CMS is anticipating Congressional action to avert the negative update for the 2012 Medicare Physician Fee Schedule. Therefore, CMS is extending the 2012 Annual Participation Enrollment Period through Tuesday, February 14, 2012. The enrollment period now runs Monday, November 14, 2011 through Tuesday, February 14, 2012.
The effective date for any participation status change during the extension, however, remains Sunday, January 1, 2012, and will be in force for the entire year.
Contractors will accept and process any participation elections or withdrawals made during the extended enrollment period that are post-marked on or before Tuesday, February 14, 2012
Saturday, December 31, 2011
Thursday, December 29, 2011
Compliance Deadline for the Transition to ASC X12 Version 5010 is Less Than One Week Away
Though CMS has announced an enforcement discretionary period of 90 days for Version 5010 compliance, the deadline remains Sunday, January 1, 2012. Enforcement will not be exercised until Sunday, April 1, 2012; however, it is important that organizations continue to complete the transition to Version 5010 as soon as possible, if they have not done so already.
Holding of Institutional Provider 2012 Date-of-Service Claims
As the Centers for Medicare & Medicaid Services (CMS) implements calendar year 2012 changes, Medicare claims administration contractors will be holding some institutional provider claims containing 2012 services for up to the first 10 business days of January 2012 (i.e., Sunday, January 1, 2012, through Tuesday, January 17, 2012). Claims will be released as system testing is successfully completed, which we expect during that time frame.
The hold should have minimal impact on provider cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. However, if you follow the status of your claim during the claims processing cycle, the claim status may not reflect what you would normally see because of the claims hold.
Medicare claims for services rendered on or before Saturday, December 31, 2011, are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames. We appreciate your patience as we implement calendar year 2012 changes.
The hold should have minimal impact on provider cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. However, if you follow the status of your claim during the claims processing cycle, the claim status may not reflect what you would normally see because of the claims hold.
Medicare claims for services rendered on or before Saturday, December 31, 2011, are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames. We appreciate your patience as we implement calendar year 2012 changes.
Nursing Education and Loan Repayment Program (NELRP) 2012 Application Cycle Now Open!
The Health Resources and Services Administration (HRSA), Bureau of Clinician Recruitment and Service (BCRS), is pleased to announce the 2012 application cycle for NELRP is now open and will remain open through February 15, 2012.
NELRP offers Registered Nurses (RNs), advanced practice registered nurses, such as Nurse Practitioners (NPs), and nurse faculty an opportunity to repay 60 percent of their outstanding qualifying educational loans in exchange for a two-year service commitment at a Critical Shortage Facility (CSF) or an accredited school of nursing.
This year, the program has been modified to adapt to changes in the nursing profession and to ensure support for communities with the greatest need.
For 2012, the program is reserving up to half of the award funding for NPs; the remaining funding will continue to support RNs and nurse faculty.
As in previous years, NELRP is expected to be competitive. If there are more qualified applicants than available funding, NELRP will prioritize applications based upon the following criteria:
Nurses at CSFs:
Preference will be given to nurses based on the greatest financial need, the type of facility, and the mental health or primary care Health Professional Shortage Area (HPSA) designation. For more information on CSFs, HPSAs and funding preferences, review the Application and Program Guidance here
Nurse Faculty at Schools:
Preference will be given to faculty with the greatest financial need and to faculty working at schools of nursing with at least 50 percent enrollment of students from a disadvantaged background.
The deadline to apply to NELRP is February 15, 2012 at 5 pm ET. To learn more about NELRP eligibility and requirements, visit: here .
NELRP offers Registered Nurses (RNs), advanced practice registered nurses, such as Nurse Practitioners (NPs), and nurse faculty an opportunity to repay 60 percent of their outstanding qualifying educational loans in exchange for a two-year service commitment at a Critical Shortage Facility (CSF) or an accredited school of nursing.
This year, the program has been modified to adapt to changes in the nursing profession and to ensure support for communities with the greatest need.
For 2012, the program is reserving up to half of the award funding for NPs; the remaining funding will continue to support RNs and nurse faculty.
As in previous years, NELRP is expected to be competitive. If there are more qualified applicants than available funding, NELRP will prioritize applications based upon the following criteria:
Nurses at CSFs:
Preference will be given to nurses based on the greatest financial need, the type of facility, and the mental health or primary care Health Professional Shortage Area (HPSA) designation. For more information on CSFs, HPSAs and funding preferences, review the Application and Program Guidance here
Nurse Faculty at Schools:
Preference will be given to faculty with the greatest financial need and to faculty working at schools of nursing with at least 50 percent enrollment of students from a disadvantaged background.
The deadline to apply to NELRP is February 15, 2012 at 5 pm ET. To learn more about NELRP eligibility and requirements, visit: here .
Wednesday, December 28, 2011
Register NOW for 2012 Forum - Essential Perspectives for Safety Net Providers
Our annual event brought to you by the Colorado Rural Health Center and ClinicNET is just around the corner. Join us April 11th - 13th at the Sheraton Denver West in Lakewood, Colorado and participate in the numerous education, training and networking opportunities available to you. For more information on this event or to register please visit our website or contact Courtnay Ryan at cr@coruralhealth.org. See you there!
Upcoming CRHC Webinars
Please join CRHC for these upcoming webinars – click on the titles for more information and to register:
· Community Health Needs Assessments – January 11
· Top 10 CAH Deficiencies and What We Can Do About It… - January 27
· Utilization Management for CAHs – February 28
· CAH Swing Beds: Part I – March 20
· CAH Swing Beds: Part II – April 3
Tuesday, December 27, 2011
Colorado Rural Credentialing Network – Register Now for 2012!
Credentialing of physicians and other healthcare practitioners is a key risk management function for facilities, both large and small. Further, it has become a complex and seldom understood process. CRHC’s Colorado Rural Credentialing Network provides rural hospitals and clinics with information, education, and resources pertaining to this important task. For an annual fee of $250 (CRHC members)/$375 (non-members), participants will have:
- Access to participate in quarterly interactive Educational Credentialing Webinars facilitated by an expert credentialing specialist
- Up-to-Date Tools, Resources, Templates, and Materials, Archived Network Webinars and Information (through a member-only website)
- Peer Networking opportunities
- No-Cost Access to a certified credentialing specialist for general credentialing questions
- Access to personalized credentialing consultations at a group discount rate
To join the 2012 Colorado Rural Credentialing Network, complete the registration form. Quarterly webinars will begin in February 2012.
Thursday, December 22, 2011
CRHC Webinar – Community Health Needs Assessments
Community Health Needs Assessments are a great way to highlight for the community the importance of local hospitals and clinics, both in regard to health and to economic impact! Please join CRHC’s Clint Cresawn on January 11 from 1-2pm for an informative webinar about new technical assistance packages designed to assist with community health needs assessments. Participants will learn about:
- Assessments as a way to mobilize and partner with community members around issues of health, healthcare, and healthy living
- Assessments as a way to make the economic case for supporting and expanding local funding of the local healthcare system
- Assessments as a Public Relations tool, garnering additional good will – and patients – for the facility
- Assessments as a way of educating community members and community leaders about local healthcare challenges and triumphs
By the end of this session, you will know how CRHC and Colorado STRIDES can assist you with all these items, as well as how we can help not-for-profit 501(c)3 hospitals conduct the new IRS required Community Health Needs Assessment. For more information and to register, click here.
