Thursday, June 25, 2015

MLN Connects Provider eNews for June 25th, 2015

MLN Connects® Provider eNews for June 25, 2015
View this edition as a PDF

In This Edition:

Countdown to ICD-10
  • ICD-10 Deadline: October 1, 2015 
  • ICD-10 Training Series for Small and Rural Practices 
  • Claims that Span the ICD-10 Implementation Date 
  • ICD-10 FAQs: CMNs, Prescriptions, and Orders 
  • Coding for ICD-10-CM: Continue to Report CPT/HCPCS Modifiers for Laterality 
  • Transition to ICD-10 for Home Health 

MLN Connects® National Provider Calls
  • ESRD QIP System Training — Registration Now Open 
  • ESRD QIP: Reviewing Your Facility's PY 2016 Performance Data — Register Now 
  • 2016 PFS Proposed Rule: Medicare Quality Reporting Programs — Register Now 
  • ESRD QIP: Proposed Rule for Payment Year 2019 — Register Now 

MLN Connects® Events
  • IQCP for CLIA Laboratory Non-waived Testing: Workbook Tool — Webcast 

Announcements
  • Are You Providing an Annual Wellness Visit to Your Medicare Patients? 
  • Affordable Care Act Payment Model Saves More than $25 Million in First Performance Year 
  • National Medicare Fraud Takedown Results in Charges against 243 Individuals for Approximately $712 Million in False Billing 
  • Changes to the Medicare Opt-Out Law for Physicians and Practitioners 
  • Corrections to eCQM Measures for 2016 Reporting 

Claims, Pricers, and Codes
  • July 2015 Outpatient Prospective Payment System Pricer File Update 
  • CY 2015 Home Health PPS Mainframe Pricer Software Available 

Medicare Learning Network® Educational Products
  • Medicare Learning Network® Products Available In Electronic Publication Format 
  • New Medicare Learning Network® Educational Web Guides Fast Fact

Weekly CREATE Bulletin

Deadlines for 2015 – 2016 Announced!


Submission Deadlines:

Review Dates:

July 13, 2015

July 28, 2015

August 10, 2015

August 25, 2015

September 14, 2015

September 29, 2015

October 12, 2015

October 28, 2015

November 9, 2015

November 17, 2015

December 1, 2015

December 15, 2015

January 11, 2016

January 26, 2016

February 8, 2016

February 23, 2016

March 14, 2016

March 29, 2016

April 11, 2016

April 26, 2016

May 9, 2016

May 24, 2016

June 13, 2016

June 28, 2016





















Thank you for all you do for all our Colorado communities! We are here to support you, so please do not hesitate to contact us with questions or concerns.

If you have any questions about the CREATE Grant process, please contact Megan Lyda at ml@coruralhealth.org or 720-248-2742.


MLN Connects Provider eNews for June 18th, 2015

MLN Connects® Provider eNews for June 18, 2015
View this edition as a PDF

In This Edition:
  • MLN Connects® National Provider Calls 
  • ESRD QIP System Training — Save the Date 
  • ESRD QIP: Reviewing Your Facility's PY 2016 Performance Data — Register Now 
  • 2016 PFS Proposed Rule: Medicare Quality Reporting Programs — Registration Now Open 
  • ESRD QIP: Proposed Rule for Payment Year 2019 — Register Now 
  • New MLN Connects® National Provider Call Audio Recording and Transcript 

CMS Events
  • Medicare Learning Network® Webinar: Medicare Basics for New Providers Part Two: Billing, Reimbursement, and Appeals 
  • PERM Cycle 1 Provider Education Sessions 

Announcements
  • Medicare Provides Coverage of HIV Screening 
  • Medicare and Medicaid 50th Anniversary Count Down 
  • Use New Interactive Case Studies to Explore ICD-10 Concepts 
  • Corrections to eCQM Measures for 2016 Reporting 
  • 2015 PQRS GPRO: 1 Week Left to Register by June 30 Deadline 

Claims, Pricers, and Codes
  • CY 2015 Home Health PPS Mainframe Pricer Software Available 

Medicare Learning Network® Educational Products
“Using the ICD-10-PCS New Technology Section X Codes” MLN Matters® Article — Released
“Reminder to Billing Procedures Related to the Department of Veterans Affairs (VA) – Companion Information to CR8198” MLN Matters® Article — Released
“FAQs – International Classification of Diseases, 10th Edition (ICD-10) End-to-End Testing” MLN Matters® Article — Revised
“General Equivalence Mappings Frequently Asked Questions” Booklet — Revised
“ICD-10-CM/PCS Myths and Facts” Fact Sheet — Revised
“ICD-10-CM Classification Enhancements” Fact Sheet — Revised
“ICD-10-CM/PCS The Next Generation of Coding” Fact Sheet — Revised
Medicare Learning Network® Product Available In Electronic Publication Format

Customer Contact Center

Customer Contact Center Survey "How are we doing?"

Please take a few moments to complete a short survey and give us your valued opinion. We are looking for feedback on your interaction with the Customer Contact Centers (General Inquiries, Claims Correction, Electronic Data Interchange (EDI) and Provider Enrollment). Your responses will help us enhance our service to you. Take our survey today *.


Novitas Solutions Upcoming Education Events Week of June 22, 2015


Join us for one of our upcoming educational events! Learn more about the Medicare program and discover ways to improve the accuracy and efficiency of your Medicare billing process by participating in the free educational events hosted by Novitas Solutions. Below is a list of upcoming events for the week of June 22, 2015. Visit the Novitas Medicare Website to register!

