Medicare Part A and B News-Jurisdiction H for November 26th, 2014

The following information is provided by Novitas Solutions.

Medicare News
Medicare Learning Network (MLN) Articles from CMS

New:

• MM8982 – Update to Medicare Deductible, Coinsurance, and Premium Rates for 2015
• MM8999 – Calendar Year (CY) 2015 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule

Revised:

• MM8871 – Screening for Hepatitis C Virus (HCV) in Adults

Medicare Part A and B News-Jurisdiction H for November 24th, 2014

The following information is provided by Novitas Solutions.

Medicare News

Website Satisfaction Surveys
Have you completed a website satisfaction survey this month? Novitas Solutions randomly offers our customers a website satisfaction survey [which we encourage you to take every 30 days] that gives you a direct line to provide your feedback. Tell us how you feel about our recent website design changes. How about your thoughts on our NEW Fee Schedule Tool? Are there other enhancements we could make to our website? Each survey completed is reviewed by a team of experts, who continually look for ways to improve your web experience.

Your opinion matters and we want to hear it. We look forward to hearing from you soon.


Medicare Physician’s Fee Schedule Code Search & Downloads
You asked and we delivered! We are happy to announce the new and improved Medicare Physician’s Fee Schedule Code Search & Downloads! No more searching in multiple places to find what you’re looking for. This is a one-stop shop for all your fee schedule needs. Attached are instructions with screen images to help you navigate.

Note: The 2015 fees for single code searches will not be available until January 2015. However, the 2015 fee schedule is available through the Download option.

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.

Therapy Caps Applied to Hospital and Critical Access Hospital (CAH) Outpatient Therapy

Note from the instructor: Therapy Caps Applied to Hospital and Critical Access Hospital (CAH) Outpatient Therapy

Click here to read the full article.

How does your organization train its physicians?
HCPro is interested in learning about physician training at your organization. To show our thanks, we will select one respondent at random to win a complimentary HCPro on-demand webcast of his or her choice. Click here to take the survey or follow the link above for more information.

This week in Medicare updates
This week’s updates include updates to Medicare deductible, coinsurance, and premium rates and coverage for hepatitis C screening. Click the link above to read more about this week’s updates.


Upcoming events
CMS is hosting forums and calls in the upcoming months. Click the link above for registration information.

The Untold Story of ICD-10

The Untold Story of ICD-10 - If It Isn't Documented It Didn't Happen

Tuesday, December 2, 2014
12:00-1:00 pm Central Time

Understanding the pivotal role of clinical documentation improvement (CDI) and ICD-10 in quality care, appropriate reimbursement and accurate physician profiling and how to easily and accurately implement them. Most clinicians agree on the benefits of documentation. They know records must be clear, concise and specific. They understand "if it isn't documented, it didn't happen". Yet all too often, they fail to record important details that, if known, could result in better care and more appropriate reimbursement. They lose countless hours responding to coder queries that could be better spent caring for patients.

Learning Objectives:

• Understand why it is important to embed CDI and ICD-9-CM/ICD-10-CM guidelines in the clinical workflow 
• Understand how an effective CDI program can lead to quality care, appropriate reimbursement and accurate physician profiling by demonstrating the severity of illness, medical necessity and utilization of resources 
• Gain insight on how to document for severity of illness by using specific clinical terminology and evidenced-based criteria 
• Become familiar with select CDI scenarios in ambulatory care in Family Medicine, Internal Medicine and Orthopedics 
• Become familiar with a CDI scenario that illustrates the complexity of CDI in inpatient facilities

Learn more and register now.

AgriSafe Webinar: Understanding OSHA's Agricultural Exemptions & Standards

Understanding OSHA's Agricultural Exemptions & Standards

Date: Monday, December 1, 2014
Time: 12:00pm - 1:00pm Central Time

Summary:
This presentation takes a practical look at the exemption status, how it is defined and where it affects various segments of production agriculture. This program is designed for workers in production agriculture, worksite managers and supervisors, agricultural business owners and those involved in family farming or ranching.

Participants will be able to:

• Identify OSHA standards specific to agriculture 
• Identify General Industry OSHA standards that should be considered in agriculture 
• Understand OSHA exemption 
• Differentiate between federal OSHA, state OSHA, NIOSH, EPA (Environmental Protection Agency) and WPS (Worker Protection Standard) 
• Locate resources to aid in OSHA standards compliance. 

Register Here!

Telehealth Webinar: Impact of Social Media in Health Care

Telehealth Webinar: "Impact of Social Media in Health Care"

Wednesday, December 10th, 2014 ~ 12:00pm MST

(11am PT; 12pm Arizona; 1pm MST; 1pm CST; 2pm EST)

Learning Objectives:
1. Understand how patients and consumers are suing social media as it relates to their
health care.
2. Understand how health care providers and organizations including hospitals, are using social
media.

For more information and registration instructions go to

 http://telemedicine.arizona.edu/distant-education/upcoming-workshops

Medicare Part A and B News- Jurisdiction H for November 18th, 2014

The following information is provided by Novitas Solutions.

Medicare News

New Medicare Insights Weekly Podcasts Now Available
In this week's Medicare Insights Weekly podcast, we provide a high-level overview of the International Classification of Diseases, Tenth Revision, diagnosis and inpatient procedure codes. The podcast will be on hiatus until December 8. From all of us at Novitas Solutions, Have a safe and Happy Thanksgiving!


Important edit changes for Institutional claims effective January 4, 2015
CMS issued Change Request (CR) 8753 edit spreadsheet changes for Institutional electronic claims. The Institutional edit changes below will be implemented the evening of January 4, 2015.



