to manage the process and their program compliance. Finally, the program will look at proactive steps that Hospitals can take to help prepare for audits.

Learning Objectives:

After this presentation, participants will be able to identify the different types of EHR audits and understand their nature and scope.
Participants will be able to identify best practices, common pitfalls, and mitigation strategies for the various audits.

Click here to register for this exciting webinar!

Board Training Three Part Webinar Series

Session 1
11/17/2014 4:30-6:00
Setting Standards for Fiscal Oversight
CLICK HERE to register

The first session will focus on Setting Standards for Fiscal Oversight.

"Budget approval" is greatly overestimated as a governance tool. How can boards effectively set standards for multiple layers of fiscal concerns, such as budgeting, actual financial condition/activities, protection of financial/physical/brand assets, and compensation and benefits?

Participants gain understanding of:

How to establish clear governing policies for financial issues.
The importance of assessing financial performance against board-established criteria.
-Actual examples of governing policies for budgeting, financial condition and activities, compensation and benefits, and asset protection.

Session 2
11/18/2014 4:30-6:00
Evaluating CEO and Board Performance
CLICK HERE to register

The second session will focus on Evaluating CEO and Board Performance.

Most Boards recognize that ensuring rigorous and fair assessment of CEO performance is a critical function. They are often challenged, however, by the lack of clear criteria in place by which to assess executive performance. Similarly, one of the healthiest behaviors exhibited by boards committed to accountability is that they assess their own performance.

This webinar will explore methods to establish criteria and performance measures in a way that dramatically reduces the surprises and drama that often cause strife and dysfunctional Board/executive relationships.

Participants gain understanding of:

· Three key methods of collecting performance data.
· The role of “interpretations” in delegation and performance monitoring, and how they can optimize alignment of priorities between Board and CEO.
· The types of policies and standards boards should set for themselves.
· Methods to assess four key areas of Board performance: Meeting Assessment, Overall Board Performance, Policy Review, and Individual Board Member Participation

Session 3
11/19/2014 4:30-6:00
Officer’s Forum

CLICK HERE to register

This session will focus on an Officer's Forum.

For many boards of directors, the roles of officers are steeped in tradition. Wearing the traditional board officer “hats” in the demanding environments (health care and fiduciary) in which hospital boards operate today not only falls short of enhancing accountability and success – they can actually work to their detriment! This webinar looks at the role of Board officers and the CEO with a modern lens, illustrating ways lay-leaders can effectively serve their boards and communities, adding to their boards’ governance effectiveness. Common/traditional bylaws language defining officers’ roles will be explored, and examples of alternatives offered.

MLN Connects Provider eNews for October 30th, 2014

MLN Connects™ Provider eNews for October 30, 2014

View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

• Transitioning to ICD-10 — Last Chance to Register

Announcements

• HHS Secretary Announces $840 Million Initiative to Improve Patient Care and Lower Costs
• Hospital Appeals Settlement: Act by October 31
• Get Ready for DMEPOS Competitive Bidding
• SNF PPS Payment Reform Research Project
• Antipsychotic Drug Use in Nursing Homes: Trend Update
• Third Quarter Hospice Item Set Question and Answer Document Available
• EHR Incentive Program: Hardship Exception Applications Due November 30
• PQRS: Submission Engine Validation Tool is Now Available for Testing

Claims, Pricers, and Codes

• Physicians, Providers, and Suppliers Must Use Revised CMS 855R Starting May 31
• Demand Letters for Polysomnography Claims

Medicare Learning Network® Educational Products

• “ICD-10-CM/PCS Billing and Payment Frequently Asked Questions” — Revised
• “ICD-10-CM/PCS The Next Generation of Coding” — Revised
• “ICD-10-CM/PCS Myths and Facts” — Revised
• “ICD-10-CM Classification Enhancements” — Revised
• “General Equivalence Mappings Frequently Asked Questions” — Revised
• Medicare Learning Network® Web-Based Training Course with Continuing Education Credits
• Medicare Learning Network® Products Available in Electronic Publication Format

Coverage of Gender Reassignment Surgery

Please take a minute to read the Novitas bulletin in response to the recent coverage changes for gender reassignment surgery.

Phase 3 Revalidation (requests dated after September 20, 2013) Mailing Address:

Novitas JH Provider Enrollment
P.O. Box 44137
Jacksonville, FL 32231

Note that although Internet-based PECOS instructs providers to send hardcopy certification statements/supporting documentation to a specific Novitas address, please mail all Phase 3 revalidation documents to the address immediately above.

Thursday, October 23, 2014

Credentialing Network Webinar, Part 4

You are invited to participate in the Colorado Rural Credentialing Network Webinar series. These quarterly webinars will be interactive and informative, providing insight on credentialing needs.

The final webinar will take place:

November 19th, 2014 11:00am-12:00am

The webinars can be purchased individually at $99 for CRHC members or $149 for CRHC non-Members. To register for the first webinar, click on the Register Now link below. You will be invoiced following the webinar. Or save by purchasing all four webinars through a Credentialing Network Membership, which is $250 for CRHC Members and $375 for CRHC non-members – for information about the Credentialing Network, contact Liz Kelman at lk@coruralhealth.org.

Medicare Part A and B News-Juriscition H for October 23rd, 2014

The following information is provided by Novitas Solutions.

New Letter Generation Software being used by Novitas Provider Audit, Reimbursement and Settlement Department

Effective 10/20/14 Novitas began using new letter generation software. This change will streamline our process and eliminate some of the letters Novitas sends out to providers. For example, Novitas has eliminated the need to send both a notification letter and a demand letter when an overpayment exists. In the past, providers would receive a notification letter that a tentative, NPR or lump sum was completed and an overpayment existed. Providers would later receive a demand letter for the amount indicated on the notification letter. Under the new process, only one letter will be sent which will serve as both the notification and demand for payment. These letters will contain contact information if providers have any questions.

Certified Application Counselor Program

Did you know that clinics can apply to be sites to assist with enrollment applications?