SAMHSAs Topics in the News

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

Topics in the News

New Hampshire Court Sees Veterans as More than Defendants
Eight flags dignify the first-floor courtroom inside the Ninth Circuit Court: the Stars and Stripes, the state flag, one for each branch of the armed forces and the black POW-MIA flag. It's a powerful symbol that here, veterans are treated with the honor and respect that they've earned. This is New Hampshire's first Veterans Behavioral Health Track court. Those who created it are determined it won't be the last.
Read more…


New Monument at Minnesota State Capitol Honors Military Families
A new memorial has been installed on the grounds of the Minnesota State Capitol. The Minnesota Military Family Tribute recognizes the families of active military members and veterans. Tribute spokeswoman Jenifer Skjerven said it's a way to honor and thank families for their sacrifices.
Read more…


Webinar: Assessing and Reducing Violence in Military Veterans
June 25, 2015; 1:00 - 2:30 p.m. EDT
Research shows that up to one-third of military service members and veterans report engaging in violence or aggression toward others, highlighting the need to improve violence risk assessment. Health care providers have a unique opportunity to identify, treat and refer patients who may be at high risk. The discussion will review the complex link between posttraumatic stress disorder (PTSD) and violent behavior in the military population, particularly when combined with alcohol misuse.
Learn more and register…


Webinar: Evidence-Based Trauma-Specific Interventions for Persons with Behavioral Health Needs in the Justice System
June 29, 2015; 2:00 – 4:00 p.m. EDT
SAMHSA's GAINS Center is pleased to announce the first in a three-part series of webinars on the application of evidence-based practices for adults with mental and co-occurring disorders in the justice system. The webinar will focus on what the research says and how to bridge the gap from research to practice. Identifying "what works" and applying the evidence-based knowledge to service delivery is critically important to achieve better outcomes. Too few people with mental illness and substance use disorders who are justice-involved receive comprehensive and appropriate services. A goal of the webinar series is to promote the implementation of evidence-based practices with justice-involved persons.
Learn more and register…


DoD Updates Equal Opportunity Policy to Include Sexual Orientation
The Defense Department has updated its military equal opportunity program to protect service members against discrimination because of sexual orientation, Defense Secretary Ash Carter said. Speaking at a DoD-Pentagon Pride Month event, the secretary said the department has made a lasting commitment to living the values it defends, including treating everyone equally.
Read more…

Study May Help Department of Veterans Affairs Find Patients With High-Risk of Suicide
Clinicians are challenged every day to make difficult decisions regarding patients’ suicide risk. Using Veterans Health Administration (VHA) health system electronic medical record data, Veterans Affairs (VA) and National Institute of Mental Health scientists were able to identify very small groups of individuals within the VHA’s patient population with very high, predicted suicide risk -- most of whom had not been identified for suicide risk by clinicians. Such methods can help the VHA to target suicide prevention efforts for patients at high risk, and may have more wide-ranging benefits.
Read more…


Study Shows Risk for Suicide Lower among Men and Women Veterans Who Use VA Care
Understanding and identifying risk factors among patients who receive care is a top priority for clinicians and researchers in VA’s VHA. This is especially true when developing and analyzing the effectiveness of treatment for those most susceptible to suicide.
Read more…


A Veteran Suicide Prevention Network Built by Veterans
Six weeks ago, Special Forces veteran Johnny Primo logged on to his Instagram account and says he was horrified to see a suicide note from a veteran who lived just a few miles away. The note read: "Very few people know the truth ... I want this in everyone's memory." Desperate to help, Primo tracked down his address.
Read more…


VA Campaign Encourages Public to Help Raise PTSD Awareness
As the country recognizes PTSD Awareness Month, the VA National Center for PTSD is inviting the public to participate in its “PTSD Awareness: June 2015” campaign, which began June 1. This year’s goal is to help more veterans, their families, caregivers, and community members understand what PTSD is and know that there are specific treatments that can help improve and save lives.
Read more…

ICD-10: 100/Step 3

Each day this week we are highlighting 1 of the 5 steps from the new Quick Start Guide:
1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. Today our focus is:

Step: 3 Update Your Processes
  • It is crucial to update hard-copy and electronic forms (e.g., superbills, CMS 1500 forms
  • Resolve any documentation gaps identified while coding top diagnoses in ICD-10 
  • Make sure clinical documentation captures key new coding concepts: 
    • Laterality—or left versus right 
    • Initial or subsequent encounter for injuries 
    • Trimester of pregnancy 
    • Details about diabetes and related complications 
    • Types of fractures 
Tips

  • Create a documentation checklist for any new concepts that need to be captured for ICD-10 coding
  • Remember that ICD-10 does not change the requirements for good documentation, which is always about capturing the complete clinical picture in order to provide high-quality patient care
  • Review NCDs and LCDs with ICD-10 codes to ensure consistency with internal policies (e.g., coding, billing, and documentation processes)
  • Outpatient and office procedure codes aren’t changing—ICD-10 does not affect the use of CPT and HCPCS coding for outpatient and office procedures


To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals.

ICD-10: 100 days/Step 2

Each day this week we are highlighting 1 of the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. Today our focus is:


Step: 2 Train Your Staff

  • Train staff on ICD-10 fundamentals using the wealth of free resources from CMS, which include the ICD-10 website, Road to 10, Email Updates, National Provider Calls, and webinars. Free resources are also available from: 
    • Medical societies, health care professional associations 
    • Hospitals, health systems, health plans, vendors 
  • Identify top codes. What ICD-9 diagnosis codes does your practice see most often? Target the top 25 to start. You might want to look at common diagnosis codes available from: 
    • Road to 10 (see Specialty References) 
    • Medical specialty societies 
    • Using the documentation available, code current cases in ICD-10. Flag any cases where more documentation is needed. 
Tips
  • Training for clinical staff—e.g., physicians, nurse practitioners, physician assistants, registered nurses—should focus on documentation, new coding concepts captured in ICD-10 
  • Training for coding and administrative staff—e.g., coders, billers, practice managers—should focus on ICD-10 fundamentals 
  • You can review your superbills, encounter forms, and practice management system reports to identify your most commonly used ICD-10 codes 
  • If time permits, expand your ICD-10 coding of current cases to include 50 or more of your top codes, until 80% of your claims are covered 
  • You don’t have to use 68,000 codes—as you do now, your practice will likely use a very small subset of ICD-10 codes 
  • You will use a similar process to look up ICD-10 codes that you use with ICD-9 
  • While crosswalks from ICD-9 to ICD-10 can be useful references, ICD-10 codes should be based on the clinical documentation rather than selected from a crosswalk 
  • Practices that do not prepare for ICD-10 will not be able to submit claims for services performed on or after October 1, 2015
To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals.