- Assessments as a way to mobilize and partner with community members around issues of health, healthcare, and healthy living
- Assessments as a way to make the economic case for supporting and expanding local funding of the local healthcare system
- Assessments as a Public Relations tool, garnering additional good will – and patients – for the facility
- Assessments as a way of educating community members and community leaders about local healthcare challenges and triumphs
By the end of this session, you will know how CRHC and Colorado STRIDES can assist you with all these items, as well as how we can help not-for-profit 501(c)3 hospitals conduct the new IRS required Community Health Needs Assessment. For more information and to register, click here.
Wednesday, December 21, 2011
Colorado Cancer, Cardiovascular Disease and Pulmonary Disease (CCPD) Review Committee Survey
The Cancer, Cardiovascular Disease and Pulmonary Disease (CCPD) Review Committee is currently reviewing its funding priorities and strategic approach. As stakeholders of CCPD, the committee members value your input as they develop future strategic budgets for the CCPD grants program. Please provide your answers to the following questions by JANUARY 3rd, 2012 so that the Review Committee can make maximal use of your input in its decision-making process.
At its January 13th meeting, the CCPD Review Committee will invite further input from interested members of the community and respondents will have an opportunity at that time to elaborate on the responses they give here. Please provide answers on this survey, as the Review Committee will only accept public comment from those organizations that have provided responses on the survey. Additionally, feel free to forward the link to others who may be interested in providing their feedback.
If you consider you or your organization to be stakeholder of the CCPD, please click here to provide your feedback:
At its January 13th meeting, the CCPD Review Committee will invite further input from interested members of the community and respondents will have an opportunity at that time to elaborate on the responses they give here. Please provide answers on this survey, as the Review Committee will only accept public comment from those organizations that have provided responses on the survey. Additionally, feel free to forward the link to others who may be interested in providing their feedback.
If you consider you or your organization to be stakeholder of the CCPD, please click here to provide your feedback:
Top 10 CAH Deficiencies and What We Can Do About It…
Join CRHC for this webinar on January 27 with presenter Terry Mahar from Eide Bailly, where we will focus on the top 10 most common deficiencies cited related to the CAH Medicare Conditions of Participation both in Colorado, as well as nationally. For each deficiency, the CoP will be reviewed and defined, and process improvement methods (i.e. changes in policy or practice, etc.) on how to be in compliance with that CoP will be discussed. This webinar will also review and discuss the newest revisions/additions to the Medicare CAH CoP’s. This webinar is FREE for all CRHC-member Colorado CAHs, $79 for non-member Colorado CAHs and $99 for all others. For more information and to register, click here.
Don’t miss the opportunity to offer loan repayment to your healthcare providers!
Do you have a healthcare provider at your facility who is interested in loan repayment? Let them know that the 2012 National Health Service Corps (NHSC) Loan Repayment Program application cycle is open. The application cycle is open from December 13, 2012 to May 15, 2012.
Up to $60,000 for a 2-year commitment is available to your primary care healthcare providers (based on HPSA)!
NHSC provides loan repayment to fully trained primary care providers in exchange for a two-year full-time service obligation in an underserved community. After completing their initial years of service, loan repayors may apply for additional years of support! Eligible providers include primary care Family Physicians, Internists, OB/GYNs, Pediatricians, Dentists, Psychiatrists, Physician Assistants, Nurse Practitioners, Certified Nurse Midwives, Dental Hygienists and licensed mental health professionals.
Many types of health care facilities are NHSC eligible sites including Critical Access Hospitals, Rural Health Clinics, Community Health Centers, and safety-net clinics.
To find out more about the NHSC Loan Repayment Program, please visit http://nhsc.hrsa.gov/.
Would you like to speak with someone to find out if your facility is eligible for loan repayment? Contact Colorado Provider Recruitment (CPR) at cpr@coruralhealth.org or (303) 832-7493.
Up to $60,000 for a 2-year commitment is available to your primary care healthcare providers (based on HPSA)!
NHSC provides loan repayment to fully trained primary care providers in exchange for a two-year full-time service obligation in an underserved community. After completing their initial years of service, loan repayors may apply for additional years of support! Eligible providers include primary care Family Physicians, Internists, OB/GYNs, Pediatricians, Dentists, Psychiatrists, Physician Assistants, Nurse Practitioners, Certified Nurse Midwives, Dental Hygienists and licensed mental health professionals.
Many types of health care facilities are NHSC eligible sites including Critical Access Hospitals, Rural Health Clinics, Community Health Centers, and safety-net clinics.
To find out more about the NHSC Loan Repayment Program, please visit http://nhsc.hrsa.gov/.
Would you like to speak with someone to find out if your facility is eligible for loan repayment? Contact Colorado Provider Recruitment (CPR) at cpr@coruralhealth.org or (303) 832-7493.
Tuesday, December 20, 2011
2012 ICD-10-CM Code Updates Now Available from CMS
CMS has posted the 2012 ICD-10-CM code updates to the CMS website, including the 2012 ICD-10-CM index and tabular, code titles, addendum, General Equivalence Mappings (GEMs), and reimbursement mappings files. The 2012 ICD-10-CM files contain information on the new diagnosis coding system, ICD-10-CM, that is being developed as a replacement for ICD-9-CM, Volumes 1 and 2. These files are available on the 2012 ICD-10-CM and GEMs webpage at http://www.CMS.gov/ICD10/11b14_2012_ICD10CM_and_GEMs.asp. To access the files, scroll to the bottom of the page to the “Downloads” section.
The 2012 ICD-10-PCS (procedure) files were posted in June on the 2012 ICD-10-PCS and GEMs webpage at http://www.CMS.gov/ICD10/11b15_2012_ICD10PCS.asp.
The 2012 ICD-10-PCS (procedure) files were posted in June on the 2012 ICD-10-PCS and GEMs webpage at http://www.CMS.gov/ICD10/11b15_2012_ICD10PCS.asp.
Providers Not Required to Supply Advanced Diagnostic Imaging (ADI) Certification Information via Enrollment Process
In January 2012, all Part B suppliers including physicians, and non-physician practitioners performing the technical component of advanced diagnostic imaging services—also known as ADI—who are paid under the Medicare Physician Fee Schedule will need to be accredited by one of the CMS-approved accrediting organizations. The accreditation organization will transmit all necessary data to CMS on an ongoing basis. Your Medicare billing contractor will receive these data from CMS. Due to this file being received at CMS from the accrediting organizations, it is not necessary for the providers to supply the ADI information on their respective 855 form(s) or in the PECOS enrollment system.
Reminder: When submitting your information to the accrediting organization, make sure you provide the NPI that you used to register the legal business name of the facility in the National Plan and Provider Enumeration System (NPPES). If you provided the incorrect NPI, please notify your accrediting organization as soon as possible.