Medicare Learning Network (MLN) Articles from CMS

New:
SE1432 – Revised Centers for Medicare & Medicaid Services (CMS) 855R Application - Reassignment of Medicare Benefits

Revised:
MM8384 – Medicare Shared Systems Modifications Necessary to Capture Various HIPAA Compliant Fields


The Holiday Season is Here!
The holiday season is upon us and while we are happy to work with you, your written and/or verbal feedback is the only gift that we need! Please note that Novitas employees are prohibited from accepting any gifts from providers at any time and not just during the holiday season. Thank you!

MLN Connects Provider eNews for November 13th, 214

MLN Connects™ Provider eNews for November 13, 2014
View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

• 2015 Physician Fee Schedule Final Rule: Changes to Physician Quality Reporting Programs — Registration Now Open
• National Partnership to Improve Dementia Care in Nursing Homes — Register Now
• Certifying Patients for the Medicare Home Health Benefit — Registration Now Open
• New MLN Connects™ National Provider Call Audio Recordings and Transcripts

CMS Events

• Participate in ICD-10 Acknowledgement Testing Week: November 17 through 21, 2014

Announcements

• Recognizing Lung Cancer Awareness Month and the Great American Smokeout
• Dialysis Facility Compare Star Ratings and Data Release for January 2015
• Coverage of Speech Generating Devices
• Clinical Laboratory Improvement Amendments Proposed Rule
• PQRS Negative Payment Adjustment
• FY 2016 IRF Quality Reporting Program Submission Deadline: November 15
• FY 2016 LTCH Quality Reporting Program Submission Deadline: November 15
• OASIS Updates for Home Health Agencies
• Get Ready for DMEPOS Competitive Bidding
• EHR Incentive Program: Deadlines for 2014 Hospital Reporting on November 30
• Changes to Medicare EHR Incentive Program Hardship Exceptions
• ICD-10 Resources for Small Physician Practices on Medscape

Claims, Pricers, and Codes

• ICD-10 MS-DRG v32 Definitions Manual and Medicare Code Editor Files Available
• 2015 HCPCS Annual Update
• Acute Inpatient PPS FY 2015.2 Software Release Available
• FDG PET for Solid Tumors: Claims Hold Extension

Medicare Learning Network® Educational Products

• "Safeguarding Your Medical Identity” Web-Based Training Course — Revised
• “Medicare Enrollment and Claim Submission Guidelines” Booklet — Revised
• “Medicaid Program Integrity: Understanding and Preventing Provider Medical Identity Theft” Booklet — Revised
• “Medicaid Program Integrity: Preventing Provider Medical Identity Theft” Fact Sheet — Revised
• “Medicaid Program Integrity: Safeguarding Your Medical Identity Using Continuing Medical Education (CME)” Educational Tool — Revised
• Medicare Learning Network® Products Available in Electronic Publication Format

New CMS 855R

SE1432 – Revised Centers for Medicare & Medicaid Services (CMS) 855R Application - Reassignment of Medicare Benefits

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1432.pdf

The revised CMS 855R application will be available for use on the CMS.gov website as of December 29, 2014. MACs may accept both the current and revised versions of the CMS 855R through May 31, 2015, after which the revised CMS 855R application will be required to be submitted.

After May 31, 2015, MACs will return any newly submitted CMS 855R applications on the previous version (07/11) to the provider/supplier with a letter explaining that the CMS 855R has been updated and the current version of the CMS 855R (11/12) must be submitted.

Physicians, non-physician practitioners, providers, and suppliers must use the revised CMS 855R application starting June 1, 2015. The revised CMS 855R has been streamlined and some sections have been re-ordered for clarity. The revised form includes an optional section for primary practice location address. This information is shared with other programs such as Physician Compare to help beneficiaries identify where their physicians are primarily practicing. This address must be one that is affiliated with the individual/organization where the benefits are being reassigned.

ICD-10 Testing Drop-in Article

Medicare ICD-10 Acknowledgement Testing

The Centers for Medicare and Medicaid Services (CMS) is in the process of implementing ICD-10. All covered entities must be fully compliant on October 1, 2015. CR8858 instructs all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment MAC Common Electronic Data Interchange (CEDI) contractor to promote ICD-10 Acknowledgement Testing with trading partners during three separate testing weeks, and to collect data about the testing. The first testing week was held November 17-21, and two additional weeks are scheduled:

·         March 2 – 6, 2015

·         June 1 – 5, 2015

While submitters may acknowledgement test ICD-10 claims at any time through implementation, the ICD-10 testing weeks have been created to generate awareness and interest, and to instill confidence in the provider community that CMS and the MACs are ready and prepared for the ICD-10 implementation.

These testing weeks will allow trading partner’s access to MACs and CEDI for testing with real-time help desk support. The event will be conducted virtually and will be posted on the CMS website, the CEDI website and each MAC's website.

Key points of the testing process:

·         Test claims with ICD-10 codes must be submitted with current dates of service since testing does not support future dates of service.

·         Claims will be subject to existing NPI validation edits.

·         MACs and CEDI will be staffed to handle increased call volume during this week.

·         Test claims will receive the 277CA or 999 acknowledgement as appropriate, to confirm that the claim was accepted or rejected by Medicare.

·         Test claims will be subject to all existing EDI front-end edits, including Submitter authentication and NPI validation.

·         Testing will not confirm claim payment or produce a remittance advice.

·         MACs and CEDI will be appropriately staffed to handle increased call volume on their Electronic Data Interchange (EDI) help desk numbers, especially during the hours of 9:00 a.m. to 4:00 p.m. local MAC time, during this week.

·         Your MAC will announce and promote these testing weeks via their listserv messages and their website

MACs and CEDI will be appropriately staffed to handle increased call volume on their Electronic Data Interchange (EDI) help desk numbers, especially during the hours of 9:00 a.m. to 4:00 p.m. local MAC time, during these testing weeks. For more information about acknowledgement testing, refer to the information on your MAC’s website.