As part of the Certified Application Counselor Program, Connect for Health Colorado designates organizations that agree to certify staff or volunteers to perform the duties of Certified Application Counselors. These Designated Organizations must:

Submit a Designated Organization application for approval by Connect for Health Colorado, including all required back-up documentation.
Sign the Certified Application Counselor Program Designated Organization Agreement with Connect for Health Colorado and submit with the application. Only organizations will be designated. We do not accept applications from individuals.
Successfully complete mandatory training. Information on the training will be forwarded to the organization upon approval of their application.

For more information, visit the Connect for Health Colorado website here.

MLN Connects Provider eNews for October 23rd

MLN Connects Provider eNews for October 23rd, 2014 is now available. To learn about recent announcements, upcoming events, and relevant resources, click here.

CDPHE Conference Call on Ebola

URGENT INFORMATION ON EBOLA
Next Conference Call, Friday, October 24 @ 3 pm on Colorado Preparedness Efforts Related to the Ebola Outbreak

The Colorado Department of Public Health and Environment (CDPHE) will be holding regularly scheduled statewide conference calls on Colorado’s preparedness efforts related to the Ebola Outbreak. CDPHE will conduct a brief update on Colorado's preparedness efforts, and review national guidelines and then open the call up for questions.

Suggested attendees include:

Local public health agencies - disease control and emergency preparedness staff
Hospital infection preventionists
Hospital emergency managers
Healthcare providers
Clinical labs
Other local partners involved in disease control and emergency preparedness/response

In order to accommodate all callers, we are asking each agency/facility to only use one line to call in.

Participant Access Instructions - Dial in 5-10 minutes prior to start time using the Participant Phone Number and Participant Passcode.

Toll Free: 1-888-245-0920
Participant Passcode: 975295

Medicare Part B News-Jurisdiction H for October 21st, 2014

The following information is provided by Novitas Solutions.

Medicare News

Other Part B Frequently Asked Question (FAQ) Topics
Have a question and not sure what to do? Check out our recently updated FAQs and get answers to your questions like "Can a Physician Assistant (PA) bill a service in the ER as 'incident to' an attending group number?" or, "What specific verbiage is considered acceptable for electronic signatures?"

Insufficient Documentation
The CERT A/B MAC Outreach & Education Task Force created an educational guide to explain the Comprehensive Error Rate Testing (CERT) program and share information with providers on how to provide accurate and supportive medical record documentation. Please take a moment to read this important information and visit the CERT page on our website.

Ebola resources for healthcare professionals

For information regarding Ebola for healthcare professionals, see this resource provided by the Office of the Assistant Secretary for Preparedness and Response.

Medicare Part A News- Jurisdiction H for October 21st, 2014

The following information is provided by Novitas Solutions.

System Alert
Issued 10/21/2014 at 8:40 AM

IPPS Pricer Issue causing inpatient claims to suspend
An issue has been identified with the 2015 Inpatient Prospective Payment System (IPPS) Pricer causing inpatient claims with discharge date 10/01/14 and greater to receive Pricer Return Code (RTC) 65 and assigning reason code 37015 or RTC 52 and assigning reason code 37001. The claims are suspending to status locations SMPROV and SMPROZ.

The FISS notified CMS of the issue and they are awaiting an updated IPPS Pricer.

Medicare News

Phase 3 Revalidation (requests dated after September 20, 2013) Mailing Address:

Novitas JH Provider Enrollment
P.O. Box 44137
Jacksonville, FL 32231

Note that although Internet-based PECOS instructs providers to send hardcopy certification statements/supporting documentation to a specific Novitas address, please mail all Phase 3 revalidation documents to the address immediately above.

SAMHSA's Service Members, Veterans, and their Families Technical Assistance Center

Webinar: Connecting Your CAH with Your Community

Connecting Your CAH with Your Community
Wednesday November 5, 2014
12:00-1:00 pm Central Time

Just because your critical access hospital (CAH) is the closest place for your community's residents to receive care, that doesn't mean they will automatically choose you. The relationship your CAH has with the community can significantly influence this decision. The stronger, more positive your connection with the community, the more trust, confidence and loyalty residents will feel toward your facility. This leads to community members who are more likely to use your services, become employees, attend hospital events and refer you to friends and family. On the flip side, a negative relationship could make residents more willing to travel farther away for healthcare. So how do you maintain, enhance or create positive community engagement?

Join Mike Milligan, president of Legato Healthcare Marketing, as he walks
through the three key audiences you need to reach-and the strategies and tactics to do so- to ensure your CAH has a strong, positive and beneficial connection with your community.

Learn more or register now.

Webinar: What's Your Practice's Cash Flow Score?

What's Your Practice's Cash Flow Score?
Tuesday, November 4, 2014
12:00 - 1:00 pm Central Time

In this interactive webinar participants will be able to rank the systems their practice uses against industry benchmarks on the following topics:

Maintaining patient engagement
Setting payment expectations
Supporting front and back office billing processes
Following up with patient payments
Using a collection agency

Attendees will receive on-the-spot results as to how their practice compares to others on the webinar as well as our previously performed survey of medical practices.

Learn more or register now.

CAH Section Federal Register Final IPPS 2015

The CAH section of the Federal Register for IPPS 2015 can be found here, starting on page 50162.

Using CAPT Tools to Understand and Prevent Youth Marijuana Use

Description
Good prevention planning depends on a clear understanding of the research base—but locating and understanding the research on emerging problems such as youth marijuana use can be challenging. The CAPT’s new suite of decision-support tools is designed to help busy, state-level decision makers and frontline practitioners understand and apply the latest research on youth marijuana use. The suite includes the following resources:
Strategies and Interventions to Prevent Youth Marijuana Use: An At-A-Glance Resource Tool
Risk and Protective Factors Associated with Youth Marijuana Use
Prevention Programs that Address Youth Marijuana Use
Preventing Youth Marijuana Use: An Annotated Bibliography

This information session will explore the purpose of each of these four documents, how they were developed, and how they can be used to guide prevention practice. Presenters will also provide specific examples of how states, tribes, and jurisdictions can use these tools with their sub-recipients.