Medicare News for June 24th, 2015

The following is provided by Novitas Solutions.

Customer Contact Center Survey "How are we doing?"

Please take a few moments to complete a short survey and give us your valued opinion. We are looking for feedback on your interaction with the Customer Contact Centers (General Inquiries, Claims Correction, Electronic Data Interchange (EDI) and Provider Enrollment). Your responses will help us enhance our service to you. Take our survey today *.


MLN Matters Article Updates


Medicare Learning Network (MLN) Articles from CMS

Revised:

ICD-10: 100 days/Quick Step 1

Each day this week we are highlighting 1 of the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. Today our focus is:


Step: 1 Make a Plan

  • Assign target dates for completing steps outlined here 
  • Most important, obtain access to ICD-10 codes. The codes are available from many sources and in many formats: 
    • Code books 
    • CD/DVD and other digital media 
    • Online (e.g., go to cms.gov/ICD10 and select “2016 ICD-10-CM and GEMS” to download 2016 Code Tables and Index) 
    • Practice management systems 
    • Electronic health record (EHR) products 
    • Smartphone apps 
  • Decide role(s) your clearinghouse(s) will play in your transition. Some providers who are not ready could benefit from contracting with a clearinghouse to submit claims: 
    • Clearinghouses can help by: 
      • Identifying problems that lead to claims being rejected 
      • Providing guidance about how to fix rejected claims (e.g., more or different data need to be included) 
    • Clearinghouses cannot help you code in ICD-10 codes unless they offer third-party billing/coding services 
Tips
  • You must use: 
    • ICD-10 codes for all services provided on or after October 1 
    • ICD-9 codes for all services provided before October 1 
  • Identify everywhere in your practice that you use ICD-9 codes to make sure you know what processes and systems need to be updated for ICD-10; for example: 
    • Patient registration and scheduling 
    • Clinical documentation/health records 
    • Referrals and authorizations 
    • Order entry 
    • Coding 
    • Billing 
    • Reporting and analysis 
  • Even clearinghouses that offer coding and billing services cannot translate ICD-9 codes to ICD-10 codes unless they have the detailed clinical documentation required to select the right code 
  • Practices that do not prepare for ICD-10 risk disruptions in cash flow 
  • For a more in-depth approach to planning, see the Action Plan section of the Road to 10 

To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals.

2015 340B Recertification


The 340B drug pricing program provides significant savings to eligible health care providers that opt to participate. The ACA extended 340B program eligibility to Critical Access Hospitals (CAHs), Sole Community Hospitals (SCHs), free-standing cancer hospitals, and rural referral centers. HRSA’s Office of Pharmacy Affairs (OPA) requires all participating hospitals to recertify annually in order to ensure that hospitals’ contact information is correct and that hospitals remain compliant with program requirements. To discuss the recertification process and assist with technical questions, OPA will be hosting a webinar July 8, 2015 at 12 PM EST. To access the webinar, please go to : https://hrsa.connectsolutions.com/hr2015_webinar/ using Dial-In (888) – 790-1763 and Participant Code 7334728. This presentation will be recorded and archived on 340B prime vendor program website. In preparation for recertification, hospitals can visit the 340B Program database and verify their information. If incorrect, hospitals can update this information by submitting an online change request to OPA. Hospitals should direct any questions about registration or recertification to the 340B Prime Vendor Program at 1-888-340-2787 or ApexusAnswer@340bpvp.com .

Denver Arthritis Clinic: Equipment for Sale

The Denver Arthritis Clinic has several piece of equipment that are available:

  • Beckman Coulter HmX with autoloader is 6 years old, runs well, performs complete blood count plus 5 part differential.
  • Biotek – EL311 Elisa microplate reader
  • Biotek – ELX 50/8 microplate washer
  • Centrifuge
  • Matrix Impact 2 – 8 channel pipet
For more information, please contact Martha Ferraro at MFerraro@DACdenver.com. 


Contraception Initiative & Medicaid.gov

Contraception Initiative & Medicaid.gov
Today, the Centers for Medicare & Medicaid Services (CMS) added a contraception initiative to the Quality of Care section on Medicaid.gov.

CMS has established a Maternal and Infant Health Initiative (the Initiative) for the Medicaid and Children’s Health Insurance Program (CHIP) programs. Under the Initiative, CMCS will promote the use of effective methods of contraception in order to improve pregnancy timing and spacing and in turn, the health outcomes for both women and children.

To get more information about the initiative, visit http://www.medicaid.gov/medicaid-chip-program-information/by-topics/quality-of-care/contraception.html.

Thursday, June 18, 2015

NRHA Rural Roads

The summe edition of NRHA's Rural Roads magazine is now available to read online. This edition includes articles on geography and healthcare access, small-town HIV outbreaks, rural childhood obesity, and more. Click here to read.

Upcoming MLN Connects National Provider Calls


Thursday, June 18, 1:30-3:00 PM ET: ICD-10: Preparing for Implementation and New ICD-10-PCS Section X

During this MLN Connects Call, CMS subject matter experts present strategies and resources to help you prepare for ICD-10 implementation on October 1, 2015. Also, learn about ICD-10-PCS Section X for new technologies, which will be used by hospitals.

· For more information about these calls and the MLN Connects® National Provider Call Program , visit www.cms.hhs.gov/npc

· Providers and MAC staff can register until 12 noon the day of a call athttp://www.eventsvc.com/blhtechnologies/

· Please share information about MLN Connects® National Provider Calls with your provider community and internally.

CMS Table of Preventive Services

CMS has published an updated interactive table of preventive services, which can be found on the Medicare Learning Network website.

2015-2016 HPP Funding

The 2015-2016 HPP (emergency preparedness) funding information for hospitals and RHCs will be released soon. Look for an email from Greg Jones at CDPHE/OEPR for details. If your emergency preparedness contact person has changed or if you want to confirm or add contacts for your facility please email Ron Seedorf at rs@coruralhealth.org.