End-to-End Testing

During 2015, CMS plans to offer three separate end-to-end testing opportunities. Each opportunity will be open to a limited number of providers that volunteer for this testing. As planned, approximately 2,550 volunteer submitters will have the opportunity to participate over the course of the three testing periods. End-to-end testing includes the submission of test claims to Medicare with ICD-10 codes and the provider’s receipt of a Remittance Advice (RA) that explains the adjudication of the claims.

CMS plans to conduct end-to-end testing with Medicare fee-for-service providers and industry stakeholders in January, April, and July 2015. Registration for the January testing has closed, but opportunities will be available to register for the testing in April and July. The goal of this testing is to demonstrate that:

·         Providers and submitters are able to successfully submit claims containing ICD-10 codes to the Medicare claims systems.

·         CMS software changes made to support ICD-10 result in appropriately adjudicated claims.

·         Accurate Remittance Advices are produced.

Want More Information About ICD-10?
For the latest news and resources to help you prepare for the October 1, 2015, deadline, sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.

ICD-10 Resources Drop-in Article

CMS ICD-10 Resources

With the October 1, 2015, ICD-10 compliance date less than one year away, now is the time to prepare for the transition. To support the health care community, the Centers for Medicare & Medicaid Services (CMS) offers resources that explain ICD-10 for providers, payers, vendors, and non-covered entities.

Medscape Continuing Medical Education Resources

CMS has created two videos and one expert column to help educate health care professionals about ICD-10. Beyond providing tips and advice, these free resources offer continuing medical education (CME) and nursing continuing education (CE) credits. Anyone who completes the modules can earn a certificate.

·         Video: ICD-10: Getting From Here to There -- Navigating the Road Ahead

·         Video: ICD-10 and Clinical Documentation

·         Expert Column: Preparing for ICD-10: Now Is the Time

Road to 10 Tool for Small Physician Practices

Available on the Provider Resources page at cms.gov/ICD10, the “Road to 10” tool is an online resource built with the help of providers in small practices. This tool is intended to help small medical practices jumpstart their ICD-10 transition and can help you:

·         Understand the basics of ICD-10

·         Build an ICD-10 action plan to map out your transition

·         Answer frequently asked questions

·         Learn how ICD-10 affects your practice with tailored clinical scenarios and documentation tips for Family Practice and Internal Medicine, Obstetrics and Gynecology, Orthopedics, Cardiology, and Pediatrics

CMS.gov Resources

To support the health care community with the transition to ICD-10, CMS has developed a variety of resources available at cms.gov/ICD10, including fact sheets, guides, and webinar presentations. CMS also distributes regular Email Update messages with information about ICD-10. Subscribe today to stay up to date on the latest news and resources from CMS.

CAH Rural Designation

CMS just released a list of Critical Access Hospitals that are no longer located in rural areas. Here is a link to that list:

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Downloads/FY2015-CAH-Rural-to-Urban.pdf

If a CAH is located in one of these counties, it must reclassify as rural using the regulations at 42 CFR §412.103 by September 30, 2016 in order to be considered rural after September 30, 2016. It is possible that Critical Access Hospitals (CAHs) on this list may have already reclassified as rural or may be in the process of reclassifying as rural. Someone should verify that the CAHs are aware of this change in their rural status and ensure they are taking the necessary steps to be reclassified.

Understanding Medicare Webinar

The CMS National Training Program is hosting an Understanding Medicare webinar on Wednesday, December 3, 2014.

This webinar is designed for new partners who counsel people with Medicare, and for partners requiring a refresher. Participants will receive a high-level overview of Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance), Medicare Part C (Medicare Advantage), and Medicare Part D (Medicare prescription drug coverage).

The audio portion of the webinar will be delivered via your computer. Please check your computer settings in advance to ensure that your speaker volume is adjusted appropriately.

Continuing education credits are not offered for this session.

Webinar details:
Date: December 3, 2014
Time: 1:00 p.m. to 3:00 p.m. ET.

Sign up here: https://goto.webcasts.com/starthere.jsp?ei=1043429

MLN Connects Provider eNews for November 20th, 2014

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

In This Edition:

MLN Connects™ National Provider Calls

• 2015 Physician Fee Schedule Final Rule: Changes to Physician Quality Reporting Programs — Register Now 
• National Partnership to Improve Dementia Care in Nursing Homes — Register Now 
• Certifying Patients for the Medicare Home Health Benefit — Register Now 
• New MLN Connects™ National Provider Call Audio Recording and Transcript 

CMS Events

• "Home Health Change of Care Notice and Advance Beneficiary Notice of Noncoverage” Webinar — Registration Open 

Announcements

• National Home Care and Hospice Month 
• Seasonal Influenza and Diabetes Awareness 
• Affordable Care Act and Health Care Coverage: CME Articles on Medscape 
• Prior Authorization Process for Repetitive, Scheduled, Non-Emergent Ambulance Transport 
• 2013 QRURs Available 
• PEPPER Still Available for SNFs, Hospices, CAHs, LTCHs, IPFs, IRFs and PHPs 
• Distribution of 2012 PQRS Supplemental Incentive Payments 
• EHR Incentive Program: How to Report Once in 2014 for Medicare Quality Reporting Programs 
• EHR Incentive Programs: Summary of Care Meaningful Use Requirements in Stage 2 

Medicare Learning Network® Educational Products

• The Medicare Learning Network® Autumn 2014 Catalog — Released 
• “Revised Centers for Medicare & Medicaid Services (CMS) 855R Application – Reassignment of Medicare Benefits” MLN Matters® Article — Released 
• “Medicare Billing: 837I and Form CMS-1450” Fact Sheet — Revised 
• “Medicare Billing: 837P and Form CMS-1500” Fact Sheet — Revised 
• “Evaluation and Management Services Guide” Educational Tool — Revised 
• New Medicare Learning Network® Provider Compliance Fast Fact 
• Medicare Learning Network® Product Available in Electronic Publication Format

Colorado Healthy Hospital Compact leads national movement to improve nutrition

Hospitals from across Colorado joined the Colorado Department of Public Health and Environment Nov. 14 in launching the Colorado Healthy Hospital Compact, a first-of-its kind agreement to promote healthy food and beverage options in hospital cafeterias, vending machines and patient menus and support new moms in breastfeeding their babies.

