Updated TrailBlazer Resources

TrailBlazer has revised its CAH Manual and CAH Documentation Errors Job Aid. To access the TrailBlazer CAH Manual, click here. To access the updated CAH Documentation Errors Job Aid, click here.

CMS Denver Regional Office Spring Newsletter

The Spring 2010 edition of “The Pulse of CMS”, the Denver Regional CMS Office’s Spring Newsletter is now available by clicking here.

CAH CoPs – Credentialing and Privileging for Telemedicine Services

CMS has issued a proposed rule that would revise its conditions of participation for hospitals and CAHS to allow for a less burdensome credentialing and privileging process for physicians and practitioners providing telemedicine services. The rule is posted in the May 26 Federal Register--click here to view it. The CMS deadline for comments on the proposed rule is July 26, 2010.

340B Program Update

The Patient Protection Affordability Care Act expanded the 340B Drug Pricing program to CAHs for outpatient drugs. A last-minute change to the legislation eliminated newly-eligible hospitals’ ability to use the 340B program for “orphan drugs”, or drugs intended to treat rare forms of disease. This exception could have an impact on rural hospitals’ ability to treat patients with cancer or other rare diseases. Additionally, because of limitations the 340B program has on using group purchasing organizations, participating hospitals could pay more for orphan drugs than prior to health reform. To read more on CRHC’s Policy Blog, click here. Information about the 340B program is available online at the HRSA Pharmacy Services Support Center (PSSC), HRSA Office of Pharmacy Affairs, and 340B Prime Vendor Program.

In Need of Assistance?

CRHC offers dozens of programs and services to help RHCs manage their finances, improve patient care, add Health Information Technology, stay current on CMS changes, be prepared for an unexpected RHC survey, recruit and retain healthcare providers, and more! Some services are offered completely FREE of charge, and fees for the rest are lower than you'll find anywhere else--some services, such as our Financial Excellence in Revenue Management (FERM) program, will immediately show financial returns that far exceed your original cost! Contact Rich Marquez at rm@coruralhealth.org or 303.577.0373 for more information today!

CMS Rural Health Open Door Forum

The next CMS Rural Health Open Door Forum is scheduled for Tuesday, June 8, 2010 from 2pm-3pm ET. To participate, dial 800.837.1935 Conference ID 76344548.

HUD 242 (FHA Section 242) Funding

The Federal Housing Administration (FHA) helps hospitals access affordable financing for capital projects. Uses may include new construction, refinancing, and modernization, remodeling, equipment, and expansion. For more information, click here.

Children's Safety Network Webinar -- Addressing Disparities: Rural Injury and Violence Prevention

Monday, June 7, 2010; 1:30-3:00pm EST
The Children's Safety Network National Injury and Violence Prevention Resource Center is pleased to invite you to a webinar on rural injury and violence prevention.  Learn about key issues and promising prevention strategies, explore the disparity between rural and urban injury rates, and hear about how one state is addressing rural all-terrain vehicle injuries.  Space is limited. To reserve your webinar seat now, click here.

CSN is pleased to announce the speakers for this webinar are:

• Mary E. Aitken, MD, MPH, Director, Arkansas Children's Hospital Injury Prevention Center
• Monique Sheppard, PhD, Director of the CSN Economics and Data Analysis Resource Center
• Sally Kerschner, MSN, RN, MCH Planning Specialist in the Division of Maternal and Child Health of the Vermont Department of Health

If you have any questions or comments, please email Zoe Baptista at zbaptista@edc.org.  Within 4 days of registering you will receive a confirmation email containing information about joining the Webinar.

Look What CRHC Can Do For You!

CRHC can help RHCs manage their finances, improve patient care, add Health Information Technology, stay current on CMS changes, be prepared for an unexpected RHC survey, recruit and retain healthcare providers, and more! Contact Rich Marquez at rm@coruralhealth.org or 303.577.0373 for more information today!

Colorado Colorectal Screening Program (CCSP) Annual Meeting

June 10, 2010; 8-2 pm

The Colorado Colorectal Screening Program has endoscopically screened over 10,000 people throughout the State of Colorado since 2006 and is one of the premier cancer prevention programs in the country. As outlined below, an insightful meeting agenda is planned. All CCSP partners (patient navigators, medical directors, healthcare providers and community partners are invited to attend. CCSP’s annual meeting will be held at the Anschutz Medical Campus-Aurora, CO in the Education Building 1, Room 1300 (room entrance is located on the 2nd floor. For more information, click here.