June iCARE Webinar

Please join us Tuesday, June 30 at 11:00 AM MST for our June iCARE webinar. Registration is free, and can be completed here. Contact Caleb Siem with any questions at cs@coruralhealth.org

Tuesday, June 16, 2015

Register Today for Billing and Coding Workshops

Billing and Coding –Working Through ICD-10 Together
ICD-10 Workshop for Rural Healthcare Facilities

Presented By: ARHPC – Gary Lucas, CPC, CPC-I, AHIMA ICD-10 Ambassador, ARHPC Adjunct Faculty

Dates and Locations:


**Topics covered will require the following coding manuals: ICD-10CM (2014)**
How to assure claims will be processed and revenue cycles won’t crash and burn

• Conversion of top 20 codes for your facility
⇒ creating documentation tips for providers)
• Review ICD-9 claims denied-reworked-successfully resubmitted
⇒ now rework using ICD-10 (documentation gap analysis – stage 2)
⇒ start your ICD-10 workflow analysis (what adjustments will you need to make)
• Are your vendors and payers really ready?
• How will your query process change?
• What to do if providers just won’t engage.

***All attendees MUST bring their coding manual with them, to the class.***

This class is approved for 5 hours of CEU’s and recognized by AHIMA

Upon completion of this workshop, attendees will be eligible to take an ICD-10 proficient test through ARHPC at no additional cost.

Pricing

SHIP Grant Participants: $60.00/person
(use coupon code: SHIPGRANT)
Not sure if you are a SHIP Grant participant? Click here
CRHC members: $149/person
(use coupon code: MEMBER3033)
Not sure if you are a CRHC member? Click here
All others: $179.00

*Early bird discount $10 off available until June 12th

Questions? Contact Danette Swanson atds@coruralhealth.org or call 303.577.0357. Questions about payment or registration, contact web@coruralhealth.org or call 303.832.7493.

Cancellation Policy: An alternate registrant from the same institution will be accepted under the original registration. Registration fees are non-refundable unless notice of an individual’s cancellation is received at CRHC two weeks prior to the date of the boot camp.
CRHC IS THE RECIPIENT OF THE FEDERAL HRSA SMALL RURAL HOSPITAL IMPROVEMENT PROGRAM (SHIP) GRANT: CFDA 93.301; AWARD 5 H3HRH00038-13-00 (9-1-2014 THROUGH 8-31-2015)

Weekly CREATE Bulletin

Having trouble with grant writing? We can help!

Grant Writing 101 - Submitting your best application

Join us for the second of a four part series dedicated to helping you with your grant writing in 2015 and beyond. Megan Lyda, Manager of the CREATE program, and Matt Enquist, Outreach Coordinator, as we delve into the second part of our series. We’ll focus on grant composition (proofreading, planning your grant based on the guidance, LOIs, and grammar and voice) and we’ll save plenty of time for questions.

Click here to sign up!

Thank you for all you do for all our Colorado communities! We are here to support you, so please do not hesitate to contact us with questions or concerns.

If you have any questions about the CREATE Grant process, please contact Megan Lyda at ml@coruralhealth.org or 720-248-2742.



MLN Connects Provider eNews for June 11th, 2015

MLN Connects® Provider eNews for June 11, 2015
View this edition as a PDF

In This Edition:

MLN Connects® National Provider Calls
  • National Partnership to Improve Dementia Care and QAPI — Last Chance to Register 
  • Hospice Quality and Hospice Item Set Manual V1.02 — Last Chance to Register 
  • ICD-10: Preparing for Implementation and New ICD-10-PCS Section X — Last Chance to Register 
  • ESRD QIP: Reviewing Your Facility's PY 2016 Performance Data — Register Now 
  • ESRD QIP: Proposed Rule for Payment Year 2019 — Register Now 

CMS Events

  • Medicare Learning Network® Webinar: Medicare Basics for New Providers Part Two: Billing, Reimbursement, and Appeals 
  • PERM Cycle 1 Provider Education Sessions 

Announcements
  • Updated Results for ICD-10 End-to-End Testing Week in April 
  • Recognizing Men’s Health Month and Men’s Health Week 
  • CMS Finalizes Rules for Medicare Shared Savings Program 
  • Comprehensive Prevention Program Effectively Reduces Falls among Older People 
  • EHR Incentive Programs: Comments on Meaningful Use Proposed Rule Due June 15 
  • 2015 PQRS GPRO: 2 Weeks Left to Register by June 30 Deadline 
  • EHR Incentive Program: Deadline for Eligible Professionals Hardship Exception is July 1 
  • ICD-10 Resources for Medicare Providers 

Claims, Pricers, and Codes
  • 2016 ICD-10-CM Files, ICD-10-PCS Files, and GEMs Available 
  • FY 2015 Inpatient PPS PC Pricer Update Available 

Medicare Learning Network® Educational Products
  • “Information and Resources for Submitting Correct ICD-10 Codes to Medicare” MLN Matters® Article — Released 
  • “Transcatheter Aortic Valve Replacement (TAVR) Hospital Program Volume Requirements” MLN Matters® Special Edition Article — Released 
  • “Revised and Clarified Place of Service (POS) Coding Instructions” Podcast — Released 
  • “Medicare Fee-For-Service (FFS) International Classification of Diseases, 10th Edition (ICD-10) Testing Approach” MLN Matters® Article — Revised 
  • “Skilled Nursing Facility (SNF) Billing Reference” Fact Sheet — Reminder 
  • Medicare Learning Network Product® Available In Electronic Publication Format 
  • Subscribe to the Medicare Learning Network® Educational Products and MLN Matters® Electronic Mailing Lists

Thursday, June 11, 2015

Webinar: Physical Activity and Obesity

Physical Activity and Obesity: How to get your patient moving!
Tuesday, July 14, 2015 ~ 12:00pm
(12pm PDT; 12pm Arizona; 1pm MDT; 2pm CDT; 3pm EDT)

Learning Objectives:
1. Be able to identify the 3 levels of Physical Activity Guidelines that affect patients with obesity
2. Define NEAT and describe the difference and impact of moving from sedentary to light activity
3. List the Exercise Rx Top Ten

Weight Loss and Weight Management: Current Theories & Best Practices
This four session, interactive webinar series brings together national leaders in nutrition, exercise and bariatric medicine who will address what is needed to have a successful weight loss and management program for children and adults in family and community practice settings. The series will start with a presentation and discussion on dynamic energy balance, an important new perspective on what metabolic changes occur during weight loss and how these changes have to be taken into account as part of a weight loss program. The second session will focus specifically on exercise and energy expenditure and weight loss. The final two sessions will present pediatric and adult case studies to highlight the promoters and challenges that lead to successful patient care, in regards to weight loss and maintaining weight loss.