State health department Executive Director and Chief Medical Officer Dr. Larry Wolk recognized founding partners, new partner hospitals and those that have achieved a level of recognition under the Compact's comprehensive standards.

Founding Partners

Children's Hospital Colorado, Denver Public Health, Jefferson County Public Health Kaiser-Permanente Healthcare, LiveWell Colorado, Lutheran Medical Center, Tri-County Health Department, University of Colorado School of Medicine, Department of Pediatrics.


Partner Hospitals

Gold: Children's Hospital Colorado, Lutheran Medical Center

Silver: Avista Adventist Hospital, Littleton Adventist Hospital, St. Anthony Summit Medical Center

Bronze: Denver Health Medical Center, St. Anthony Hospital

New: Longmont United Hospital, Medical Center of Aurora, Sky Ridge Medical Center

The state health department is committed to making Colorado the healthiest state in the nation. State health experts worked with founding partners to develop the nationally-recognized compact as a way to improve hospital nutrition and reduce obesity. While Colorado is the leanest state in the nation, one in five Colorado adults and one in seven Colorado children are obese.

Compact hospitals choose programs to implement and are recognized for what they achieve against a comprehensive set of standards. Here are the four programs available and a sample of the standards for each:

-Healthy Food Program: Compact hospitals offer daily healthy adult and child meals and a proportion of healthy snacks and side dishes.

-Healthy Beverage Program: Compact hospitals offer free water and sugarless drink options.

-Marketing Program: Compact hospitals promote healthy food and beverage choices through signage, labeling and discounts.

-Breastfeeding Support Program: Compact hospitals provide trained staff members to help mothers breastfeed their babies in the hospital and refer them to lactation support services upon discharge. They also must offer staff members a time and place to breastfeed.

Webinar: Choosing a Telehealth Service Provider

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

Choosing a Telehealth Service Provider 

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 this webinar:  https://hrsa.connectsolutions.com/sbtelehealth/ 

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

When Service Members Need Mental Health Help
Ryan Rigdon, then 24, held his life in his hands, but it was all in a day’s work. As a Navy senior explosive ordnance disposalman, his job was using robotic technology to disarm roadside bombs. He had volunteered, received extensive training, and was deployed to Iraq right after the U.S. military surge.
Read more…

NADCP Webinar: Computerized Assessment and Referral System (CARS): Revolutionizing DUI Assessment
December 15, 2014; 2:00 p.m. EST
The National Center for DWI Courts in conjunction with the Foundation for Advancing Alcohol Responsibility is proud to announce a webinar featuring Dr. Sarah E. Nelson. Dr. Nelson is the Associate Director for Research at the Division on Addiction, Cambridge Health Alliance, a teaching affiliate of Harvard Medical School and an Assistant Professor of Psychiatry at Harvard Medical School. Please join Dr. Nelson as she unveils a new assessment tool, the Computerized Assessment and Referral System (CARS).
Learn more and register…

Government, Mental Health Advocates Work to Prevent Suicide among Maine, U.S. Veterans
These lost lives are part of a much larger national problem, according to data compiled by the U.S. Department of Veterans Affairs, which is why federal and state officials and suicide prevention advocates are taking steps to raise awareness of the issue.
Read more…

Predicting Suicides after Psychiatric Hospitalization in U.S. Army Soldiers: The Army Study to Assess Risk and Resilience in Service Members (Army STARRS)
The U.S. Army experienced a sharp increase in soldier suicides beginning in 2004. Administrative data reveal that among those at highest risk are soldiers in the 12 months after inpatient treatment of a psychiatric disorder.
Read more…

PTSD in Iraq and Afghanistan Veterans
PTSD is a significant public health problem in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) deployed and non-deployed veterans and should not be considered an outcome solely related to deployment. A study finds that 15.7% of OEF/OIF deployed veterans screened positive for PTSD compared to 10.9% of non-deployed veterans. Overall 13.5% of study participants screened positive for PTSD.
Read more…

DoD Celebrates National Native American Heritage Month
The observance of National Native American Heritage Month each November gives the Defense Department an opportunity to honor the service of some 21,000 American Indian and Alaska Native service members and civilians, a defense official told DoD News.
Read more…

Rental Assistance Helps More Than 340,000 Veterans Afford Homes, but Large Unmet Needs Remain
Rental assistance helps more than 340,000 veterans — the great majority of them poor or near poor — afford decent housing. It appears to have played a central role in the 33 percent reduction in veterans’ homelessness between 2010 and 2014, and it allows recipients to devote more of their limited resources to other basic needs, like food or medicine. But it reaches only a fraction of veterans in need; many veterans continue to experience homelessness or pay very high shares of their income for housing.
Read more…
Read the full report…

Impact of Social Media in Healthcare and Telemedicine

Impact of Social Media in Healthcare and Telemedicine, Arizona Telemedicine Blog

Did you know that there are more than 75,000 health care professionals on Twitter? That 41 percent of consumers are using Facebook, Twitter, YouTube and online forums to select health care providers? Or that social media can help track the spread of fast-moving illnesses like influenza?

When you think of social media in health care, you might think it’s all about marketing. But experts agree, it goes beyond that.

Farris Timimi, medical director for the Mayo Clinic Center for Social Media, said that social media in health care is a "moral obligation.”