When
Tuesday, October 21, 2014
1:30 p.m. – 3:00 p.m. ET
12:30 p.m. – 2:00 p.m. CT
11:30 a.m. – 1:00 p.m. MT
10:30 a.m. – 12:00 p.m. PT

Access

To access the event in Adobe Connect, go to:
http://edc.adobeconnect.com/capt-dst-marijuana/

To connect to audio:
Dial: 1-866-337-7074; no passcode required

We recommend that you test your connection at least one hour prior to the start of the webinar. To test your connection, go to:
http://edc.adobeconnect.com/common/help/en/support.

You must have Adobe Flash Player (v11 or later) installed on your computer to participate. To download this, go to http://get.adobe.com/flashplayer/.

To review Adobe Connect’s Visual Quick Start Guide, go to https://seminars.adobeconnect.com/_a227210/vqs-participants/

If you experience any difficulty connecting to the webinar or audio line, you may call our tech support line 781-609-7596.

Materials

Questions?

For content-related questions, please contact Gisela Rots (grots @edc.org). For technology related-questions, please contact Consie English (cenglish @edc.org).

OIG Report on CAHs

The Office of the Inspector General (OIG) of Health and Human Services released a report recently on the calculation of patient coinsurance amounts between critical access hospitals (CAH) and PPS hospitals. The National Rural Health Association’s has issued the following response to the report:

CAHs are billing Medicare and beneficiaries according to Medicare rules and regulations, any deviance from these guidelines would result in fines and penalties resulting from non-compliant billing.
Medicare can correct this policy very simply by holding harmless beneficiaries on coinsurance calculations between CAH and PPS hospitals. This change would increase Medicare payments to CAHs in order ensure that CAHs receive 101 percent of cost.
NRHA disagrees with OIG’s assertion that CAH participation in a possible fix be contingent upon re-certifying their CAH status. All CAHs were designated according to rules and regulations in place at varying points in time historically. The Necessary Provider program allowed for a state’s right to designate hospitals it deemed essential according to an overall rural health plan. These rural health plans were approved, in turn, by CMS. All CAHs should be fully reimbursed at 101 percent of their cost if a coinsurance change is implemented.
NRHA believes that the current CMS policy unfairly penalizes rural patients, which is not the intent of Congress. We ask Congress to direct CMS to not shift the burden to providers or to patients.

CRHC will continue to monitor this issue and keep you up to date. If you have any questions or feedback, please contact Michelle Mills, mm@coruralhealth.org or Jen Dunn, jd@coruralhealth.org.

Advisory Panel on Hospital Outpatient Payment

The Centers for Medicare & Medicaid Services (CMS) announced that they will be accepting nominations for the "Advisory Panel on Hospital Outpatient Payment." The purpose of the panel is to advise the Secretary of the Department of Health and Human Services and the Administrator of the Centers for Medicare & Medicaid Services on the clinical integrity of the Ambulatory Payment Classification (APC) groups and their associated weights and supervision of hospital outpatient services. CMS will be taking submissions for nominees until November 21, 2014. Persons wishing to nominate individuals to serve on the panel or to obtain further information may contact Carol Schwartz at 410-786-3985.

CMS Home Health Conditions of Participation NPRM

CMS recently issued a proposed rule, the first update to the Medicare and Medicaid Conditions of Participation for home health agencies since 1989. The proposed changes would update data transmission requirements; focus the patient assessment requirement; and formalize communication and care coordination structures. Home health agencies would be required to maintain a quality assessment and performance improvement program, as well as require additional supervision and training when an agency suspects that home health aide skills are insufficient. CMS will accept comments on the proposed rule for 60 days after publication in the October 9 Federal Register. The proposed rule in the Federal Register is open for comments. Refer to the fact sheet for additional information.

Webinar: Financial Distress of CAHs

Live Webinar Repeat on October 31, 2014:

Change in Profitability and Financial Distress of Critical Access Hospitals (CAHs) from Loss of Cost-Based Reimbursement

Due to high interest, this past webinar will be repeated live and participants will be able to ask questions.

Speaker: Mark Holmes, PhD from the North Carolina Rural Health Research Center
Date: Friday, October 31, 2014
Time: 2:00pm Eastern

The webinar will focus on the financial distress of Critical Access Hospitals.

It is free, no registration is required, and there is no limit to the number of participants.

Connection Information:

Webinar URL: https://hrsa.connectsolutions.com/rhrg_cah/

Enter as a Guest.
Conference phone: 800-369-3185
Participant passcode: 6083799

Questions? Contact:
Shawnda Schroeder, PhD
Rural Health Research Gateway Deputy Principal Investigator
shawnda.schroeder@med.und.edu

CDC Emergency Partners Update: 2014 Ebola Response - October 16, 2014

CDC has activated its Emergency Operations Center to respond to Ebola. Below, please find resources and guidance that we hope will be useful to you and your organization. Please share with your colleagues and networks.

In this email:
o Announcements
o Ebola Cases and Deaths
o Online Resources
o Summary Key Messages

Announcements

CDC and Frontier Airlines Announce Passenger Notification Underway

The CDC confirms that the second healthcare worker who tested positive on Oct. 14 for Ebola traveled by air Oct. 13, the day before she reported symptoms. Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is asking all 132 passengers on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on October 13 (the flight route was Cleveland to Dallas Fort Worth and landed at 8:16 p.m. CT) to call 1 800-CDC INFO (1 800 232-4636). Public health professionals will begin interviewing passengers about the flight, answering their questions, and arranging follow up. Individuals who are determined to be at any potential risk will be actively monitored.

Read CDC’s press release and the complete press briefing transcript and audio.

Texas Reports Positive Tests for Ebola in Two Health Care Workers

On October 10, a healthcare worker at Texas Presbyterian Hospital who provided care for the index patient reported a low-grade fever and was referred for testing. The healthcare worker tested positive for Ebola according to preliminary tests by the Texas Department of State Health Services’ laboratory. The healthcare worker was isolated after the initial report of a fever. CDC confirms that the healthcare worker is positive for Ebola. On the morning of October 14, a second healthcare worker at Texas Presbyterian Hospital who provided care for the index patient reported to the hospital with a low-grade fever and was isolated. The healthcare worker tested positive for Ebola.