For more information and registration instructions go to

Clinics! Please Complete Your Clinic Profile

If you haven't done so already, please complete and return the 2015 Clinic Profile document to Liz Kelman at lk@coruralhealth.org

This profile is sent out annually to all rural clinics in Colorado to be completed by clinic leadership staff. We at CRHC understand the time restraints you and your staff have and the heavy workload that you carry. It is not our intention to add to this load, but to collect pertinent information from you that will in turn help us to advocate on your behalf. It is extremely important to collect even the minimal amount of demographic data from all rural clinics in the state in order to have a unified voice in promoting services, payment reform and funding opportunities for you. In addition, having up to date contact information will ensure that you receive all updates and announcements from us in a timely manner.

Please let us know if you have any questions!

National EMS Memorial Service

Weekend Tribute Announced for Air Medical and EMS Line of Duty Deaths

The “Weekend of Tribute” for the Air Medical Memorial and National EMS Memorial Services will be June 25-28th. This year 33 individuals from 7 states and 6 countries will be honored between the two services. The events begin Thursday evening at the Air Medical Memorial site in Littleton, followed by a Remembrance Ceremony at 7:00 a.m. on Friday morning. Activities then transition to the Antlers Hilton in Colorado Springs on Friday afternoon. The National EMS Memorial Service will be held at the Pikes Peak Center at 6:00 on Saturday evening. Also of interest that week, the Colorado portion of the National EMS Memorial Bike Ride will depart from Ft. Collins on Wednesday, en route to Littleton and then onto Colorado Springs as part of the Weekend of Tribute.

The Weekend of Tribute is organized and hosted by the following organizations: Air Medical
Memorial, National EMS Memorial Bike Ride, National EMS Memorial Service, and the
Survivors Network for Air and Surface Medical Transport. The lives of air medical and EMS
providers who died in the line of duty in 2014 will be honored and celebrated.

Families, friends, colleagues of the fallen, and the public are invited and encouraged to attend in
a show of support as we honor our own for their selfless service and sacrifice.

Specific times and locations for all events are listed at www.weekendoftribute.org

Naxalone Now Available at Pharmacies and Harm Reduction Organizations

Pharmacists and Harm Reduction Agencies can now request naloxone standing orders from CDPHE


Senate Bill 15-053 expands access to the life-saving drug naloxone, used to reverse overdoses to narcotic drugs such as certain prescription medications and heroin. As a result of the new law, the chief medical officer of the Colorado Department of Public Health and Environment (CDPHE) may issue standing orders for naloxone to be dispensed by pharmacies and harm reduction organization employees and volunteers who do not already have affiliated medical providers that can provide the orders.

The law helps expand statewide naloxone access to those who need it most and protects individuals from civil or criminal liability if they provide naloxone in good faith to an individual experiencing an opioid-related drug overdose.

“This legislation will save lives,” said Dr. Larry Wolk, chief medical offer of the Colorado Department of Public Health and Environment. “While our first aim is prevent the abuse of both illegal and prescription opioids, we now can make a lifesaving antidote more readily available to people who can help someone at risk.”


For more resources on how to safely administer naloxone and to make a request for standing orders visit: www.colorado.gov/cdphe/naloxoneorders.

Weekly CREATE Bulletin

Who is 2015’s Most Eligible Student?

Who is eligible for a CREATE grant to fund a course? Well, unfortunately, not everyone. A student eligible for CREATE on the course roster must be affiliated with an eligible agency (an agency with the purpose of providing emergency medical and trauma services in Colorado) and must successfully complete all course requirements to be considered eligible.

If a student is from an agency or entity other than the applicant agency, a letter of support or form signed by an appropriate representative from their agency that includes student’s name, class name, date they are attending (or attended) the course, and the student’s relationship with the agency. This requirement applies to all training courses, but does not apply to conferences.

If applicable, the form or letter needs to be submitted with the other reporting requirement items after course completion. Any additional back-up material regarding eligibility should be retained by the grantee entity and does not need to be submitted.


Thank you for all you do for all our Colorado communities! We are here to support you, so please do not hesitate to contact us with questions or concerns.

If you have any questions about the CREATE Grant process, please contact Megan Lyda at ml@coruralhealth.org or 720-248-2742.





CMS Releases Interactive Case Studies

Use New Interactive Case Studies to Explore ICD-10 Concepts

The Centers for Medicare & Medicaid Services (CMS) has released interactive case studies that can help you understand key ICD-10 documentation concepts.

Available on the Road to 10 tool at cms.gov/ICD-10, the case studies present:
  • Clinical scenarios 
  • Short quizzes on related coding concepts 
  • Documentation tips 
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.

CMS finalizes rules for Medicare Shared Savings Program

HHS Intergovernmental and External Affairs Notification
June 4, 2015

From: Paul Dioguardi
Director, Office of Intergovernmental and External Affairs
U.S. Department of Health and Human Services

RE: CMS finalizes rules for Medicare Shared Savings Program

The Centers for Medicare & Medicaid Services (CMS) today released a final rule updating the Medicare Shared Savings Program to encourage the delivery of high-quality care for Medicare beneficiaries and build on the early successes of the program and of the Pioneer Accountable Care Organization (ACO) Model. This final rule is an effort to provide support for the care provider community in creating a delivery system with better care, smarter spending, and healthier people.