To read more, click here.

Drug Abuse Resources for Professionals with Limited Internet Access

The National Institute on Drug Abuse (NIDA) is making it even easier to use materials from its PEERx teen prescription drug abuse program. PEERx, part of the NIDA for Teens initiative, provides science-based resources to encourage open discussions with teens about this important issue. These resources are now available on a free flash drive for use by rural health professionals who do not have reliable Internet access in their classrooms or at events. The drive includes the following resources:

• The Educators Guide is a compilation of NIDA's teen prescription drug abuse prevention resources and presents examples of how state and local organizations have used these resources in their communities. 
• Choose Your Path interactive videos allow teens to assume the role of the main character and make decisions about abusing prescription drugs. After each scene, the viewer selects what the main character will do next and sees the results of each decision. 
• The Activity Guide offers ideas for planning events in schools and communities. 
• Fact sheets provide essential information on prescription and over-the-counter drugs. 
• The PEERx presentation is a PowerPoint file with teen prescription drug abuse statistics and information about PEERx and other NIDA for Teens resources. 

Order your free flash drive by emailing peerx@iqsolutions.com. Also visit http://teens.drugabuse.gov/ for NIDA’s teen blog and resources for National Drug Facts Week, an annual week-long observance when organizations and schools across the country host educational, community-based activities and events.

Medicare Part A and B News-Jurisdiction H for November 12th, 2014

The following information is provided by Novitas Solutions.

Top Claim Submission Errors (Medicare Part B)

The October Top Claim Submission Errors and resolutions are now available. Please take a moment to review these errors and avoid them on future claim submissions.


12/09/2014 JH Part A Update - New Novitas Website Webinar Cancelled

The JH Part A Update - New Novitas Website webinar on 12/09/2014 has been cancelled. Please stay tuned to our website for a rescheduled date.

Medicare Part A and B News-Jurisdiction H for November 11th, 2014

The following information is provided by Novitas Solutions.

New Medicare Insights Weekly Podcasts Now Available

Want to learn more about the Novitas Medicare Learning Center? In this week's Medicare Insights Weekly podcast, we share tips, helpful hints and reminders about this new educational tool. Don't miss this informative podcast.

Demand Letters for Polysomnography Claims
In June, Medicare Administrative Contractors (MACs) began to demand and recover what CMS initially considered to be identified overpayments associated with an Office of Inspector General study on polysomnography claims. In August, this activity was suspended. Providers should not appeal these overpayments, as all claim denials will be reversed. Any recouped money will be refunded, including interest. No action is required by providers.

MLN Provider eNews for November 13th, 2014

View the MLN Connects™ Provider eNews

View this edition as a PDF

In This Edition:

• MLN Connects™ National Provider Calls 
• 2015 Physician Fee Schedule Final Rule: Changes to Physician Quality Reporting Programs — Registration Now Open 
• National Partnership to Improve Dementia Care in Nursing Homes — Register Now 
• Certifying Patients for the Medicare Home Health Benefit — Registration Now Open 
• New MLN Connects™ National Provider Call Audio Recordings and Transcripts 

CMS Events

• Participate in ICD-10 Acknowledgement Testing Week: November 17 through 21, 2014 

Announcements

• Recognizing Lung Cancer Awareness Month and the Great American Smokeout 
• Dialysis Facility Compare Star Ratings and Data Release for January 2015 
• Coverage of Speech Generating Devices 
• Clinical Laboratory Improvement Amendments Proposed Rule 
• PQRS Negative Payment Adjustment 
• FY 2016 IRF Quality Reporting Program Submission Deadline: November 15 
• FY 2016 LTCH Quality Reporting Program Submission Deadline: November 15 
• OASIS Updates for Home Health Agencies 
• Get Ready for DMEPOS Competitive Bidding 
• EHR Incentive Program: Deadlines for 2014 Hospital Reporting on November 30 
• Changes to Medicare EHR Incentive Program Hardship Exceptions 
• ICD-10 Resources for Small Physician Practices on Medscape 

Claims, Pricers, and Codes

• ICD-10 MS-DRG v32 Definitions Manual and Medicare Code Editor Files Available 
• 2015 HCPCS Annual Update 
• Acute Inpatient PPS FY 2015.2 Software Release Available 
• FDG PET for Solid Tumors: Claims Hold Extension 

Medicare Learning Network® Educational Products

• "Safeguarding Your Medical Identity” Web-Based Training Course — Revised 
• “Medicare Enrollment and Claim Submission Guidelines” Booklet — Revised 
• “Medicaid Program Integrity: Understanding and Preventing Provider Medical Identity Theft” Booklet — Revised 
• “Medicaid Program Integrity: Preventing Provider Medical Identity Theft” Fact Sheet — Revised 
• “Medicaid Program Integrity: Safeguarding Your Medical Identity Using Continuing Medical Education (CME)” Educational Tool — Revised 
• Medicare Learning Network® Products Available in Electronic Publication Format

Physical and Behavioral Healthcare Integration for Consumers with Mental Illness

Physical and Behavioral Healthcare Integration for Consumers with Mental Illness
Webinar: Wednesday, November 19th 12:00pm-1:00pm MT
Hosted by the Center for Improving Value in Health Care

This webinar is intended to provide information about the importance of collaboration between physical and behavioral health professionals when treating individuals with severe and persistent mental illness. Chris Radigan and Steve Fisher from Mental Health Centers of Denver will be discussing the comorbidity of serious and persistent mental illness and physical health issues, root causes, obstacles to consumer engagement in treatment, and programs and training they have developed to help their consumers meaningfully engage in treatment and preventive care. These programs have been successful in preventing initial hospitalization and supporting consumers transitioning out of the hospital.