Ebola Cases and Deaths

As of October 12, 2014*

· Suspected and Confirmed Case Count: 8997

· Suspected Case Deaths: 5006

· Laboratory Confirmed Cases: 4493

Updates on cases and deaths can be found on the CDC website.

*Case counts updated in conjunction with World Health Organization updates and are based on information reported by the Ministries of Health.

Tuesday, October 14, 2014

Webinar: Infectious Disease and Infection Control

Please join us for a webinar on Infectious Disease and Infection Control topics.

Dr. Clay Watson, a Denver-based infectious disease physician will be speaking on;

Ebola-the disease, the virus, isolation
MERS CO-V-the virus, the disease, signs and symptoms
Influenza 2014 update
Vaccination-Flu- shots, New guidelines on pneumococcal vaccinations
Infection Control reporting, Hospital acquired infections –public reporting and insurance reimbursement, Critical Access Hospitals-what’s required, what’s coming?
Telemedicine-the current state, doc to doc, doc to patient
Antibiotic stewardship-Do I need a program?

Discussion and questions to Follow presentation.

Cost:

Free for CRHC members
$99.00 for non-CRHC members

Nailed It! Cost Effective Project Budget and Financial Need Narrative Writing

Join us for a look at the Cost Effective Project Budget and Financial Need narrative sections of a CREATE Grant Application. What is the ERC looking for in these scoring sections? Learn tools and tips to increase your applications scores and meet the criteria to get that approval you need.

Register here.

Medicare Part A and B News- Jurisdiction H for October 10th

The following information is provided by Novitas Solutions.

MLN Connects™ Provider eNews for October 9, 2014
View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

• Overview of the 2013 Quality and Resource Use Reports — Registration Now Open
• CMS 2014 Certified EHR Technology Flexibility Rule — Registration Now Open
• Transitioning to ICD-10 — Register Now

MLN Connects™ Videos

• Monthly Spotlight: Physician Quality Reporting System

Announcements

• CMS Announces Two Medicare Quality Improvement Initiatives
• New Outreach & Education Page at CMS.gov
• Work with Older Adult Patients? New Medscape Video for CME Credit
• Electronic Funds Transfer Upgrades to the Internet-based PECOS System
• Open Payments: Know the Numbers and Decode the Data
• CMS is Accepting Suggestions for Potential PQRS Measures
• PQRS: Physician Compare 2013 Group Practice Quality Measure Preview Period through November 7
• New FAQs for PQRS
• EHR Incentive Programs: Hardship Exception Applications to Avoid 2015 Payment Adjustment due November 30
• EHR Incentive Programs: Eligible Hospitals and Requirements for CEHRT to Participate in 2015
• EHR Incentive Programs: Learn How to Report 2014 eCQMs through the QualityNet Portal

Medicare Learning Network® Educational Products

• “Dual Eligible Beneficiaries Under the Medicare and Medicaid Programs” Fact Sheet – Revised
• Medicare Learning Network® Products Available in Electronic Publication Format

Medical Policy Local Coverage Determination (LCD) and Article Updates

Medical Policy Updates
Due to system limitations, between October 9, 2014 and December 3, 2014 the following JH LCDs accessed through the policy search application are future LCDs that will become effective on December 4, 2014. The active (current) LCDs can be accessed below or by the following link. Full Index of Current Active LCDs and Future Effective LCDs

Cardiac Event Detection Monitoring (L32679)
Intravenous Immune Globulin (IVIG) (L32712)
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (L32610)
Treatment of Varicose Veins and Venous Stasis Disease of the Lower Extremities (L32678)

The following JH Local Coverage Determinations have been posted for notice. They will become effective December 4, 2014:

Cardiac Event Detection Monitoring (L32679)
Cardiac Rhythm Device Evaluation (L30529)
Intravenous Immune Globulin (IVIG) (L32712)
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (L32610)
Pharmacokinetic (PK) Testing for Chemotherapy Dosing (L35269)
Routine Foot Care (L27486)
Services That Are Not Reasonable and Necessary (L31686)
Transoral Incisionless Fundoplication (L32932)
Treatment of Varicose Veins and Venous Stasis Disease of the Lower Extremities (L32678)

Comments Received and Contractor Responses

The following JH drafts are not being finalized at this time. The current active LCDs will remain in effect:

Debridement of Mycotic Nails (DL27487)
Monitored Anesthesia Care (DL32628)
Surgical Treatment of Nails (DL72532)

The following JH LCDs have been revised:

Biomarkers for Oncology (L34796)
Category III Codes (L32691)
Sacral Nerve Stimulation (L34707)
Spinal Cord Stimulation (Dorsal Column Stimulation) (L34705)
Thrombolytic Agents (L34743)

The following JH LCD has been retired:

MyPRS Genetic Expression Profile Testing (L32636)

Local Coverage Article Updates

The following JH Articles have been revised:
Biomarkers for Oncology (A52317)
NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions (A49325)

Medicare Billing Guide- CAHs and RHCs

The Medicare Billing Guide for CAHs and RHCs has been released. To view it, click here.

Medicare News- October 13th, 2014

Medicare News

Novitas Solutions Website - A Guide to the New Look
We hope you have been enjoying the benefits of the newly designed Novitas Solutions internet site. Here's a look at some of the new features and layout improvements that we have recently introduced. We hope you will find this information helpful as you navigate our site.

Novitas Solutions 2014 Medicare Symposium Registration
Join us for our upcoming symposium in Houston, TX on Thursday, October 23! This event will be held at the Crowne Plaza Houston NRG Stadium Hotel.

Time is fading fast! Now is your chance to register and attend our free 2014 Medicare Symposiums with the Provider Outreach and Education team. We offer a wide variety of class topics including Evaluation and Management Services, Two-Midnight Rule, claim form overviews, and Medicare basics. Don’t miss this golden opportunity to get the latest updates and changes to the Medicare program brought to you live and in-person.

Registration closes two days before the event date. We recommend that you register at least seven days before the event date.