The Medicare Shared Savings Program final rule will both enhance the focus on primary care services and provide additional flexibility in the program, which should grow participation. CMS is making these modifications to the proposed regulations after considering comments received from the December 2014 Notice of Proposed Rulemaking.

“Accountable Care Organizations have shown early but exciting progress in improving quality of care, while providing more patient-centered care at a lower cost,” said CMS Acting Administrator Andy Slavitt. “The ACO rules today strengthen our ability to reward better care and lay the groundwork for more providers to become successful ACOs.”

The final rule issued today improves the program over the proposed rule in a number of areas, including but not limited to:

· Creates a new Track 3, based on some of the successful features of the Pioneer ACO Model, which includes higher rates of shared savings, the prospective assignment of beneficiaries, and the opportunity to use new care coordination tools;

· Streamlines the data sharing between CMS and ACOs, helping ACOs more easily access data on their patients in a secure way for quality improvement and care coordination that can drive critical improvements in beneficiaries’ care;

· Establishes a waiver of the 3-day stay Skilled Nursing Facility (SNF) rule for beneficiaries that are prospectively assigned to ACOs under Track 3; and

· Refines the policies for resetting ACO benchmarks to help ensure that the program continues to provide strong incentives for ACOs to improve patient care and generate cost savings, and announces CMS’ intent to propose further improvements to the benchmarking methodology later this year.

The Medicare Shared Savings Program was created by Section 3022 of the Affordable Care Act to promote better health for Medicare fee-for-service beneficiaries by encouraging physicians, hospitals, and other health care providers to improve patient health and experience of care and to reduce growth in costs. The program is voluntary and accepts applications on an annual basis in which organizations agree to participate for three years.

Over 400 ACOs are participating in the Medicare Shared Savings Program, serving over 7 million beneficiaries. Early results released last November indicated the Medicare Shared Savings Program ACOs starting in the first two years of the program improved quality of care for beneficiaries, as ACOs improved performance in 30 of 33 quality measures.

According to an independent evaluation report released by CMS earlier this month, the Pioneer Accountable Care Organization (ACO) Model generated over $384 million in savings to Medicare over its first two years – an average of approximately $300 per participating beneficiary per year – while continuing to deliver high-quality patient care. The Pioneer ACO Model is the first that meets the tests to have its elements incorporated into other Medicare programs.

ACOs are a part of the Department’s broader initiative to create a health care system that results in better care, smarter spending, and healthier people. The Administration earlier this year announced the goal of tying 30 percent of Medicare payments to quality and value through alternative payment models, such as ACOs, by 2016 and 50 percent of payments by 2018.

For more information on the Medicare Shared Savings Program, click here.


Questions or Concerns? Contact HHSIEA@hhs.gov.

2015 MAC Satisfaction Indicator (MSI) Survey

The following is a message from CMS:

Your feedback matters!

Your opinion is important to us. Please help us by participating in the 2015 MAC Satisfaction Indicator (MSI) survey. Complete the quick 10 minute survey to share your experience with the services we provide.

You can access the survey starting Monday, June 15th at:
https://cfigroup.qualtrics.com/SE/?SID=SV_3UBxriB8PrHOZEN&MAC_BRNC=7

The CFI Group is conducting this survey on behalf of the Centers for Medicare & Medicaid Services (CMS). We appreciate your willingness to participate and assure you your responses will be kept completely confidential.

If you experience technical difficulties accessing or submitting the survey, please contact CFI Support at nripberger@cfigroup.com.

Registration Deadline: Building Transformation from the Inside Out

Innovate! Collaborate! Motivate!
Building Transformation from the Inside Out
June 26, 2015 8am–3:30pm

Effective care transitions are a vital part of health care transformation. Learn to streamline internal processes such as Teachback, Discharge Planning, Medication Reconciliation and Utilizing Post-Acute Services.

Registration Deadline 6.19.15!

Speaker Line-up:


What comes next in Care Transitions and the ACA?
Dr. Jay Want, CMO, Center for Improving Value in Health Care

Improving Medication Reconciliation for Transitions
Kate Perica, University of Colorado Hospital

Teachback Fundamentals for Everyone
Kat Bottinelli, RN, BSN, CTI Care Transitions Coach, St. Anthony Hospital

Lunch: Success Story & Poster Session
Jodi Smith, MSN, CCMC, ANP-BC, ND Director of Hospital Operations,
Specialty Services and Care Coordination Kaiser Permanente, Colorado

Discharge Planning Done Right (Panel)
Maria Orren, Team Select Home Health
Dr. Adolphe Edward, CEO, Kindred Hospital ,Denver
Sarah Sunleaf, Clinical Transitions Case Manager for Vivage
Lisa Clark, RN BSN, Longmont United Hospital

Organizing Post-Acute Services (Panel)
Don Backstrom, Senior Director of Geriatrics at Kaiser Permanente
Optio Health Services


For more information, agendas and registration, visit:
www.healthy-transitions-colorado.org/resources/cultivating-the-network-of-care-symposia-series/ 

CMS Conducts Second Successful Medicare FFS ICD-10 End-to-End Testing Week in April

CMS Conducts Second Successful Medicare FFS ICD-10 End-to-End Testing Week in April

From April 27 through May 1, 2015, Medicare Fee-For-Service (FFS) health care providers, clearinghouses, and billing agencies participated in a second successful ICD-10 end-to-end testing week with all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment (DME) MAC Common Electronic Data Interchange (CEDI) contractor. CMS was able to accommodate most volunteers, representing a broad cross-section of provider, claim, and submitter types.

This second end-to-end testing week demonstrated that CMS systems are ready to accept ICD-10 claims. Approximately 875 providers and billing companies participated, and testers submitted over 23,000 test claims. View the results.

Overall, participants in the April end-to-end testing week were able to successfully submit ICD-10 test claims and have them processed through Medicare billing systems. The acceptance rate for April was higher than January, with an increase in test claims submitted and a decrease in the percentage of errors related to diagnosis codes. Most of the claim rejections that occurred were due to errors unrelated to ICD-9 or ICD-10.