Chris Radigan, LCSW LAC, is a program manager for an adult outpatient team at the Mental Health Center of Denver. He also co-leads MHCD's full Dialectical Behavioral Therapy team and works with a local Primary Care office to provide consultation and brief treatment to consumers at their PCP's office.

Steve Fisher, LPC, is a program manager for Wellshire Behavior Services, a Mental Health Center of Denver program that works to provide brief therapy to individuals who may not need long term treatment. He co-leads MHCD's full Dialectical Behavioral Therapy team with Chris and provides training to all clinical staff about how to effectively work with consumers and medical providers to increase treatment collaboration.

Click Here for Free Registration

Webinar: Get Smart About Antibiotics

Join Telligen, the Quality Innovation Network-Quality Improvement Organization, also known as QIN-QIO, for this "quick-learn" webinar about the 2014-2015 flu season.

Who Should Attend:

All healthcare providers: physician offices, home health, hospitals, ambulatory care, nursing homes,and anyone interested in flu prevention

Attendees will hear about:

· The vaccines available for the 2014-2015 flu season
· Proven preventive actionsthat can be implemented right now
· What you can do to prevent the flu

Presenters:

Dr. Christine LaRocca

Telligen Medical Director; board certified in Internal and Geriatric Medicine will moderate this event.

Dr. Paul Mulhausen

M.H., F.A.C.P., Telligen Chief Medical Officer provides clinical guidance at the executive level. With expertise in the care of people across the healthcare continuum, Dr. Mulhausen supports Telligen's core belief to deliver the right care, in the right setting at the right cost, every time. He will share his best practice and preventive expertise.

Dr. Sheam Bakri

Telligen Clinical Pharmacy Specialist, will share her pharmacological knowledge about the vaccines for this flu season.

Get more information
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Board Webinar Series

Colorado Rural Health Center is pleased to announce that we will be having another Board Training/Education Webinar Series. This series will be facilitated by Bill Charney and begin November 17^th at 4:30pm. This will be a three part webinar series held on three consecutive evenings. Please invite your board members to participate in this educational opportunity. There is no cost for CRHC member facilities.

Part I

Meeting Title:

Board Training/Education pt 1 Setting Standards for Fiscal Oversight

Date & Time:

Mon, Nov 17, 2014, 4:30 PM Mountain Standard Time

Audio Details:

Dial-In Number(s):

U.S. & Canada: 866.740.1260

Access Code: 4070410

Registration Link:

https://cc.readytalk.com/r/lhmh9mhfk6iz&eom

Part II

Meeting Title:

Board Training/Education pt 2 Evaluating CEO and Board Performance

Date & Time:

Tue, Nov 18, 2014, 4:30 PM Mountain Standard Time

Meeting Type:

Web & Audio

Audio Details:

Dial-In Number(s):

U.S. & Canada: 866.740.1260

Access Code: 4070410

Registration Link:

https://cc.readytalk.com/r/do77we0b8e5k&eom

Part III

Meeting Title:

Board Training/Education pt 3 Officer's Forum

Date & Time:

Wed, Nov 19, 2014, 4:30 PM Mountain Standard Time

Meeting Type:

Web & Audio

Audio Details:

Dial-In Number(s):

U.S. & Canada: 866.740.1260

Access Code: 4070410

Registration Link:

https://cc.readytalk.com/r/um8kptecwtem&eom

Complimentary Webinar: Post-Election Advocacy Update

Friday, November 14, 2014
1:00 PM-2:00 PM (Eastern) REGISTER NOW*

*You must first select the blue "sign in" at the top of the page and login to register.

Presented by:
Ted Slafsky, President and Chief Executive Officer, SNHPA
Kathryn DiBitetto, Director of Government Relations, SNHPA

Duration: 60 minutes, including 15-minute Q/A

As the weather cools down here in Washington, 340B remains a hot topic on Capitol Hill. In July, over 100 lawmakers showed their support for the program by signing pro-340B letters in the House and Senate. However, AIR 340B and other critics continue working to discredit the program and the good work your hospital does caring for our most vulnerable. With the November Congressional elections, major changes may be in store for 2015 and beyond – with problematic implications for your institution and its patients. You won’t want to miss this timely event so you can learn how we can work together to safeguard 340B in the wake of the election.

Join us to learn about:

• The 2014 midterm Congressional election results and what they mean for 340B; 
• What’s in store for the final session of the 113th Congress and the incoming Congress; 
• How you can play an active role in 340B advocacy efforts. 

Who Should Attend:
C-level executives, government relations specialists, communications directors, pharmacy directors and others involved in the 340B program.

Registration: This event is complimentary, but pre-registration is required. It is limited to 340B hospitals and SNHPA corporate partners. The registration deadline is November 13. A confirmation will be e-mailed to you once you register so please be sure to enter your e-mail address correctly. Webinar instructions will be e-mailed the day before the event.

Questions: Please contact Liam Steadman at liam.steadman@snhpa.org or (202) 536-2282. 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

MLN Connects Provider eNews for November 6th, 2014

MLN Connects™ Provider eNews for November 6, 2014

View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

• 2015 Physician Fee Schedule Final Rule: Changes to Physician Quality Reporting Programs — Registration Opening Soon
• National Partnership to Improve Dementia Care in Nursing Homes — Registration Now Open
• Certifying Patients for the Medicare Home Health Benefit — Registration Opening Soon
• New MLN Connects™ National Provider Call Audio Recording and Transcript