See the following MLN articles for more information on the ADI certification requirement :
Accreditation for Physicians and Non-Physician Practitioners Supplying the Technical Component (TC) of Advanced Diagnostic Imaging (ADI) Services
Advanced Diagnostic Imaging Accreditation Enrollment Procedures
Reminder: When submitting your information to the accrediting organization, make sure you provide the NPI that you used to register the legal business name of the facility in the National Plan and Provider Enumeration System (NPPES). If you provided the incorrect NPI, please notify your accrediting organization as soon as possible.
See the following MLN articles for more information on the ADI certification requirement :
Accreditation for Physicians and Non-Physician Practitioners Supplying the Technical Component (TC) of Advanced Diagnostic Imaging (ADI) Services
Advanced Diagnostic Imaging Accreditation Enrollment Procedures
Attention Health Professionals: Information Regarding the Holding of 2012 Date-of-Service Claims for Services Paid Under the 2012 Medicare Physician Fee Schedule
Attention Health Professionals: Information Regarding the Holding of 2012 Date-of-Service Claims for Services Paid Under the 2012 Medicare Physician Fee Schedule
The negative update under current law for the 2012 Medicare Physician Fee Schedule is scheduled to take effect on January 1, 2012, eight business days from today. Consequently, as on numerous occasions in the past, the Centers for Medicare & Medicaid Services (CMS) will instruct its Medicare claims administration contractors to hold claims containing 2012 services paid under the Medicare Physician Fee Schedule for the first 10 business days of January (i.e., January 1, 2012, through January 17, 2012). The hold should have minimal impact on provider cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.
Medicare Physician Fee Schedule claims for services rendered on or before December 31, 2011, are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.
The Administration is disappointed that Congress has failed to pass a solution to eliminate the sustainable growth rate (SGR) formula-driven cuts, and has put payments for health care for Medicare beneficiaries at risk. We continue to urge Congress to take action to ensure these cuts do not take effect.
CMS will notify you on or before January 11, 2012, with more information about the status of Congressional action to avert the negative update and next steps regarding the claims hold.
The negative update under current law for the 2012 Medicare Physician Fee Schedule is scheduled to take effect on January 1, 2012, eight business days from today. Consequently, as on numerous occasions in the past, the Centers for Medicare & Medicaid Services (CMS) will instruct its Medicare claims administration contractors to hold claims containing 2012 services paid under the Medicare Physician Fee Schedule for the first 10 business days of January (i.e., January 1, 2012, through January 17, 2012). The hold should have minimal impact on provider cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.
Medicare Physician Fee Schedule claims for services rendered on or before December 31, 2011, are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.
The Administration is disappointed that Congress has failed to pass a solution to eliminate the sustainable growth rate (SGR) formula-driven cuts, and has put payments for health care for Medicare beneficiaries at risk. We continue to urge Congress to take action to ensure these cuts do not take effect.
CMS will notify you on or before January 11, 2012, with more information about the status of Congressional action to avert the negative update and next steps regarding the claims hold.
Monday, December 19, 2011
Only 18 Days Until the HIPAA 5010 Compliance Date!
January 1, 2012 – PC-ACE Pro32 Version 2.32 File Automatically Effective With ASC X12 5010. 
ASC X12 835 5010 Move-to-Production Procedures.
5010 Address and Nine-Digit ZIP Code Requirement.
Reminders:
ASC X12 837 5010 Move-to-Production Procedures.
5010 Testing Procedures Manual – Updated.
New CMS ICD-10 Articles.
Visit TrailBlazer’s 5010 Information Web page to ensure you receive the latest information and important updates throughout the ANSI Version 5010 implementation. If you have any questions, please contact the EDI Helpline at (866) 749-4302.
ASC X12 835 5010 Move-to-Production Procedures.
5010 Address and Nine-Digit ZIP Code Requirement.
Reminders:
ASC X12 837 5010 Move-to-Production Procedures.
5010 Testing Procedures Manual – Updated.
New CMS ICD-10 Articles.
Visit TrailBlazer’s 5010 Information Web page to ensure you receive the latest information and important updates throughout the ANSI Version 5010 implementation. If you have any questions, please contact the EDI Helpline at (866) 749-4302.
Requests For Supervision Level Changes For Hospital Outpatient Therapeutic Services
On Friday, December 16th, CMS published notice CMS-1586-N announcing the first semi-annual meeting of the Advisory Panel on Hospital Outpatient Payment. This panel advises CMS on the clinical integrity of the APC groups and their associated weights and will now also review hospital outpatient supervision issues. The first meeting is scheduled for February 27, 28, and 29 and the agenda will include supervision of hospital outpatient therapeutic services. Presentations and written requests are due December 30, 2011 by 5 p.m. EST. Stakeholders interested in submitting requests for the February 2012 meeting for a change in the required supervision level for a given service should follow the presentation submission instructions in the notice and consider the following information from the 2012 OPPS/ASC final rule (76 Fed. Reg. 74370): The Panel will be charged with recommending to CMS a supervision level (general, direct, or personal) that will ensure an appropriate level of quality and safety for delivery of a given service, as defined by a HCPCS or CPT code. In recommending a supervision level to CMS, the Panel will assess whether there is a significant likelihood that the supervisory practitioner would need to reassess the patient and modify treatment during or immediately following the therapeutic intervention, or provide guidance or advice to the individual who provides the service. In answering that question, the Panel will consider the following factors but may also consider others as appropriate: Complexity of the service; Acuity of the patients receiving the service; Probability of unexpected or adverse patient event; Expectation of rapid clinical changes during the therapeutic service or procedure; Recent changes in technology or practice patterns that affect a procedure's safety; The clinical context in which the service is delivered. All requests for a change in the required supervision level must include justification for the change in supervision level that is sought per HCPCS code, supported to the extent possible with clinical evidence. Please refer to the 2012 OPPS/ASC final rule for further information.
Final Board of Health Rule Draft: HCW Influenza Vaccination
The Department has posted the final draft of the HCW Influenza Vaccination proposed rule. A summary of the highlights of the proposed rule are below:
Any licensed healthcare entity that, using its own methodology, can guarantee at least 90% of its healthcare workers received the influenza vaccine during the prior year shall be exempt from the more specific requirements of the rule as long as the licensee uses the same or a more stringent methodology for the current influenza season. [See §10.5]
All licensed facilities that provide acute care or long term nursing care must have a policy regarding the vaccination or masking of its healthcare workers during influenza season. [See §10.8(A) & (B)]
Acute care facilities must have a procedure to maintain documentation and submit yearly reports regarding the vaccination or medical exemption of its employees and volunteers. Long term nursing care facilities must maintain documentation and submit annual reports regarding the vaccination or medical exemption of all its employees and all its volunteers with direct patient care. [See §§10.8(C) & 10.9]
All other licensed healthcare entities not mentioned above must perform an assessment of its healthcare workers and patient clientele, adopt a policy regarding the vaccination or masking of its employees, and report its employee vaccination rate to the Department on an annual basis. [See §§10.10 through 10.12]
Please read the Statement of Purpose to gain a better understanding of the rationale for the proposed rule. The public hearing on this rule has been rescheduled for February 15, 2012. The exact time of the hearing has not yet been determined, and the agenda for the meeting will be available approximately 10 days before the hearing. All Board of Health hearings are open to the public and individuals may participate in the rule-making process by providing written comments to the Board ten days before the hearing or by making oral comments during the hearing.