• Welcome & CCSP Presentation - CCSP has endoscopically screened over 10,000 people throughout the state of Colorado since 2006, and is one of the premier colorectal cancer prevention programs in the country. Dr. Holly Wolf will provide program statistics and speak about the past, present, and future of the Program and colorectal prevention efforts in Colorado.
• Key Note Address: Healthcare in Colorado - Ms Lorez Meinhold will speak about the opportunities presented by reform to improve care for the medically underserved and provide a year in review regarding the Amendment 35 funds, the fiscal state of Colorado, and the impact on health.
• Local & National Patient Navigation: Efforts & Perspectives - Dr. Peter Raich and Ms Andi Dwyer will provide information on local patient navigation efforts in colorectal screening as well as the national impact on research and implementation regarding patient navigators.
• The Case for Prevention - Dr. Tim Byers will discuss Program screening and outcome data in the context of current and future colorectal cancer prevention efforts.
• Quality Indicators for Endoscopic Screening - Dr. Lee Richman is a national leader in addressing colonoscopy quality outcomes. He will speak on the importance of quality indicators such as polyp and adenoma detection rates.

Providers can earn 1 ERS point from COPIC for attending.

FREE Emergency Preparedness Tabletop Exercises

The DRC Group, in coordination with Florida’s Department of Health, invites healthcare providers to participate in one of the scheduled tabletop exercises being facilitated via the internet during the month of June.  There is NO CHARGE for participation in any of the exercises.

These exercises have been designed specifically for healthcare providers to evaluate and enhance existing Business Continuity and/or Emergency Operation Plans. In addition, providers who do not currently have such plans will have an opportunity to gain a thorough understanding of what should be in their plan.

Two distinctive types of exercises are available. One of the exercises will feature a hurricane scenario (June 9, 10, 15, & 16) while the other involves a commercial fire (June 22) which heavily damages your facility.

For additional information and registration, please click here.

Trailblazer 2010 J4 Medicare Tour in Colorado, Oklahoma and Texas

It is not too late to register for the remaining venues! The workshops are for Part A and Part B providers and will offer an assortment of topics that are sure to assist the provider community with their Medicare billing needs. Note: The workshops do not apply to Ambulance providers.  Multiple sessions will be offered throughout the day allowing attendees the convenience of attending the training sessions of their choice in the morning and afternoon. The tour includes:

• A full day of training sessions, with the option to select classes most pertinent to your practice
• A question and answer session at the end of the day
• A help desk for one-on-one assistance
• A valuable TrailBlazer educational CD
• Continental breakfast and lunch
• Certificates that can be used to obtain Continuing Education Units (CEUs) from the AAPC

Regstration for this event is located on the TrailBlazer Calendar of Events.

CMS 2010 ICD-10/5010 National Provider Conference Call

June 15, 2010; 12-2pm ET
CMS will host a national provider conference call on “ICD-10 Implementation in a 5010 Environment” this June. This toll-free teleconference will include a question and answer session that will give call participants an opportunity to ask questions of CMS subject matter experts. Registration information will be announced soon, so hold June 15 now for this informative provider conference call. For a list of discussion topics, click here and scroll down to the appropriate article: CMS Provider Partnership E-mail Archive.

Quality Health Indicators (QHi) Benchmarking Tool – Updates

QHi’s next Quality Education Session is scheduled for May 19 and is open to all QHi users. QHi will be holding the next Clinical Quality Advisory Committee call on May 27. This call is open to all QHi users and is an opportunity for users to provide input and direction on QHi measures. Additionally, QHi has added HCAHPS measures to its Patient Satisfaction library of measures. For more information on QHi, please contact jd@coruralhealth.org.

Special Open Door Forum (ODF): Medicare Provider and Supplier Enrollment

May 19, 2010; 3-5pm ET
CMS will hold a special ODF to discuss Medicare provider enrollment issues. Capacity is limited, so dial in early. You may begin dialing into this forum as early as 2:45 p.m. ET.

Dial: 1-800-603-1774
Reference Conference ID: 61448973

For a list of discussion topics, select the following link and scroll down to the appropriate article: CMS Provider Partnership E-mail Archive.

IHI Author in the Room Recording: The Patient Who Falls

In one of the most widely attended Author in the Room calls ever in the joint Institute for Healthcare Improvement (IHI) and JAMA audio series, gerontology pioneer and MacArthur Foundation Fellow, Dr. Mary Tinetti, of the Yale University School of Medicine, shared her newest findings on preventing falls among the elderly. Listen to an audio recording of the Author in the Room call on preventing falls.

Vaccine Preventable Diseases Course

July 12-14, 2010; Stanley Hotel
This 2½ day course, presented by the CDC and CDPHE, with a focus on Colorado-based issues, provides a comprehensive review of immunization, vaccine-preventable diseases, and their respective vaccines. The course will provide the most up-to-date immunization information from the Advisory Committee on Immunization Practices (ACIP). CEUs are available. For more information and to register, click here.