Registration is also open for the following events:

11/5 – Jackson, MS

Ebola Treatment Unit Volunteers

AmeriCares, an emergency response and global health organization headquartered in Stamford, CT, is expanding its Ebola response to include the staffing and operation of an Ebola Treatment Unit (ETU) in Liberia with our partner, the International Organization for Migration. Increasing the number of ETUs is a critical part of the strategy for Ebola treatment and containment.

We are hiring a team to operate the ETU and to teach others to do the same. It will include:

• Medical professionals (medical doctors and nurses, preferably with experience in infectious diseases)
• Water, sanitation and environmental health experts (including biological hazards, waste management and community-based hygiene promotion)
• Mental health professionals (psychiatrists, psychologists and social workers)

Prior experience in emergency contexts or under-resourced settings is desired. A minimum six-week commitment is required and includes in-country training time. All positions are salaried. If you are able to consider the assignment, please register and provide your resume at our jobs portal via the link below. We will then provide more information on position descriptions, safety training, personal protection and logistics as we proceed.

Go to: https://careers-americares.icims.com/jobs/1181/ebola-treatment-unit-staff---liberia/job

Please consider sharing this call for responders with your network. Questions about this effort should be directed to Leslie McGuire, Vice President of US Partnerships and Programs at AmeriCares, at lmcguire@americares.org or (203) 658-9632. Thank you.

Thursday, October 9, 2014

Join the NARHC resource listserv

Looking for more resources for questions regarding rural health clinics? Consider signing up for the National Association of Rural Health Clinics listserv! Click here for more information.

Understanding Simulation Training in Paramedic Education

Understanding Simulation Training in Paramedic Education – Follow-up Data from a NAEMSE Research Project

Premieres LIVE: October 20, 2014
Free to Attend Register Today

We have all heard in some iteration the saying “you can't know where you are going until you know where you have been.” Simulation training has long been used in EMS education, but in today’s changing landscape of prehospital care we find ourselves asking, is it being utilized to its fullest potential? In order to answer this question and make any determination on the future direction of this very powerful methodology we must first understand the current state of the industry.

Register Now!

What You'll Learn:

The scope of the Simulation Use in Paramedic Education Research (SUPER) project.
Where paramedic programs conduct simulation.
Where paramedic programs obtain scenarios and assess their quality.
How paramedic programs provide feedback during and after simulation.
How paramedic programs assess learner simulation performance.

Who Should Attend:

Educators
Training Officers
Program Directors
Medical Directors

Medicare Part A and B News-Jurisdiction H for October 7th, 2014

The following information is provided by Novitas Solutions.

Medicare News

New PC-ACE Pro32 Version 2.56 Upgrade Available - UPGRADE NOW!
PC-ACE Pro32 is a software program that enables electronic billing for both Medicare Part A and Part B claims in a Health Insurance Portability and Accountability Act (HIPAA)-compliant format. To provide the most up-to-date information within PC-ACE Pro32, the software program is updated quarterly. The most current upgrade, which is PC-ACE Pro32 version 2.56, was released on October 6, 2014. Please take time now to upgrade immediately.

Part B Ask-the-Contractor Teleconference Meeting Minutes Now Available!
The meeting minutes from the JH Part B Ask-the-Contractor Teleconference on September 18, 2014 are now available! Please take a moment to review.
Don't miss this Medicare Insights Weekly Podcast!
In this week's Medicare Insights Weekly podcast, we review the new screening service for hepatitis C along with other screening services covered by Medicare. Listen to this podcast to learn about the many preventive services covered for your Medicare patients.

Transitioning to ICD-10 National Provider Call
Please join the Centers for Medicare and Medicaid Services (CMS) on Wednesday, November 5, from 1:30-3:00 pm Eastern Time for the National Provider Call on Transitioning to ICD-10.

The Department of Health & Human Services (HHS) has issued a rule finalizing October 1, 2015, as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10.

During the call, CMS subject matter experts will discuss ICD-10 implementation issues, opportunities for testing, and resources. A question and answer session will follow the presentations.

Agenda:

Final rule and national implementation
Medicare Fee-For-Service testing
Medicare Severity Diagnosis Related Grouper (MS-DRG) Conversion Project
Partial code freeze and annual code updates
Plans for National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)
Home health conversions
Claims that span the implementation date

Target Audience:
Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers.

To register, visit MLN Connects™ Upcoming Calls. Space may be limited, so register early.

Medicare Part A and B News-Jurisdiction H for October 3rd, 2014

The following information is provided by Novitas Solutions.

Transitioning Medicare Administrative Contractor (MAC) Workloads to the New Banking Contractor(s)
CMS announced with MLN Matters Article Number MM8847, that some MAC workloads will be going through a Bank Transition. The Novitas Jurisdiction L (JL) and Jurisdiction H (JH) workloads are all with US Bank currently and will be remaining with US Bank. The Provider’s bank will continue to receive the Novitas payments from US Bank as they do currently, with no impact.

October 2014 Quarterly Release OverviewHere is a summary of the changes that are being implemented with the October 6, 2014 release and links to references with additional information.

Novitas Solutions 2014 Medicare Symposium Registration
Join us for our upcoming symposium in Houston, TX on Thursday, October 23! This event will be held at the Crowne Plaza Houston NRG Stadium Hotel.

Time is fading fast! Now is your chance to register and attend our free 2014 Medicare Symposiums with the Provider Outreach and Education team. We offer a wide variety of class topics including Evaluation and Management Services, Two-Midnight Rule, claim form overviews, and Medicare basics. Don’t miss this golden opportunity to get the latest updates and changes to the Medicare program brought to you live and in-person.

Registration closes two days before the event date. We recommend that you register at least seven days before the event date.

Registration is also open for the following events:

11/5 – Jackson, MS

News Release: 2015 Medicare Part B Premiums and Deductibles to Remain the Same as Last Two Years

To read the new release from CMS regarding 2015 Medicare Part B Premiums and Deductibles, click here.