Any licensed healthcare entity that, using its own methodology, can guarantee at least 90% of its healthcare workers received the influenza vaccine during the prior year shall be exempt from the more specific requirements of the rule as long as the licensee uses the same or a more stringent methodology for the current influenza season. [See §10.5]
All licensed facilities that provide acute care or long term nursing care must have a policy regarding the vaccination or masking of its healthcare workers during influenza season. [See §10.8(A) & (B)]
Acute care facilities must have a procedure to maintain documentation and submit yearly reports regarding the vaccination or medical exemption of its employees and volunteers. Long term nursing care facilities must maintain documentation and submit annual reports regarding the vaccination or medical exemption of all its employees and all its volunteers with direct patient care. [See §§10.8(C) & 10.9]
All other licensed healthcare entities not mentioned above must perform an assessment of its healthcare workers and patient clientele, adopt a policy regarding the vaccination or masking of its employees, and report its employee vaccination rate to the Department on an annual basis. [See §§10.10 through 10.12]
Please read the Statement of Purpose to gain a better understanding of the rationale for the proposed rule. The public hearing on this rule has been rescheduled for February 15, 2012. The exact time of the hearing has not yet been determined, and the agenda for the meeting will be available approximately 10 days before the hearing. All Board of Health hearings are open to the public and individuals may participate in the rule-making process by providing written comments to the Board ten days before the hearing or by making oral comments during the hearing.
Friday, December 16, 2011
Medicare FFS Revised ABN
The latest version of the ABN (with the release date of 3/2011 printed in the lower left hand corner) is now available for immediate use and can be accessed via the link below. Mandatory use of this version begins on January, 1 2012. All ABNs with the release date of 3/2008 that are issued on or after January 1, 2012 will be considered invalid. More information is available on the CMS website here.
Thursday, December 15, 2011
CONGRATULATIONS St. Thomas More Physician Group and Spanish Peaks Family Clinic !!
The Colorado Rural Health Center is proud to acknowledge two clinics in the Southeast region of the state for achieving Level III Patient Centered Medical Home ( PCMH) recognition. Way to go!!! Both St. Thomas More Physician Group of Canon City, CO and Spanish Peak Family Clinic in Walsenburg, CO have been working hard to reach this goal since 2009. These two clinics have successfully traveled the difficult journey toward this achievement and are leading the way in transforming patient care and healthcare services in Colorado! Thank you for your dedication to the patients you serve in your rural communities and keep up the good work!
Wednesday, December 14, 2011
2012 CMS OPPS Final Rule with Comment Period
CMS is accepting comments on the 2012 OPPS Final Rule until Jan 3, 2012. The final rule includes sections addressing physician supervision in hospitals and CAHs. To access the rule and comment page, click here. For a summary of the rule, click here.
2012 Colorado Rural Credentialing Network – Register Now!
Register now for CRHC’s 2012 Colorado Rural Credentialing Network. This peer learning network provides rural hospitals and clinics:
- Access to participate in quarterly interactive Educational Credentialing Webinars facilitated by an expert credentialing specialist
- Up-to-Date Tools, Resources, Templates, and Materials, Archived Network Webinars and Information (through a member-only website)
- Peer Networking opportunities
- No-Cost Access to a certified credentialing specialist for general credentialing questions
- Access to personalized credentialing consultations at a group discount rate
Participation in the Credentialing Network is just $250/year for CRHC members or $375/year for non-members. The first quarterly webinar will be held on February 15. For more information and to register, click here.
Upcoming CRHC Webinars
CRHC is pleased to offer the following upcoming webinars. For more information and to register, click on each title.
Community Health Needs Assessments
January 11, 2012, 1:00-2:00
Top 10 CAH Deficiencies and What We Can Do About It…-
January 27, 2012 11:00-12:00
Utilization Management for Critical Access Hospitals
February 28, 2012, 11:00-12:30
Community Health Needs Assessments
January 11, 2012, 1:00-2:00
Top 10 CAH Deficiencies and What We Can Do About It…-
January 27, 2012 11:00-12:00
Utilization Management for Critical Access Hospitals
February 28, 2012, 11:00-12:30
National Health Service Corps CAH Announcement
The Health Resources and Services Administration has released its 2012 guidance for the National Health Service Corps (NHSC) Loan Repayment Program (LRP), which includes a pilot program that expands eligibility to CAHs and eligible clinicians working in CAHs: primary care physicians; psychiatrists; nurse practitioners; certified nurse midwives; and physician assistants. CAHs and interested clinicians should review the 2012 guidance. CAHs that want to become service sites have to be in a Health Professional Shortage Area (HPSA) and meet other basic program requirements). Once they are approved as service sites, their clinicians can apply for loan repayment. The NHSC will pay up to $60,000 for an initial 2 years of full‐time clinical practice to clinicians serving at an NHSC‐approved service site with a HPSA score of 14 or higher. Applicants working at NHSC‐approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 2 years of full‐time clinical service. The NHSC will pay up to $60,000 for an initial 4 years of half‐time clinical practice to clinicians serving at an NHSC‐approved service site with a HPSA score of 14 or higher. Applicants working at NHSC‐approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 4 years of half‐time clinical service. The Office of Rural Health Policy (ORHP) and the NHSC have conducted Webinars related to this change (http://nhsc.hrsa.gov/downloads/criticalaccesspresentation.pdf). The NHSC has a contact available to answer questions: Lindsey Toohey (ltoohey@hrsa.gov). For additional program details, please see the 2012 NHSC Loan Repayment Program At-A-Glance Fact Sheet , the NHSC Loan Repayment Program Announcement Flyer and the complete Application and Program Guidance. Click here to read the full announcement.
Tuesday, December 13, 2011
TrailBlazer Medicare Education Listserv
TrailBlazer Provider Outreach and Education develops and promotes educational opportunities that enhance the Medicare knowledge of our providers and their staffs. All upcoming educational opportunities are posted on the Calendar of Events Web page. For a full list of recent resource links and articles please click here
Join CAH MBQIP – Tell Your Story
The Federal Health Resources and Services Administration’s Office of Rural Health Policy (ORHP) recently kicked off a new Critical Access Hospital initiative, MBQIP, the Medicare Beneficiary Quality Improvement Project. With more national attention on quality and reporting, this initiative takes a proactive and visionary approach to ensure CAHs are well-equipped and prepared to measure and demonstrate quality. Through this voluntary program, CAHs agree to give ORHP access to the data their hospital is submitting to CMS. This data will be aggregated to benchmark, demonstrate improvements, share best practices, and to generate reports to aid CAHs and states in their quality improvement activities. There is additional information about MBQIP in this YouTube video from HRSA’s Senior Health Policy Advisor, Paul Moore. To join MBQIP, contact Jen Dunn at jd@coruralhealth.org. Additionally, through CRHC’s iCARE Program (Improving Communication and Readmission) your facility has access to free technical assistance to help your hospital make improvements in many of the same areas ORHP’s MBQIP is focusing on. For more information and to join iCARE, click here. If you have any questions, please feel free to contact mm@coruralhealth.org or jd@coruralhealth.org.