In addition to acknowledgement testing, which may be completed at any time, a final end-to-end testing week will be held on July 20 through 24, 2015. The opportunity to volunteer for this testing week has closed. Testers who participated in the January and April end-to-end testing weeks are automatically eligible to test again in July.

Prepare Now for ICD-10 Implementation

Medicare claims with a date of service on or after October 1, 2015, will be rejected if they do not contain a valid ICD-10 code. The Medicare claims processing systems do not have the capability to accept ICD-9 codes for dates of service after September 30, 2015; or accept claims that contain both ICD-9 and ICD-10 codes.

There is still time to get ready for ICD-10!

Even though the October 1, 2015, mandatory implementation date is quickly approaching, providers still have time to prepare for ICD-10, and CMS has created a number of tools and resources to help you succeed. One tool is the “Road to 10,” aimed specifically at smaller physician practices with primers for clinical documentation, clinical scenarios, and other specialty-specific resources to help you with implementation.

For more information

Register Today for CRHC Billing and Coding Workshops

Billing and Coding –Working Through ICD-10 Together
ICD-10 Workshop for Rural Healthcare Facilities

Presented By: ARHPC – Gary Lucas, CPC, CPC-I, AHIMA ICD-10 Ambassador, ARHPC Adjunct Faculty

Dates and Locations:


**Topics covered will require the following coding manuals: ICD-10CM (2014)**
How to assure claims will be processed and revenue cycles won’t crash and burn

• Conversion of top 20 codes for your facility
⇒ creating documentation tips for providers)
• Review ICD-9 claims denied-reworked-successfully resubmitted
⇒ now rework using ICD-10 (documentation gap analysis – stage 2)
⇒ start your ICD-10 workflow analysis (what adjustments will you need to make)
• Are your vendors and payers really ready?
• How will your query process change?
• What to do if providers just won’t engage.

***All attendees MUST bring their coding manual with them, to the class.***

This class is approved for 5 hours of CEU’s and recognized by AHIMA

Upon completion of this workshop, attendees will be eligible to take an ICD-10 proficient test through ARHPC at no additional cost.

Pricing

SHIP Grant Participants: $60.00/person
(use coupon code: SHIPGRANT)
Not sure if you are a SHIP Grant participant? Click here
CRHC members: $149/person
(use coupon code: MEMBER3033)
Not sure if you are a CRHC member? Click here
All others: $179.00

*Early bird discount $10 off available until June 12th

Questions? Contact Danette Swanson atds@coruralhealth.org or call 303.577.0357. Questions about payment or registration, contact web@coruralhealth.org or call 303.832.7493.

Cancellation Policy: An alternate registrant from the same institution will be accepted under the original registration. Registration fees are non-refundable unless notice of an individual’s cancellation is received at CRHC two weeks prior to the date of the boot camp.
CRHC IS THE RECIPIENT OF THE FEDERAL HRSA SMALL RURAL HOSPITAL IMPROVEMENT PROGRAM (SHIP) GRANT: CFDA 93.301; AWARD 5 H3HRH00038-13-00 (9-1-2014 THROUGH 8-31-2015)

Thursday, June 4, 2015

OSHA Downloadable Resources

Did you know that HCPro features many downloadable resources regarding OSHA standards? Visit the resource page to find information on Bloodborne Pathogens, Employee Training, Hazard Communication, Infection Control, and much more.

Employer Wellness Program Rule and FAQs

Employer Wellness Program Rule and FAQs

On April 20, 2015, the Equal Employment Opportunity Commission issued a proposed rule describing how Title I of the Americans with Disabilities Act applies to employer wellness programs that are part of group health plans. Comments will be accepted through June 19, 2015. For more information, visit the EEOC factsheet and Question and Answer document. In addition, the departments of Labor, Health and Human Services, and Treasury issued answers to Frequently Asked Questions (FAQs) on wellness program requirements under the Affordable Care Act; the Department of Health and Human Services (HHS) Office for Civil Rights issued a FAQ on workplace wellness programs under the Health Insurance Portability and Accountability Act privacy, security and breach notification rules; and CMS issued a FAQ on health insurance market reforms and wellness programs. For more information, visit the HHS blog post.

Revised Critical Access Hospital (CAH) State Operations Manual (SOM), Appendix W

CMS State Operations Manual Revisions

On April 7, 2015, CMS revised the Critical Access Hospital (CAH) State Operations Manual (SOM), Appendix W. This is the guidance state survey agencies and accrediting entities use when surveying CAHs for compliance with the Medicare Conditions of Participation. CMS also issued a transmittal detailing the changes. This revision reflects regulatory changes finalized in 2014 and clarifies how survey agencies should assess CAHs' compliance in these areas. The updates were originally issued on January 16, 2015 via Survey & Certification Letter 15-19.

CMS also revised these sections of the SOM effective March 27, 2015:
  • Appendix A - Hospitals 
  • Appendix T - Hospital Swing Beds 
  • Appendix L - Ambulatory Surgical Centers (ASCs) 
  • Appendix G - Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) 
Interested stakeholders can review the entire State Operations Manual online (appendices are available through links in the Table of Contents document) as well as the transmittal detailing the changes. These revisions update the SOM to reflect regulations finalized last year and were originally issued on January 30, 2015 via Survey & Certification Letter 15-22.