AgriSafe Webinar - Applying a Developmental Framework to Advance Our Understanding of Pediatric Farm Injuries and Strategies for Prevention

May 26; 12:00-1:00 CST
During this webinar, presented by AgriSafe, participants will learn how to promote an appreciation for how developmental processes can differentially influence risk of injury on farms at different stages in childhood, share some research findings to illustrate how this approach can be applied, and enhance understanding of how injury prevention approaches might be tailored based on developmental level of the child. To join the session, click here and enter your name in the guest login box and click on 'Enter Room'.

Take Advantage of CRHC’s Rural Health Clinic Technical Assistance Services!

CRHC offers dozens of programs and services to help RHCs manage their finances, improve patient care, prepare for RHC survey and plan for health information technology initiatives. Some services are offered completely free of charge while fees for the rest are lower than you’ll find anywhere else. Some services, such as our Financial Excellence in Revenue Management (FERM) program, will immediately show financial returns that far exceed your original cost! For more information, contact Rich Marquez, RHC Program Coordinator at mailto:rm@coruralhealth.org or 303.577.0373.

CRHC’s Colorado Provider Recruitment Program

The Colorado Provider Recruitment (CPR) program is a nonprofit recruitment program that was created by CRHC to address healthcare workforce shortages in rural and underserved communities in Colorado. CPR provides a variety of recruitment and retention related services to communities searching for healthcare providers, as well as providers who wish to practice in rural or underserved communities. CPR recruits primary care providers including Family Medicine, Internal Medicine, Pediatrics, OB/GYN, Physician Assistants, and Nurse Practitioners. We also recruit Certified Nurse Midwives, Dentists, Dental Hygienists, and specialists on request. For more information click here or email at cpr@coruralhealth.org. To see CPR history, funding, advertising and sourcing efforts, and placements to date, please check out the most recent Quarterly Report.

2010 CAH Advisory Council Meeting – Save the Date!

November 4-5, 2010
The 2010 CAH Advisory Council meeting will take place on November 4-5. This annual meeting brings together participants from CRHC, CAHs, and community partners to discuss Colorado’s CAH Program accomplishments and gather input on direction for the coming year. More details to come.

TrailBlazer J4 Medicare Tour – Colorado Dates

TrailBlazer will be conducting the 2010 J4 Medicare Tour in Colorado Springs on June 15 and in Grand Junction on June 17. The workshops are for Part A and Part B providers and will offer an assortment of topics to assist the provider community with their Medicare billing needs, including sessions for CAHs and RHCs. The fee is $125 per person and includes a full day of training sessions, an educational CD, Q&A session, a help desk for one-on-one assistance, a certificate to obtain CEUs, and breakfast and lunch. For more information and to register, click here.

TrailBlazer Medicare Secondary Payer (MSP) Audit Resources

There are a number of resources on the TrailBlazer and CMS websites to help CAHs ensure they are complying with MSP regulations and prepare for MSP audits. Available resources include: TrailBlazer Medicare Secondary Payer webpage, TrailBlazer MSP Audit FAQs, TrailBlazer MSP Encore Web-Based Training, and the CMS MSP Manual Chapter 5.

New from the Medicare Learning Network

The April 2010 edition of the Medicare Learning Network (MLN) Catalog of Products is now available and may be accessed on the CMS website. The MLN Products Catalog is an interactive downloadable document that lists all MLN products by media format. The catalog has been revised to provide new customer-friendly links that are embedded within the document. All product titles and the word “download,” when selected, will link you to the online version of the product. The word “hard copy,” when selected, will automatically link you to the MLN Product Ordering page. To access the catalog, click on the MLN Product Catalog link.

Reminder – Obtaining the PS&R via the Re-designed PS&R

This is a reminder to all providers of the requirements of CR 6519, dated June 12, 2009, which notified providers that the new, redesigned Provider Statistical and Reimbursement system (PS&R Redesign) is now operational.

Providers are now responsible for obtaining their own PS&Rs to be used for filing all cost reports with FYs ending on or after January 31, 2009. The PS&R Redesign allows users the ability to download summary PS&R reports via the Internet. FIs/MACs will no longer produce and distribute these summary reports to their providers. It is the providers' responsibility to obtain their own PS&R needed to file their cost report.

The PS&R Redesign utilizes Individuals Authorized Access to CMS Computer Systems (IACS) for authentication and security purposes. To obtain a PS&R, providers must first establish an IACS account and also be approved for PS&R access prior to attempting to access the PS&R Redesign. The provider IACS verification process includes the submission of supporting documentation and may take several weeks to complete the entire process. Trailblazer strongly encourages all providers not currently approved for PS&R access to begin their IACS registration immediately to ensure they will be able to access IACS and the PS&R Redesign well in advance of their cost report due date.

More information regarding the IACS process is available on the CMS IACS webpage. The CMS PS&R Redesign webpage contains an overview of the system, user manuals, quick guides and other helpful information.