MLN Connects Provider eNews, 10/9

View the MLN Connects™ Provider eNews View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

Overview of the 2013 Quality and Resource Use Reports — Registration Now Open
CMS 2014 Certified EHR Technology Flexibility Rule — Registration Now Open
Transitioning to ICD-10 — Register Now

MLN Connects™ Videos

Monthly Spotlight: Physician Quality Reporting System

Announcements

CMS Announces Two Medicare Quality Improvement Initiatives
New Outreach & Education Page at CMS.gov
Work with Older Adult Patients? New Medscape Video for CME Credit
Electronic Funds Transfer Upgrades to the Internet-based PECOS System
Open Payments: Know the Numbers and Decode the Data
CMS is Accepting Suggestions for Potential PQRS Measures
PQRS: Physician Compare 2013 Group Practice Quality Measure Preview Period through November 7
New FAQs for PQRS
EHR Incentive Programs: Hardship Exception Applications to Avoid 2015 Payment Adjustment due November 30
EHR Incentive Programs: Eligible Hospitals and Requirements for CEHRT to Participate in 2015
EHR Incentive Programs: Learn How to Report 2014 eCQMs through the QualityNet Portal

Medicare Learning Network® Educational Products

“Dual Eligible Beneficiaries Under the Medicare and Medicaid Programs” Fact Sheet – Revised
Medicare Learning Network® Products Available in Electronic Publication Format

SAMHSA's Service Members, Veterans, and their Families Technical Assistance Center

Topics in the News

VA Announces New Grants to Help End Veteran Homelessness
In addition to the $300 million in Supportive Services for Veteran Families (SSVF) program grant awards announced on August 11, 2014 serving 115,000 veterans and their family members, Secretary of Veterans Affairs Robert A. McDonald announced the award of $207 million in SSVF grants that will help an additional 70,000 homeless and at-risk veterans and their families. The grants will be distributed to 82 non-profit agencies and include “surge” funding for 56 high-need communities.
Read more...

VA Partners With Walgreens to Expand Real-Time Sharing of Medical Information of Vaccines Provided by Walgreens to Enrolled Veterans
In a first-of-its-kind partnership, the Department of Veterans Affairs (VA) announced that it will join forces with retailer Walgreens to provide greater access to Centers for Disease Control and Prevention-recommended vaccinations to veterans across the country. This partnership grew out of a successful pilot program that began in Florida to provide flu vaccines to veterans throughout the state.
Read more...

WEBINAR: DCoE - Integration of a Virtual Hope Box Mobile Application into Clinical Care
October 16, 2014; 1:00-2:30 p.m. EDT
Several behavioral health treatments have proven useful for patients who feel hopeless and may be considering suicide or self-harm. One tool used by providers is the “hope box.”
Learn more and register...

WEBINAR: National Drug Court Institute - PTSD and What it Means for Our Participants?
October 28, 2014; 2:00-3:00 p.m. EDT
Join us at 2:00 p.m. on October 28, 2014, as we go in depth in understanding, assessing, and treating participants with post-traumatic stress disorder (PTSD). Nationally, PTSD affects 5.2 million adults during a given year.
Learn more and register...

Hardship Exception Applications to Avoid Medicare Payment Adjustment 11/30/14

Hardship Exception Applications to Avoid the 2015 Medicare Payment Adjustment Due November 30, 2014

CMS is announcing its intent to reopen the submission period for hardship exception applications for eligible professionals and eligible hospitals to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use of Certified Electronic Health Record Technology (CEHRT). The new deadline will be November 30, 2014. Previously, the hardship exception application deadline was April 1, 2014 for eligible hospitals and July 1, 2014 for eligible professionals.

As part of the American Recovery and Reinvestment Act of 2009 (Recovery Act), Congress mandated payment adjustments under Medicare for eligible hospitals, critical access hospitals, and eligible professionals that are not meaningful users of CEHRT. The Recovery Act allows the Secretary to consider, on a case-by-case basis, hardship exceptions for eligible hospitals, critical access hospitals, and eligible professionals to avoid the payment adjustments.

This reopened hardship exception application submission period is for eligible professionals and eligible hospitals that:

Have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability; AND
Eligible professionals who were unable to attest by October 1, 2014 and eligible hospitals that were unable to attest by July 1, 2014 using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule.

These are the only circumstances that will be considered for this reopened hardship exception application submission period. Applications must be submitted by 11:59 PM EST November 30, 2014.

More Information
More information about the application process will be shared soon. We intend to address this issue in upcoming rulemaking. Visit the Payment Adjustments and Hardship Exceptions webpage for more information about Medicare EHR Incentive Program payment adjustments.

ICD-10 Coding Basics MLN Connects™ National Provider Call

ICD-10 Coding Basics MLN Connects™ National Provider Call

Wednesday, November 5; 1:30-3pm ET

To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.

The Department of Health & Human Services (HHS) has issued a rule finalizing October 1, 2015, as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10.

During the MLN Connects™ National Provider Call, Centers for Medicare & Medicaid Services (CMS) subject matter experts will discuss ICD-10 implementation issues, opportunities for testing, and resources. A question and answer session will follow the presentations.

Agenda:

Final rule and national implementation
Medicare Fee-For-Service testing
Medicare Severity Diagnosis Related Grouper (MS-DRG) Conversion Project
Partial code freeze and annual code updates
Plans for National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)
Home health conversions
Claims that span the implementation date

Target Audience: Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers

Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.