FY 2016 Medicare Payment Rates for Acute Care Hospital and Long-Term Care Hospitals

FY 2016 Inpatient PPS Proposed Rule
On April 30, 2015, CMS published a proposed rule outlining FY 2016 Medicare payment rates for Acute Care Hospital and Long-Term Care Hospitals. This Hospital Inpatient Prospective Payment System (IPPS) rule: 

  • Continues to implement ACA-mandated Medicare Disproportionate Share Hospital reductions, reducing payments by $1.3 billion compared to FY 2015 
  • Indicates that CMS is considering feedback regarding its Two Midnights policy and expects to address the issue in the CY 2016 Outpatient PPS proposed rule 
  • Adds eight measures in the Inpatient Quality Reporting (IQR) program and removes nine, with some shifting to electronic submission 
  • Updates the Hospital-Acquired Conditions Reduction Program, the Hospital Readmissions Reduction Program and the Hospital Value-Based Purchasing Program 
  • Requests comments on policy and operational issues surrounding expanding the Bundled Payments for Care Improvement initiative 
  • Implements the site-neutral payment rates for long-term care hospitals (LTCHs) mandated by the Pathway for SGR Reform Act of 2013 (P.L. 113-67). CMS projects that this payment change would decrease total LTCH payments by 4.6% or $250 million in FY 2016 
  • Continues phased documentation and coding payment recoupment mandated by the American Taxpayer Relief Act of 2012 by making another -0.8% adjustment 

Public comments will be accepted until June 16, 2015.* For further info and supporting data, visit the Medicare FY 2016 IPPS proposed rule homepage.


*When originally published, the deadline was June 29, 2015; however, a correction published on May 5, 2015 changed the due date to June 16, 2015, although this deadline has not yet been updated on Regulations.gov.

Proposed Rule Outlining FY 2016 Medicare Payment Rates for SNFs

FY 2016 SNF Proposed Rule
On April 20, 2015, CMS issued a proposed rule outlining FY 2016 Medicare payment rates for skilled nursing facilities (SNFs). The rule would: 

  • Increase overall payments to SNFs by $500 million or 1.4%, compared to FY 2015 levels 
  • Implement a provision of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) that reduces by 2% the annual payment update to SNFs that fail to submit required quality data under the SNF Quality Reporting Program (QRP) beginning in FY 2018. CMS proposes to adopt three QRP measures for FY 2018 that address three quality domains identified in the IMPACT Act and that comply with the IMPACT Act requirement of standardized post-acute care data reporting across home health agencies, inpatient rehabilitation facilities, long term care hospitals and SNFs. CMS intends to propose additional quality measures and resource use measures in future rulemaking 
  • Establish a 30-day all-cause, all-condition hospital readmission quality measure that will be used in a new SNF Value-Based Purchasing (VBP) Program beginning in FY 2019, as required by the Protecting Access to Medicare Act of 2014 (PAMA). CMS seeks comment on numerous issues associated with the SNF VBP Program, which will be addressed in FY 2017 SNF Prospective Payment System (PPS) rulemaking 
  • Establish new regulatory reporting requirements for SNFs and nursing facilities to electronically submit staffing information based on payroll data, as mandated by the Affordable Care Act (ACA) 

Public comments on the proposed rule will be accepted until June 15. For further information, visit the Medicare SNF PPS homepage.

Medicare Access and CHIP Reauthorization Act of 2015

MACRA
On April 16, 2015, the President signed into law H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). In part, the bill:
  • Eliminates the Sustainable Growth Rate (SGR) formula under the Medicare Physician Fee Schedule and replaces it with five years of 0.5% updates, then transitions practitioners to a system that emphasizes participation in alternate payment models such as accountable care organizations (ACOs) or value-based payment 
  • Extends and supplements Children's Health Insurance Program (CHIP) funding for two years 
  • Extends several rural-relevant payment provisions for two years, including rural add-on payments for ambulance services and home health, payments for low volume hospitals, Medicare dependent hospital payments, the work Geographic Practice Cost Index (GPCI) floor and exceptions to the therapy caps 
  • Delays Medicaid Disproportionate Share Hospital (DSH) payment cuts one year, until fiscal year (FY) 2018, and extends them to FY 2025 
  • Delays the two-midnight hospital inpatient admission policy until September 30, 2015 
  • Delays and phases in over six years a 3.2% hospital inpatient payment increase scheduled for FY 2018 
  • Authorizes and extends funding through FY 2017 for the Health Resources and Services Administration's (HRSA) Health Centers; the National Health Service Corps (NHSC); and the Maternal, Infant and Early Childhood Home Visiting, Teaching Health Center Graduate Medical Education and Family-to-Family Health Information Center programs 
  • Prohibits Medigap plans from covering the Part B deductible for new Medicare enrollees beginning in 2020 
  • Increases the share of Part B and D premiums that higher income beneficiaries must pay 
  • Scraps the Centers for Medicare & Medicaid Services (CMS) proposal to eliminate 10- and 90-day global surgical payments in 2017 and 2018 in favor of data collection to reprice the payments accurately

Health Plan Identifier RFI Comment Period Open

Submit Your Comments on the New HPID Request for Information

The Department of Health and Human Services (HHS) has released a Request for Information (RFI) on the Health Plan Identifier (HPID). The intent is to collect perspectives from all segments of the industry on the current HPID policy in order to determine future policy directions.

This RFI seeks information from the health care industry about: 
  • The HPID enumeration structure outlined in the HPID final rule, including the use of the controlling health plan (CHP)/subhealth plan (SHP) and other entity identifier (OEID) concepts. 
  • The use of the HPID in Health Insurance Portability and Accountability Act (HIPAA) transactions in conjunction with the Payer ID. 
  • Whether changes to the nation's health care system, since the issuance of the HPID final rule published September 5, 2012, have altered your perspectives about the function of the HPID. 

Submit Your Comments
The 60-day public comment period is open until July 28, 2015. Any member of the public may submit comments. Comments can be submitted in several ways, including via electronic submission or mail:
  • Electronically 
  • You may submit electronic comments to http://www.regulations.gov
  • By regular mail 
  • By express or overnight mail 
  • By hand or courier

Register for the June MLN Connects National Provider Calls

Register now for the following calls:

June 3rd - 2014 Mid-Year QRURs

June 9th - Medicare Shared Savings Program ACO: Application Review

June 16th- National Partnership to Improve Dementia Care and QAPI

June 17th- Hospice Quality and Hospice Item Set Manual V1.02

June 18th- ICD-10: Preparing for Implementation and New ICD-10-PCS Section X

June 24th – Hospital Star Ratings

All are open for registration on our NPC Page: http://www.eventsvc.com/blhtechnologies/