Monday, December 12, 2011
Free Benchmarking Resource for CAHs
The Quality Health Indicators (QHi) benchmarking tool is an online system geared towards CAHs and small rural hospitals under 50 beds. The majority of Colorado’s CAHs are QHi users, which enables participating hospitals to benchmark various clinical quality, financial, patient satisfaction, and operational measures against other CAHs in the state and around the nation. For more information about signing up for QHi, contact jd@coruralhealth.org.
Revised CMS Interpretive Guidelines for Hospitals and CAHs
Clarification is provided for existing hospital regulations 42 CFR 482.13(a) and (b), and new 42 CFR 482.13(h), concerning hospital patients’ rights, including advance directives and visitation rights. Clarification is provided for existing CAH regulations at 42 CFR 485.608(a), concerning compliance with Federal laws and regulations, including regulations governing advance directives and required patient disclosures. Guidance is provided for new 42 CFR 485.635(f), concerning CAH patients’ visitations rights. To access the CMS transmittal explaining the updates, click here. Click on the links below to access the revised documents. Please let CRHC know if you have any questions or concerns about the updates at jd@coruralhealth.org.
Appendix A - Hospitals: http://cms.gov/manuals/Downloads/som107ap_a_hospitals.pdf
Appendix W - CAHs: http://cms.gov/manuals/Downloads/som107ap_w_cah.pdf
Appendix A - Hospitals: http://cms.gov/manuals/Downloads/som107ap_a_hospitals.pdf
Appendix W - CAHs: http://cms.gov/manuals/Downloads/som107ap_w_cah.pdf
NPR on CAHs: an overlooked perspective
The Dec. 8 NPR piece produced by Kaiser Health News (KHN) didn’t report that Medicare costs are lower for rural patients than their urban counterparts. Medicare spends 4.5% less per beneficiary for rural residents compared to those living in urban areas, according to a recentStroudwater report which used 2008 Dartmouth Atlas data. The value that rural providers (including Hood Memorial Hospital in Amite, La.) bring to the Medicare program is evident, even including alternative payment methodologies applied to small, rural facilities. Closing Critical Access Hospitals (CAHs) and sending their patients to large, urban hospitals will in fact not save money, but cost more.
Rural communities struggle with disproportionate share of poverty, obesity and chronic conditions when compared to an urban environment. Independent studies have affirmed the quality of rural health care providers. For example, rural hospitals have lower risk-adjusted rates of potential safety-related events (Jollife, 2003), rural hospitals have significantly lower adverse event rates than urban counterparts (Whitener and McGranahan, 2003) and rural hospitals have significantly lower rates of post-operative hip fracture, hemorrhage and hematoma (Cromartie, 2002).
The article accurately portrays the difficulty that small, rural hospital administrators have in running a hospital located in a rural environment. NRHA congratulates
Rural communities struggle with disproportionate share of poverty, obesity and chronic conditions when compared to an urban environment. Independent studies have affirmed the quality of rural health care providers. For example, rural hospitals have lower risk-adjusted rates of potential safety-related events (Jollife, 2003), rural hospitals have significantly lower adverse event rates than urban counterparts (Whitener and McGranahan, 2003) and rural hospitals have significantly lower rates of post-operative hip fracture, hemorrhage and hematoma (Cromartie, 2002).
The article accurately portrays the difficulty that small, rural hospital administrators have in running a hospital located in a rural environment. NRHA congratulates
Friday, December 9, 2011
CMS Launches Medicaid.gov Website
The Center for Medicaid and CHIP Services (CMCS) is pleased to announce the initial launch of http://medicaid.gov/, the first Federal government website devoted to the policies -- and the people -- of Medicaid and the Children’s Health Insurance Program (CHIP). This website is the culmination of efforts at the Center for Medicaid and CHIP Services to revitalize and reorient the information the Federal government makes available about these programs. As part of its commitment to transparency and information sharing, Medicaid.gov brings to the forefront the items that States, the health policy community and other stakeholders have said they care about most, including: our Federal policy guidance; lists of pending and approved waivers; highlights of Affordable Care Act implementation efforts; State-specific program information and data; and improved search capabilities.
Wednesday, December 7, 2011
Join us! : 2012 North Carolina Agricultural Medicine: Occupational and Environmental Health for Rural Health Professionals Course
This course will provide basic information and skills to enable rural health care professionals and health and safety educators to learn the fundamentals and practical aspects of diagnosis, treatment, and prevention of occupational illnesses and injuries in the farm community.
Successful completion of this course allows health care participants to join AgriSafe® as a Provider Member. AgriSafe® Provider benefits include clinical resources, technical assistance, continuing education, and use of the trademarked name AgriSafe® in promoting agricultural health services. AgriSafe membership is also available to individuals and organizations.
is appropriate for nurses, nurse practitioners, farm worker health outreach staff, physicians, physician assistants, allied health professionals, veterinarians, emergency medical technicians, health educators, Cooperative Extension agents, occupational safety professionals and others interested in agricultural safety and health.
Training is provided jointly by faculty of Iowa's Center for Agricultural Safety and Health (I-CASH), the North Carolina Agromedicine Institute, and other skilled agricultural health and safety professionals from across NC and beyond.
For more information and/or to register, please click here
Successful completion of this course allows health care participants to join AgriSafe® as a Provider Member. AgriSafe® Provider benefits include clinical resources, technical assistance, continuing education, and use of the trademarked name AgriSafe® in promoting agricultural health services. AgriSafe membership is also available to individuals and organizations.
is appropriate for nurses, nurse practitioners, farm worker health outreach staff, physicians, physician assistants, allied health professionals, veterinarians, emergency medical technicians, health educators, Cooperative Extension agents, occupational safety professionals and others interested in agricultural safety and health.
Training is provided jointly by faculty of Iowa's Center for Agricultural Safety and Health (I-CASH), the North Carolina Agromedicine Institute, and other skilled agricultural health and safety professionals from across NC and beyond.
For more information and/or to register, please click here
Webinar: Top 10 CAH Deficiencies and What We Can Do About It
January 27, 2012, 11:00-12:00 MST
Please join CRHC for this webinar with presenter Terry Mahar from Eide Bailly where we will focus on the top 10 most common deficiencies cited related to the CAH Medicare Conditions of Participation both in Colorado, as well as nationally. For each deficiency, the CoP will be reviewed and defined, and process improvement methods (i.e. changes in policy or practice, etc.) on how to be in compliance with that CoP will be discussed. This webinar will also review and discuss the newest revisions/additions to the Medicare CAH CoP’s. This webinar is FREE for all Colorado CAHs that are CRHC Members; $79 for non-member Colorado CAHs, and $99 for all others. For more information and to register, click here.
Please join CRHC for this webinar with presenter Terry Mahar from Eide Bailly where we will focus on the top 10 most common deficiencies cited related to the CAH Medicare Conditions of Participation both in Colorado, as well as nationally. For each deficiency, the CoP will be reviewed and defined, and process improvement methods (i.e. changes in policy or practice, etc.) on how to be in compliance with that CoP will be discussed. This webinar will also review and discuss the newest revisions/additions to the Medicare CAH CoP’s. This webinar is FREE for all Colorado CAHs that are CRHC Members; $79 for non-member Colorado CAHs, and $99 for all others. For more information and to register, click here.