The article, titled “Implementation of the Redesigned Provider Statistical and Reimbursement System,” is available on the CMS MLN Matters® Web page. Effective: July 13, 2009.  Providers may reference CR 6519, Transmittal 153, dated June 12, 2009.

Revised Clinical Laboratory Fee Schedule Fact Sheet

The revised “Clinical Laboratory Fee Schedule Fact Sheet” (January 2010), which provides general information about the Clinical Laboratory Fee Schedule, coverage of clinical laboratory services and how payment rates are set, is now available in print format from the MLN. To place your order, visit the CMS website, scroll down to Related Links Inside CMS and select MLN Product Ordering Page.

HRSA’s Patient Safety and Clinical Pharmacy Collaborative

May 13, 2010; 11am-5pm EST
The 2nd Learning Session for HRSA's ongoing Patient Safety and Clinical Pharmacy Collaborative (PSPC) is scheduled for May 13th and will be broadcast via satellite link or internet web cast and will be highly interactive. HRSA would like to invite you to join the session either as a participant if you are already part of a PSPC Team or as an interested observer wanting to learn more about the outcomes of the PSPC. Click here for more information about the May 13th session. Also, HRSA is proud to announce that PSPC 3 will be starting September 2010. This would be the 3rd year of a very successful collaborative. Application acceptance will start in May 2010. For more information about the PSPC, click here or download the PSPC flyer. If you have any questions, please feel free to contact Kimberly Patton at Kimberly.Patton@hrsa.hhs.gov or patientsafety@hrsa.gov or 800.628.6297, 9am-4:30pm ET.

2011 CMS IPPS Proposed Rule

The 2011 CMS Inpatient Prospective Payment System (IPPS) Proposed Rule was released in the April 19 Federal Register. Below are provisions that would affect CAHs:

• Reimbursement for Services of CRNAs (pg 532): CMS is proposing to allow hospitals and CAHs that are urban but have applied for and been granted rural status under Medicare law to receive reimbursement for anesthesia and related care furnished by qualified CRNAs on reasonable cost basis.
• Removal of the Annual Election Requirement on Maintaining Method II Payment (pg 560): CMS is proposing a change so that, once a CAH elects the Method II payment method for outpatient services that election remains in place until it is terminated by the CAH. 
• Clarification of Which Provider Taxes May Be Allowable Costs (pg 566): CMS currently permits certain provider taxes to be treated as allowable costs if they are related to the reasonable and necessary cost of providing patient care and are actually incurred. CMS is proposing to clarify that FI/MACs will determine whether provider taxes are allowable on a case-by-case basis, based on reasonable cost principles and will determine if a reduction of the allowable tax expenses is proper to account for payments providers receive that are associated with the assessed tax.

More information including instructions for submitting comments to CMS can be found in the Federal Register by clicking here or on CMS by clicking here. Comments to CMS on the proposed rules are due by June 18.

EMS Toolkit – Turnover and Costs of Turnover

The EMS Agency Research Network for Quality & Safety Improvement (EMSARN) has released a toolkit for EMS agencies. This toolkit was designed to help EMS managers track Turnover and Costs of Turnover in their agencies. See There’s also a podcast on Turnover and Cost in EMS available.

New TrailBlazer Resources Now Available

TrailBlazer Rural Ask the Contractor Teleconference Q&A
TrailBlazer has posted Q&As from the April 14 Rural Ask-the-Contractor Teleconference. To access the Q&A document, click here.

TrailBlazer Updated CAH Manual
TrailBlazer has made revisions to the CAH Manual. To access the updated manual, click here.

Eligibility Expansions Effective May 1, 2010

Almost 70,000 more Coloradans will be eligible for Medicaid and CHP+ as of May 1, 2010. This is the first expansion as a result of the Colorado Health Care Affordability Act provider fee.

An estimated 44,000 parents who have a child on Medicaid and 24,000 children and pregnant women will be eligible for healthcare coverage as a result of the hospital provider fee, at no cost to the taxpayer.

CHP+ eligibility is increasing from 205% of the FPL, or $45,000 per year for a family of four, to 250% FPL, or about $55,000 per year for a family of four. Eligibility for parents with a child on Medicaid can now make up to 100 percent of the federal poverty level - $22,056 per year for a family of four. This is up from 60%, or $13,234.

Save The Date: Four Corners Conference on Colorectal Cancer

July 22-23, 2010
This conference will highlight colorectal cancer screening and awareness programs in Arizona, Colorado, New Mexico and Utah and sharing how to reach Native American, Latino/a and rural populations while fostering a spirit of collaboration among states to increase colorectal screening in our communities. Details coming soon or contact Teri Spector, Conference Coordinator at teri.spector@ucdenver.edu.