MLN Connects™ Videos

• Monthly Spotlight: Medicare Preventive Services

Announcements

• CY 2015 Policy and Payment Changes to the Medicare Physician Fee Schedule
• CY 2015 Policy and Payment Changes for ESRD Facilities and Implementation of Competitive Bidding-Based Prices for DMEPOS
• CY 2015 Payment and Policy Changes for Hospital Outpatient and Ambulatory Surgical Centers
• CY 2015 Payment Changes for Medicare Home Health Agencies
• Raising Awareness of Diabetes in November
• Final Rule Changes for Open Payments
• Teaching Hospitals Receiving FTE Resident Caps Under Section 5506 of the Affordable Care Act
• CMS is Accepting Suggestions for Potential PQRS Measures
• Comparative Billing Report on Modifier 25: Family Practice

Medicare Learning Network® Educational Products

• “Medicare Appeals Process” Podcast — New
• “Skilled Nursing Facility Prospective Payment System” Fact Sheet — Revised
• “Inpatient Rehabilitation Facility Prospective Payment System” Fact Sheet — Revised
• Medicare Learning Network® Products Available in Electronic Publication Format

2015 Open Meeting Dates Now Posted

The scheduled dates for the 2015 Open Meetings are now posted.

Each Novitas Solutions Open Meeting will be a combined meeting for both Medicare Administrative Contractor (MAC) Jurisdiction H (JH) and MAC Jurisdiction L (JL) contract areas.

NOTE: The Open Meeting is not a forum for discussing specific claims; or for the submission of new drugs, indications, or marketing of forthcoming drugs or medical devices. Information regarding new drugs, indications, or marketing information should be submitted according to Novitas guidelines. Specific JH claim questions, including billing and coding, should be directed to our JH Customer Service Center at 1-855-252-8782.

MSP 1500 Paper Claim Submission Reporting for Item 11

If you are permitted to submit paper, rather than electronic claims to Medicare, this article is for you. Once you have submitted your claim to the primary insurer and received their statement of payment or denial, called an Explanation of Benefits (EOB), you are now ready to submit a claim to Medicare for secondary consideration.

Correct Reporting of Medicare Secondary Payer (MSP) Type on Electronic Claims

When submitting an electronic claim to Medicare, you are required to obtain MSP insurance information from the patient. The patient’s insurance is classified as either a group health plan (GHP) or a non-group health plan (NGHP). Examples of GHP coverage are Working Aged (WA), Disability, or End Stage Renal Disease (ESRD). These types of coverage are based on current or past employment. Examples of NGHP coverage are Automobile/no-fault, Workers’ Compensation (WC), and Liability. These types of coverage are typically the result of an accident, injury, or lawsuit. Although there are other types of MSP coverage, these are the most common.

ICD-10 News Updates- November 6th

The Centers for Medicare & Medicaid Services (CMS) has released three new resources to help small physician practices prepare for ICD-10. These resources also provide continuing medical education (CME) and continuing education (CE) credits to health care professionals who complete the learning modules, and anyone who takes them will earn a certificate of completion. If you are a first-time visitor to Medscape, you will need to create a free account to access these resources.

• ICD-10: Getting From Here to There -- Navigating the Road Ahead – A video lecture giving providers an overview of ICD-10 and its benefits, the differences between ICD-9 and ICD-10, and the CMS “Road to 10” Tool. 
• ICD-10 and Clinical Documentation – A video discussing the role of documentation and coding in health care and examining why documentation is important for ICD-10. 
• Preparing for ICD-10: Now Is the Time – An expert column exploring the effect ICD-10 will have on systems, the coding process, documentation, and quality reporting. It also provides steps to prepare for ICD-10 implementation. 

Keep Up to Date on ICD-10
Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.

Medicare Part A and B News-Jurisdiction H for November 6th, 2014

The following information is provided by Novitas Solutions.


Novitas Educational Tips and Tools (NETTs)
Ever wonder about corneal tissue acquisition? A new document has been added to the NETTs page of our website specific to just that. Take a moment to visit the NETTs page and view this newly added information.


Clarification of the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) Low Volume Adjustment

CMS has issued clarifications for two criteria required for the validation of the ESRD PPS low volume payment adjustment. Additionally, the due date for 2015 ESRD PPS LV Attestations has been delayed to December 31, 2015. Please refer to this article for more information.

Board Training/Education Webinar Series

Colorado Rural Health Center is pleased to announce that we will be having another Board Training/Education Webinar Series. This series will be facilitated by Bill Charney and begin November 17^th at 4:30pm. This will be a three part webinar series held on three consecutive evenings. Please invite your board members to participate in this educational opportunity. There is no cost for CRHC member facilities.

Part I

Meeting Title:

Board Training/Education pt 1 Setting Standards for Fiscal Oversight

Date & Time:

Mon, Nov 17, 2014, 4:30 PM Mountain Standard Time

Audio Details:

Dial-In Number(s):

U.S. & Canada: 866.740.1260

Access Code: 4070410

Registration Link:

https://cc.readytalk.com/r/lhmh9mhfk6iz&eom

Part II

Meeting Title:

Board Training/Education pt 2 Evaluating CEO and Board Performance

Date & Time:

Tue, Nov 18, 2014, 4:30 PM Mountain Standard Time

Meeting Type:

Web & Audio

Audio Details:

Dial-In Number(s):

U.S. & Canada: 866.740.1260

Access Code: 4070410

Registration Link:

https://cc.readytalk.com/r/do77we0b8e5k&eom

Part III

Meeting Title:

Board Training/Education pt 3 Officer's Forum

Date & Time:

Wed, Nov 19, 2014, 4:30 PM Mountain Standard Time

Meeting Type:

Web & Audio

Audio Details:

Dial-In Number(s):

U.S. & Canada: 866.740.1260

Access Code: 4070410

Registration Link:

https://cc.readytalk.com/r/um8kptecwtem&eom

IQR Program Deadline for Clinical, PC-01, and HAI Data Submission

The purpose of this message is to remind hospitals participating in the Inpatient Quality Reporting (IQR) Program that the submission deadline for clinical data, Perinatal Care Web-Based Measure (PC-01) data, and Healthcare-Associated Infection (HAI) data is November 20, 2014, 11:59 p.m. Pacific Time.