Tuesday, December 6, 2011
Only 30 Days Until the HIPAA 5010 Compliance Date!
90-Day Period of Enforcement Discretion for Compliance With Version 5010 Deadline – CMS recently announced a 90-day enforcement discretion period for all HIPAA-covered entities regarding the Version 5010 (ASC X12 Version 5010) transition.
The compliance deadline for the implementation of Version 5010 is still January 1, 2012; however, CMS will not initiate enforcement action until March 31, 2012. CMS made this decision based on industry feedback that many organizations and their trading partners were not ready to finalize system upgrades for this transition.
· New CMS ICD-10 Articles.
Reminder:
· National Provider Call: Medicare FFS Implementation of HIPAA Version 5010 and D.0 Transaction Standards – Wednesday, December 7, 2011, 1:30–3 p.m. ET.
Visit TrailBlazer’s 5010 Information Web page to ensure you receive the latest information and important updates throughout the ANSI Version 5010 implementation. If you have any questions, please contact the EDI Helpline at (866) 749-4302.
The compliance deadline for the implementation of Version 5010 is still January 1, 2012; however, CMS will not initiate enforcement action until March 31, 2012. CMS made this decision based on industry feedback that many organizations and their trading partners were not ready to finalize system upgrades for this transition.
· New CMS ICD-10 Articles.
Reminder:
· National Provider Call: Medicare FFS Implementation of HIPAA Version 5010 and D.0 Transaction Standards – Wednesday, December 7, 2011, 1:30–3 p.m. ET.
Visit TrailBlazer’s 5010 Information Web page to ensure you receive the latest information and important updates throughout the ANSI Version 5010 implementation. If you have any questions, please contact the EDI Helpline at (866) 749-4302.
Free Quality Improvement and Lean Six Sigma Training
CRHC’s iCARE (Improving Communication and Readmission) offers Colorado CAHs the opportunity to receive free Quality Improvement training. Participating hospitals select a project focus and then can choose to take advantage of free Quality Improvement Practices Education and/or Lean Sigma Healthcare Yellow Belt or Green Belt training. The concepts hospitals learn through these trainings will help teams make improvements related to iCARE and can be applied to other areas throughout the hospital. All trainings are conducted remotely through webinars and conference calls to reduce away-time for staff and travel expenses. For more information about iCARE, click here
Looking for a cost effective non-biased peer review service?
Our program offers specialty - matched, confidential, medical opinions from a rural provider, for a rural provider, based on objective review of medical records. The program is a collaborative effort among Colorado's rural providers, and not only provides a cost effective way to manage peer review requirements, but also provides an effective means to improve patient care through identifying opportunities for a process improvement.
For more information on our Peer Review Network, please contact Jennifer Dunn at jd@coruralhealth.org
For more information on our Peer Review Network, please contact Jennifer Dunn at jd@coruralhealth.org
Monday, December 5, 2011
Patient Safety Webinar – Getting Your Board on Board
Friday, December 9, 2011, 2:45pm-4:00pm (EST)
Interested in learning more about how to effectively engage executive leadership and board members in participating in patient safety initiatives? Sign up today for this free patient safety webinar hosted by the Partnership for Patients and the National Quality Forum. More details on the webinar are below:
WEBINAR TITLE: Getting Your Board on Board
SPEAKERS: Bernie Rosof, MD, Chairman, Board of Directors, Huntington Hospital, North Shore-Long Island Jewish Health System, National Priorities Partnership Co-Chair Carol Wagner, RN, MBA, Senior Vice President Patient Safety, Washington State Hospital Association Rosemary Gibson, MSc, Patient Advocate and Author of the Treatment Trap and Wall of Silence and Section Editor, Archives of Internal Medicine Series, “Less is More”
Register today by clicking here.
Interested in learning more about how to effectively engage executive leadership and board members in participating in patient safety initiatives? Sign up today for this free patient safety webinar hosted by the Partnership for Patients and the National Quality Forum. More details on the webinar are below:
WEBINAR TITLE: Getting Your Board on Board
SPEAKERS: Bernie Rosof, MD, Chairman, Board of Directors, Huntington Hospital, North Shore-Long Island Jewish Health System, National Priorities Partnership Co-Chair Carol Wagner, RN, MBA, Senior Vice President Patient Safety, Washington State Hospital Association Rosemary Gibson, MSc, Patient Advocate and Author of the Treatment Trap and Wall of Silence and Section Editor, Archives of Internal Medicine Series, “Less is More”
Register today by clicking here.
CMS/TrailBlazer CAH Notices
CMS and TrailBlazer have recently issues notices applicable to Critical Access Hospitals: Notification of Final Primary Care Incentive Payment Files for Payment Year 2012; MM7504 – Expansion of Medicare Telehealth Services for CY 2012. ; CMS-855A Application Guidance. For more information, click here.
Save the Date! CRHC’s Annual Regional CAH Quality Improvement Workshops and CAH Board Workshops
May 1, 2012 –Location: Eastern Plains, TBD
CAH Quality Improvement Workshop, 9:00am -3:00pm
CAH Board Workshop, 4:00pm-7:30pm
May 3, 2012 – Location: Southern Colorado, TBD
CAH Quality Improvement Workshop, 9:00am-3:00pm
CAH Board Workshop, 4:00pm-7:30pm
May 10, 2012 – Location: Western Slope, TBD
CAH Quality Improvement Workshop, 9:00am-3:00pm
CAH Board Workshop, 4:00pm-7:30pm
The Quality Improvement Workshops are geared towards all CAH Quality Directors and staff. The CAH Board Workshops are geared towards all CAH Boards and CAH staff. There is no charge for Colorado CAH Boards and staff to attend. Details, locations, and registration information will be available soon.
CAH Quality Improvement Workshop, 9:00am -3:00pm
CAH Board Workshop, 4:00pm-7:30pm
May 3, 2012 – Location: Southern Colorado, TBD
CAH Quality Improvement Workshop, 9:00am-3:00pm
CAH Board Workshop, 4:00pm-7:30pm
May 10, 2012 – Location: Western Slope, TBD
CAH Quality Improvement Workshop, 9:00am-3:00pm
CAH Board Workshop, 4:00pm-7:30pm
The Quality Improvement Workshops are geared towards all CAH Quality Directors and staff. The CAH Board Workshops are geared towards all CAH Boards and CAH staff. There is no charge for Colorado CAH Boards and staff to attend. Details, locations, and registration information will be available soon.