MLN Connects Provider eNews, 10/2/2014

View the MLN Connects™ Provider eNews

View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

Hospital Compare Star Ratings: Overview of HCAHPS Star Ratings — Last Chance to Register
Hospital Appeals Settlement Update — Last Chance to Register
Overview of the 2013 Quality and Resource Use Reports — Registration Opening Soon
Transitioning to ICD-10 — Register Now
New MLN Connects™ National Provider Call Audio Recording and Transcript

CMS Events

Special Open Door Forum: Star Ratings on Dialysis Facility Compare

Announcements

National Breast Cancer Awareness Month
CMS Makes First Wave of Drug and Device Company Payments to Teaching Hospitals and Physicians Public
Get Ready for DMEPOS Competitive Bidding – Common Ownership and Common Control
PQRS GPRO Registration Extended Until October 3
Volunteers Sought for ICD-10 End-to-End Testing in January: Forms due October 3
Comply with MAC Request for Fingerprints within 30 Days
CMS Announces Availability of 2013 Quality and Resource Use Reports
EHR Incentive Program: CMS Attestation System Open
ICD-10 Compliance Date Is October 1, 2015

Claims, Pricers, and Codes

ICD-10-CM Official Guidelines for Coding and Reporting Available

Medicare Learning Network® Educational Products

“Hospital-Acquired Conditions and Present on Admission Indicator Reporting Provision” Fact Sheet — Revised
"Medicare Appeals Process" Fact Sheet — Revised
Medicare Learning Network® Products Available In Electronic Publication Format
New Medicare Learning Network® Provider Compliance Fast Fact

FREE Webinar on CEHRT for Small Practices

Event: CMS 2014 Certified EHR Technology (CEHRT) Flexibility Rule Overview
Topic: EHR Incentive Programs

Date: Wednesday, October 15, 2014
Time: 1:00 PM - 2:00 PM Eastern Time

Registration: https://attendee.gotowebinar.com/register/5020894920993673730

Agenda:
• CMS 2014 CEHRT Flexibility Rule overview
• Stage 2 extension
• 2014 flexibility options
• Attestation System updates
• CMS responses to public comments
• Resources
• Q&A

Description:
This webinar provides PAHCOM members with an overview of the 2014 Certified EHR Technology (CEHRT) Flexibility Rule that went into effect on October 1, 2014. While directed at PAHCOM members, all are welcome and anyone focused on medical office management will benefit.

This presentation will cover guidance and instructions on how eligible professionals who have been unable to fully implement 2014 Edition CEHRT for an EHR reporting period in 2014 due to delays in 2014 Edition CEHRT availability can use the rule’s flexibility to report for 2014.

The presentation also provides information about the extension of Stage 2 through 2016. A question and answer session will follow the presentation.

Speaker:
Vidya Sellappan, HIT Initiatives Group, Office of E-Health Standards and Services

The Affordable Care Act and You: Planning for the Next Open Enrollment Period

The Affordable Care Act and You: Planning for the Next Open Enrollment Period
October 14, 2014
2pm-3pm EST
Join the webcast: http://services.choruscall.com/links/hrsa141014.html

Open enrollment in the Health Insurance Marketplace opens November 15, 2014! Please join HRSA for a presentation on a range of topics including this year’s open enrollment season, re-enrollment, best practices from the first open enrollment period, and special enrollment periods.
A new wave of powerful evidence points to one clear conclusion: The Affordable Care Act is working to make health care more affordable, accessible and of a higher quality, for families, seniors, businesses, and taxpayers alike. There are many opportunities for you to engage in this important work! The presentation is open to all HRSA grantees. There will be a Q&A at the end of the webcast.

Thursday, October 2, 2014

Part A and B News-Jurisdiction H for September 30th, 2014

The following information is provided by Novitas Solutions.

Medicare News

New Fees Available:

New Medicare Insights Weekly Podcasts Now Available

In this week's Medicare Insights Weekly podcast, we review the four new modifiers for distinct procedural services that are effective January 1, 2015 along with other commonly used modifiers. Don't miss this podcast!

Medicare Part A and B News-Jurisdiction H for September 29th, 2014

The following information is provided by Novitas Solutions.

Medicare News

Customer Contact Center Survey
Your feedback is important to us. Please take a moment to complete the Customer Contact Center Survey so we can better assist you.

Medicare Learning Network (MLN) Articles from CMS

New:

Enhanced Provider Enrollment Status Inquiry Tool

We updated our online status tool to include the issue date of Phase 3 revalidation notices. If you have not yet received a notice, and want to know if one was issued, you may use the status tool as your source of information.

Novitas Solutions 2014 Medicare Symposium Registration

Join us for our upcoming symposium in Houston, TX on Thursday, October 23! This event will be held at the Crowne Plaza Houston NRG Stadium Hotel.

Time is fading fast! Now is your chance to register and attend our free 2014 Medicare Symposiums with the Provider Outreach and Education team. We offer a wide variety of class topics including Evaluation and Management Services, Two-Midnight Rule, claim form overviews, and Medicare basics. Don’t miss this golden opportunity to get the latest updates and changes to the Medicare program brought to you live and in-person.

Registration closes two days before the event date. We recommend that you register at least seven days before the event date.

Registration is also open for the following events:

11/5 – Jackson, MS

Medicare Part A News-Jurisdiction H for September 26th, 2014

The following information is provided by Novitas Solutions.

MLN Connects™ Provider eNews for September 25, 2014
View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

Hospital Compare Star Ratings: Overview of HCAHPS Star Ratings — Registration Opening Soon
Hospital Appeals Settlement Update — Registration Now Open
Transitioning to ICD-10 — Register Now
New MLN Connects™ National Provider Call Video Slideshow

Announcements

Volunteers Sought for ICD-10 End-to-End Testing in January: Forms due October 3
National Partnership to Improve Dementia Care Exceeds Goal to Reduce Use of Antipsychotic Medications in Nursing Homes: CMS Announces New Goal
Hospital Appeals Settlement: New FAQs Posted
Groups: Remember to Register for 2014 PQRS GPRO Participation by September 30
2014 PQRS 2nd Quarter Interim Feedback Dashboard Reports Available
2013 PQRS and eRx Incentive Program Incentive Payments Available
2013 PQRS and eRx Incentive Program Feedback Reports Available
2012 eRx Incentive Program and 2012 PQRS Supplemental Incentive Payments Available
Completion and Submission Timeframes for Hospice Item Set Records
Important Skill Sets for Doctors and Nurses: CME Articles Available on Medscape
New Resources and Webinars from National Health IT Week
PQRS: New Quality Reporting Training Modules to Help Ensure Satisfactory 2014 Reporting
2014 CAHPS for PQRS Survey
New PQRS FAQs Available
New and Updated FAQs for the EHR Incentive Programs

Claims, Pricers, and Codes

FDG PET for Solid Tumor Claims

Medicare Learning Network® Educational Products

“Medicare Billing Information for Rural Providers and Suppliers” Booklet — Revised
“Rural Health Clinic” Fact Sheet — Revised
“Avoiding Medicare Fraud & Abuse: A Roadmap for Physicians” Fact Sheet — Revised
“Critical Access Hospital” Fact Sheet — Revised
Subscribe to the Medicare Learning Network® Educational Products and MLN Matters® Electronic Mailing Lists

Novitas Solutions 2014 Medicare Symposium Registration

Join us for our upcoming symposium in Houston, TX on Thursday, October 23! This event will be held at the Crowne Plaza Houston NRG Stadium Hotel.