Eligible IQR hospitals with an active IQR Notice of Participation are required to upload clinical data and complete the PC-01 submission using the Web-Based Measures data entry tool, through the QualityNet Secure Portal (https://cportal.qualitynet.org/QNet/pgm_select.jsp). Hospitals that do not deliver babies must enter a zero (0) for the Perinatal Care Elective Delivery Measure (PC-01) each discharge quarter.

Please see the Quick Start Guide: Entering Perinatal (PC-01) Data into the New Secure Portal (http://www.qualityreportingcenter.com/resources/resources/iqr/) for further details.

HAI data submission is completed through the National Health & Safety Network (NHSN) application found at http://www.cdc.gov/nhsn/login.html. If your facility does not meet the criteria necessary for having to report the HAI data or has not renewed its HAI Exception status within the past year, please complete the HAI Exception form found at http://qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier2&cid=1228760487021 and submit through the QualityNet Secure Portal.

To verify the status of your clinical data submission, you may run your Provider Participation Report, Case Status Summary Report, and other applicable reports. To verify the status of your PC-01 submission, you may run your Provider Participation Report or check your Inpatient Web-Based Measures summary screen.

Please see the Quick Start Guide: Accessing and Using Your Provider Participation Report (http://www.qualityreportingcenter.com/resources/resources/iqr/) for further details.

The Centers for Medicare & Medicaid Services (CMS) encourages all participating hospitals to submit data at least two days prior to the deadline to allow time to address any submission issues.

Medicare Part A and B News- Jurisdiction H for November 5th, 2014

The following information is provided by Novitas Solutions.

Important Credit Balance WARNING!

Credit Balance Reports are not considered valid/accepted unless they are complete and accurate.

Effective immediately, telephone calls will be made to all contacts for Credit Balance Reports received with invalid, incomplete, and/or inaccurate information. These, among others, are reasons phone calls will be made:

• Incorrect Provider Number. Please ensure the 6-digit PTAN is valid (Do not use NPI). 
• This Provider Number does not appear in our database. Please verify that the PTAN reported is accurate and that you do submit credit balance reports to Novitas for PART A (you bill using a UB04 and not a CMS-1500 claim form). 
• More than one Provider Number listed on the Credit Balance Report. One PTAN per certification. 
• Certification Page is missing. 
• No signature and/or title of person who signed or signature must be of Owner, Administrator, Director, CEO, CFO, or Certified Officer of the facility. 
• The following is not indicated at the bottom of the report: whether the provider 1) qualifies as a low utilization provider, 2) the credit balance report detail pages are attached, or 3) there are no Medicare credit balances to report for this quarter. 
• Quarter end date is incorrect or missing (Should be 03/31/YY, 06/30/YY, 09/30/YY, or 12/31/YY format) 
• Date of certification under the signature is missing. 
• Report indicates there are credit balance report detail pages and they are missing or the report indicates there are no credit balances, but detail pages are submitted. 
• 838 Detail Page is incomplete or inaccurate. Please complete all blocks of detail page. 
• 838 Detail Page indicates “Check” as method of payment but no check was attached. 
• Other 

To ensure we are able to reach out to the appropriate person, please ensure that the contact information (fax number and mailing information) provided on the original documentation is accurate.

In the future, Credit Balance reports will be returned if incomplete or invalid.

Please contact us at 410-891-5552 if you have any questions about reports that have been returned or if you need specifics as to how to correct the rejected reports.


Medicare Learning Network (MLN) Articles from CMS

New:
MM8841 – Quarterly Update to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) 

The following event has been added to the December Events Calendar:

12/12/2014 Modifier 59 Changes
2:00pm-3:00pm ET, 1:00pm-2:00pm CT
Register today for this event!

Want to Know More about Novitasphere? Upcoming Novitasphere Portal Webinar Sessions
Are you looking for more information on Novitasphere Portal and its use? Want to know more about the process for enrolling? Please join us for one of our upcoming informative webinar sessions!

The Novitasphere Portal Overview sessions will provide an overview of the features of Novitasphere, our Part B provider portal. The Novitasphere Provider Portal Enrollment Overview will review the required steps for enrolling in Novitasphere, including details of completing the IACS User ID process. The Novitasphere Direct Data Entry (DDE) Overview will review just the process of submitting claims and retrieving reports using the Direct Data Entry (DDE) function in Novitasphere.

We will have time for a Question and Answer session during each session.

Our upcoming webinars are listed below.

• Novitasphere Portal Overview – Wednesday, November 12, 2014 at 2:00PM Eastern Time (ET)
• Novitasphere Portal Enrollment Overview – Tuesday, November 18, 2014 at 2:00 PM ET
• Novitasphere DDE Overview – Thursday, November 20, 2014 at 2:00 PM ET.

We will continue to host this series of Webinars monthly through December 2014.

Customers must register for an account through our new Novitas Medicare Learning Center in order to register for these events. Please visit our Novitas Medicare Learning Center page for more information, including how to create a Novitas Medicare Learning Center Training Account. Please note, registering for an account in the Novitas Medicare Learning Center will gain you access to these educational events, but will not enroll you for Novitasphere Portal usage.

Handouts will be provided as a download during the session and through the Novitas Medicare Learning Center.

Credentialing Network Webinar Series, Part 4

The fourth and final webinar in the Colorado Rural Credentialing Network Webinar series will take place on November 19th at 11:00am. The webinars can be purchased individually at $99 for CRHC members or $149 for CRHC non-Members. The webinars are free for Credentialing Network Members. To register for the webinar, click on the registration link below. You will be invoiced following the webinar.

For more information, contact Liz Kelman at lk@coruralhealth.org 

Register Here!