Friday, December 2, 2011
Webinar: Business of Telemedicine and Sustainability
Wednesday, December 14, 2011 12:00pm MST
The University of Arizona Rural Health Office and the Southwest Telehealth Resource Center invite you to a free webinar on the implementation and practice of telemedicine. This is an opportunity to learn:
Revenue and Expense considerations when developing a telemedicine program
Basic business principles as they relate to telemedicine sustainability
The Arizona Telemedicine Program's business Model
To register for this free webinar, go to: http://www.telemedicine.arizona.edu/upcomingworkshops.cfm
The University of Arizona Rural Health Office and the Southwest Telehealth Resource Center invite you to a free webinar on the implementation and practice of telemedicine. This is an opportunity to learn:
Revenue and Expense considerations when developing a telemedicine program
Basic business principles as they relate to telemedicine sustainability
The Arizona Telemedicine Program's business Model
To register for this free webinar, go to: http://www.telemedicine.arizona.edu/upcomingworkshops.cfm
Thursday, December 1, 2011
CAH Capacity Building Award – Application Deadline Dec 2!
The guidance and online application for the CRHC 2011/2012 CAH Capacity Building Awards is now available. Through these awards, Colorado CAHs are eligible for up to $5,000 in funding. Click here to access the guidance. Click here to apply online. Applications are due by December 2, 2011. If you have any questions, please contact Jen Dunn at jd@coruralhealth.org.
Revisions to Medicare Conditions of Participation
The Centers for Medicare and Medicaid Services released proposed revisions to the Medicare Conditions of Participation for hospitals including Critical Access Hospitals (CAH). Some of the proposed revisions include privileging for non-physician staff, incorporating a nursing care plan into an interdisciplinary care plan, and changes to nursing services to allow for the preparation and administration of drugs. Under these revisions, the “direct services” requirement for CAHs would be removed and gives CAHs flexibility in determining whether to provide these services directly, under contract, or through another arrangement. Access the proposed rules here. Please send any comments or questions to Jen Dunn at jd@coruralhealth.org.
Wednesday, November 30, 2011
Colorado Rural Health Care Grant Program Application Available!
The application and materials for the fifth cycle of the Colorado Rural Health Care Grant Program, administrated by the Colorado Rural Health Center, are now available.
Questions? Contact Shelly Collings at 720.248.2742 or sc@coruralhealth.org.
- DEADLINE: Online Intent to Apply Forms — January 13, 2012 ; Applications — Noon (12:00 pm) February 15, 2012
- ELIGIBILITY: Organizations that are located outside of Colorado's urbanized areas that provide outpatient primary care services—including medical, oral, and mental health
- FUNDING PRIORITIES: Projects that support rural health infrastructure and strengthen the capacity of rural entities to provide outpatient primary care services
- AWARD AMOUNT: Maximum award is $50,000 per applicant
Questions? Contact Shelly Collings at 720.248.2742 or sc@coruralhealth.org.
Want to Learn More About Credentialing – Register Now for the 2012 Colorado Rural Credentialing Network!
Credentialing of physicians and other healthcare practitioners has become a key risk management function for facilities, both large and small. Further, it has become a complex and seldom understood process. The CRHC Colorado Rural Credentialing Network assists hospitals and clinics with credentialing issues specific to accreditation requirements, significant legislation, and civil litigation. For more information and to register, click here.
National Influenza Vaccination Week is December 4-10 – Get the flu vaccine, not the flu
National Influenza Vaccination Week (NIVW) is a national observance that was established by the Centers for Disease Control and Prevention (CDC) in 2005 to highlight the importance of continuing influenza vaccination—as well as fostering greater use of flu vaccine—after the holiday season into January and beyond. For the 2011-2012 season, NIVW is scheduled for December 4-10 and this year’s events will encourage everyone 6 months and older to “Get the flu vaccine, not the flu.”
Influenza is among the most common respiratory illnesses in the United States, infecting millions of people every flu season. An annual flu vaccination is the best way to prevent the flu and the flu-related complications that could lead to hospitalization and even death. Also, since flu viruses are constantly changing and immunity can decline over time, annual vaccination is needed for optimal protection.
Influenza can cause severe illness and even death for anyone, regardless whether or not they have high risk conditions. However, people with certain long-term health conditions are at much greater risk of suffering from serious flu complications, as demonstrated last season when 80 percent of adults hospitalized from flu complications had a long-term health condition (asthma, diabetes, and chronic heart disease were the most common).
What Can You Do? National Influenza Vaccination Week presents a great opportunity for healthcare providers to educate seniors and others with Medicare that a flu vaccine is the first and best way to prevent influenza, and that it’s particularly important in people who are at higher risk of serious flu complications. It is also a great time to inform those with Medicare about other preventive services covered by Medicare that may be appropriate for them.
For More Information:
The CMS Guide to Medicare Preventive Services
Medicare Immunizations Billing Quick Reference Chart
CMS Adult Immunizations Brochure
Medicare Preventive Services Quick Reference Information Chart
The CDC Vaccines and Immunizations Web Page
Remember: The flu vaccine plus its administration are covered Part B benefits. The flu vaccine is NOT a Part D-covered drug.
For more information on coverage and billing of the flu vaccine and its administration, and related provider resources, visit 2011-2012 Provider Seasonal Flu Resources and Immunizations. For the 2011-2012 seasonal flu vaccine payment limits, visit http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp.
Influenza is among the most common respiratory illnesses in the United States, infecting millions of people every flu season. An annual flu vaccination is the best way to prevent the flu and the flu-related complications that could lead to hospitalization and even death. Also, since flu viruses are constantly changing and immunity can decline over time, annual vaccination is needed for optimal protection.
Influenza can cause severe illness and even death for anyone, regardless whether or not they have high risk conditions. However, people with certain long-term health conditions are at much greater risk of suffering from serious flu complications, as demonstrated last season when 80 percent of adults hospitalized from flu complications had a long-term health condition (asthma, diabetes, and chronic heart disease were the most common).
What Can You Do? National Influenza Vaccination Week presents a great opportunity for healthcare providers to educate seniors and others with Medicare that a flu vaccine is the first and best way to prevent influenza, and that it’s particularly important in people who are at higher risk of serious flu complications. It is also a great time to inform those with Medicare about other preventive services covered by Medicare that may be appropriate for them.
For More Information:
The CMS Guide to Medicare Preventive Services
Medicare Immunizations Billing Quick Reference Chart
CMS Adult Immunizations Brochure
Medicare Preventive Services Quick Reference Information Chart
The CDC Vaccines and Immunizations Web Page
Remember: The flu vaccine plus its administration are covered Part B benefits. The flu vaccine is NOT a Part D-covered drug.
For more information on coverage and billing of the flu vaccine and its administration, and related provider resources, visit 2011-2012 Provider Seasonal Flu Resources and Immunizations. For the 2011-2012 seasonal flu vaccine payment limits, visit http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp.
Advisory Panel on Ambulatory Payment Groups Changes Name; Seeks New Members
The Advisory Panel on Ambulatory Payment Groups will now be known as the Hospital Outpatient Panel and the work of the panel is changing, too. The scope of work will now include supervision of outpatient hospital services. We have expanded the membership to 19, and we are currently soliciting 6 new members. We need volunteers from the rural and critical access hospital (CAH) communities. Nominations for the Panel are due by Tue Dec 27. If you would like to nominate someone, please send a complete application to Paula.Smith@cms.hhs.gov. Federal Register Notice “CMS-1593” includes details on what to include in the application.