Time is fading fast! Now is your chance to register and attend our free 2014 Medicare Symposiums with the Provider Outreach and Education team. We offer a wide variety of class topics including Evaluation and Management Services, Two-Midnight Rule, claim form overviews, and Medicare basics. Don’t miss this golden opportunity to get the latest updates and changes to the Medicare program brought to you live and in-person.

Registration closes two days before the event date. We recommend that you register at least seven days before the event date.

Registration is also open for the following events:
11/5 – Jackson, MS

CMS Offers RAC Settlement Option to Hospitals

The Centers for Medicare & Medicaid Services will provide any acute care or critical access hospital willing to withdraw their pending recovery audit appeal of claims with a "timely partial payment" of 68 percent of the disputed claims' net allowable amount. The CMS Office of Medicare Hearings and Appeals has a significant backlog of hospital inpatient claims appeals, and the agency is encouraging hospitals to "make use of this administrative agreement mechanism to alleviate the administrative burden of current appeals on both the hospital and Medicare system." The eligible claims, according to CMS, are appeals pending for inpatient-status claim denials by Medicare contractors on the basis that services may have been reasonable and necessary, but treatment on an inpatient basis was not, with dates of admissions prior to Oct. 1, 2013. Hospitals that wish to appeal should do so by Oct. 31, 2014, or request an extension. CMS will review the spreadsheets of claims and appeals submitted by hospitals, then the hospitals will review any discrepancies and resubmit spreadsheets as needed, and finally the appeals will be dismissed and the hospitals will be paid.

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.

2014 At a Glance Newsletters

Geographic Variation in Premiums in Health Insurance Marketplaces

This Policy Brief analyzes the 2014 premiums of health insurance plans available in the new marketplaces created by the Affordable Care Act. Using methodology developed in an earlier Policy Brief, we find that initially, a state-based marketplace design and an “MSAs+1” rating area design are associated with lower average premiums. Rating areas with more than 1000 people per square mile also tend to have the lower premiums. We find that the rating areas with the highest average premiums are characterized by smaller populations, greater land areas, and far fewer health providers per square mile.

Contact Information:
Keith J. Mueller, PhD
RUPRI Center for Rural Health Policy Analysis
Phone: 319.384.3832
keith-mueller@uiowa.edu

Webinar: 340B Compliance and Self-Audits

Interactive Webinar: 340B Compliance and Self-Audits

We invite you to attend a special webinar on Tuesday, October 28 from 1:00 to 2:30 PM (Eastern) on 340B compliance and self-audits.

The laws governing the 340B program are complex. Hospitals must have a thorough understanding of 340B requirements to ensure that their compliance and self-audit plans adequately address program rules. We receive many 340B compliance questions about specific situations encountered by hospitals in their day-to-day environment. The need to be compliant is especially acute because HRSA continues to audit hospitals. The agency is also directly contacting hospitals with compliance concerns. Regular self-audits play a critical role in helping hospitals ensure that they are staying compliant.

This webinar will feature Dianna Pimlott, Director of Pharmacy Services at PeaceHealth Peace Harbor Medical Center in Florence, Oregon. Ms. Pimlott will address in detail her hospital’s self-audit process and what they have learned from performing regular self-audits. This webinar also will:
Share findings from HRSA’s audits of hospitals and discuss ways to address these issues
Address common 340B compliance questions raised by members
Explore disclosure of noncompliance to HRSA and manufacturers
Describe a variety of valuable SNHPA compliance resources available to members

SEND US YOUR QUESTIONS! We would like to give you the opportunity to have your specific questions addressed in this webinar. Please send your 340B compliance questions to SNHPA Counsel, Greg Doggett at greg.doggett@snhpa.org in advance of the webinar, and we will make every effort to address those issues in the presentation.

WHO SHOULD ATTEND: Compliance officers, in-house counsel, pharmacy directors, 340B pharmacy managers, CFOs, and government relations staff.

SPEAKERS: The webinar will feature Dianna Pimlott, Director of Pharmacy Services at PeaceHealth Peace Harbor Medical Center in Florence, Oregon, as well as SNHPA Senior Vice President and General Counsel Maureen Testoni, and SNHPA Counsel Jeff Davis and Greg Doggett.

Pre-registration is required (including for member hospitals and Platinum Level Corporate Partners for whom this event is free). Please click HERE to register. The deadline is October 27. A confirmation will be e-mailed to you once you register so please be sure to enter your e-mail address correctly. If you have questions about your registration or creating a log-in account, please contact Evangeline SoleynJohn at (202) 552-5865 or evangeline.soleynjohn@snhpa.org.

MORE INFORMATON: Feel free to contact Lee-Anne Gabrielli at lee-anne.gabrielli@snhpa.org or (202) 552-5856.

Note from the Instructor: Frequently Asked Questions Posted for the 68% Solution

"Last week, CMS hosted an MLN Connects™ National Provider Call regarding the administrative agreement it is offering to acute care hospitals and critical access hospitals (CAHs) to resolve patient status denials and their related appeals with admission dates prior to October 1, 2013. A Frequently Asked Question document was also posted to the CMS Inpatient Hospital Reviewswebsite that provided some clarity to the solution that is being put on the table."

To view the rest of the article posted on the Medicare Insider, click here.

Pages

Thursday, October 30, 2014

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 like to receive ACA Implementation News or our ACA Communication Updates please click here.

Thursday, October 23, 2014

Tuesday, October 14, 2014

Thursday, October 9, 2014

Thursday, October 2, 2014