Tuesday, November 29, 2011
Important Billing information for CAHs Paid Under Optional Method Regarding PCIP - TrailBlazer
Critical Access Hospital (CAH) providers were instructed to submit their National Provider Identifiers (NPIs) using the “other provider” field located in loop 2310C on the 4010A1 electronic claim format effective April 1, 2012. With the implementation activities to convert from the Accredited Standards Committee (ASC X12) Version 4010A1 to the Version 5010A2 format, loop 2310C was redefined to mean “other operating physician.” For providers using the 837I 5010A2 format, the correct loop is 2310D, “rendering physician”; however, Medicare systems are not updated to assign Primary Care Incentive Payment Program (PCIP) bonus payments to the NPI reported in this field. As a result, CMS plans to update system and billing instructions to address this change. In the meantime, to ensure there is not a delay in the PCIP bonus payments, CAH providers shall continue to submit claims using the “other provider” field, loop 2310C rather than in loop 2310D until further notice from CMS. For more information, click here.
Did You Know?
2012 Annual Participation Open Enrollment Period – Every year, Medicare contractors conduct an open participation enrollment period to provide eligible physicians, practitioners and suppliers with an opportunity to make their calendar year Medicare participation decision. Providers who want to maintain their current participation status do not need to take any action during the upcoming annual participation enrollment program. Providers will not be receiving the usual Compact Disk (CD) from TrailBlazer announcing the annual open participation enrollment period. CMS has directed Medicare contactors to produce a postcard mailing, instead of a CD, for eligible physicians, practitioners and suppliers. In early November the postcard announcing the open enrollment period was mailed to eligible physicians, practitioners and suppliers. Specific information about the annual open enrollment period, including the Form CMS-460, is available on TrailBlazer’s PAR Enrollment Web page.
Version 5010
Only 34 Days Until the HIPAA 5010 Compliance Date!
December 7, 2011, National Provider Call: Medicare FFS Implementation of HIPAA Version 5010 and D.0 Transaction Standards – Register Now!
· CMS Office of E-Health Standards and Services Announces 90-Day Period of Enforcement Discretion for Compliance With New HIPAA Transaction Standards. (Compliance is still required by January 1, 2012!)
View the new Part A Version 5010 Claim Issue for information and adjustment instructions.
Visit TrailBlazer’s 5010 Information Web page to ensure you receive the latest information and important updates throughout the ANSI Version 5010 implementation. If you have any questions, please contact the EDI Helpline at (866) 749-4302.
Part A & B
MM7648 – 2012 Annual Update to the Therapy Code List.
Part A
New Short-Term PEPPER Now Available.
MM7617 – CY 2012 End Stage Renal Disease Payment Changes.
Version 5010
Only 34 Days Until the HIPAA 5010 Compliance Date!
December 7, 2011, National Provider Call: Medicare FFS Implementation of HIPAA Version 5010 and D.0 Transaction Standards – Register Now!
· CMS Office of E-Health Standards and Services Announces 90-Day Period of Enforcement Discretion for Compliance With New HIPAA Transaction Standards. (Compliance is still required by January 1, 2012!)
View the new Part A Version 5010 Claim Issue for information and adjustment instructions.
Visit TrailBlazer’s 5010 Information Web page to ensure you receive the latest information and important updates throughout the ANSI Version 5010 implementation. If you have any questions, please contact the EDI Helpline at (866) 749-4302.
Part A & B
MM7648 – 2012 Annual Update to the Therapy Code List.
Part A
New Short-Term PEPPER Now Available.
MM7617 – CY 2012 End Stage Renal Disease Payment Changes.
Monday, November 28, 2011
Top 10 CAH Deficiencies and What We Can Do About It…
January 27, 2012; 11:00-12:00
Please join the Colorado Rural Health Center (CRHC) for this webinar with presenter Terry Mahar from Eide Bailly where we will focus on the top 10 most common deficiencies cited related to the CAH Medicare Conditions of Participation (CoP) both in Colorado, as well as nationally. For each deficiency, the CoP will be reviewed and defined, and process improvement methods (i.e. changes in policy or practice, etc.) on how to be in compliance with that CoP will be discussed. This webinar will also review and discuss the newest revisions/additions to the Medicare CAH CoP’s. This webinar is FREE for all CRHC Member Colorado CAHs; $79 for all non-member Colorado CAHs, and $99 for all others. For more information and to register, click here.
Please join the Colorado Rural Health Center (CRHC) for this webinar with presenter Terry Mahar from Eide Bailly where we will focus on the top 10 most common deficiencies cited related to the CAH Medicare Conditions of Participation (CoP) both in Colorado, as well as nationally. For each deficiency, the CoP will be reviewed and defined, and process improvement methods (i.e. changes in policy or practice, etc.) on how to be in compliance with that CoP will be discussed. This webinar will also review and discuss the newest revisions/additions to the Medicare CAH CoP’s. This webinar is FREE for all CRHC Member Colorado CAHs; $79 for all non-member Colorado CAHs, and $99 for all others. For more information and to register, click here.
, CMS announced a “90 day Enforcement Discretion Period” related to the 5010 HIPAA standard transactions
It is important to note that this is not delaying the federally mandated start date of January 1, 2011! However, it does give CMS the ability to enforce compliance in the first 90 days of 2011. You are required to continue “working …to become compliant with the new HIPAA standards..”
With this announcement we also strongly encourage all covered entities to determine how they must set up their software to allow generation of 5010 transactions for those payers who are ready on January 1st, and still allow 4010a transactions for non ready payers.
Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services Announces 90-Day Period of Enforcement Discretion for Compliance with New HIPAA Transaction Standards
Today the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS)announced that it would not initiate enforcement action until March 31, 2012, with respect to any HIPAA covered entity that is not in compliance with the ASC X12 Version 5010 (Version 5010), NCPDP Telecom D.0 (NCPDP D.0) and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards. Notwithstanding OESS’ discretionary application of its enforcement authority, the compliance date for use of these new standards remains January 1, 2012 (small health plans have until January 1, 2013 to comply with NCPDP 3.0). CMS’ Office of E-Health Standards and Services is the U.S. Department of Health and Human Services’ component that enforces compliance with HIPAA transaction and code set standards.
OESS encourages all covered entities to continue working with their trading partners to become compliant with the new HIPAA standards, and to determine their readiness to accept the new standards as of January 1, 2012. While enforcement action will not be taken, OESS will continue to accept complaints associated with compliance with Version 5010, NCPDP D.0 and NCPDP 3.0 transaction standards during the 90-day period beginning January 1, 2012. If requested by OESS, covered entities that are the subject of complaints (known as “filed-against entities”) must produce evidence of either compliance or a good faith effort to become compliant with the new HIPAA standards during the 90-day period. OESS made the decision for a discretionary enforcement period based on industry feedback revealing that, with only about 45 days remaining before the January 1, 2012 compliance date, testing between some covered entities and their trading partners has not yet reached a threshold whereby a majority of covered entities would be able to be in compliance by January 1. Feedback indicates that the number of submitters, the volume of transactions, and other testing data used as indicators of the industry’s readiness to comply with the new standards have been low across some industry sectors. OESS has also received reports that many covered entities are still awaiting software upgrades. Version 5010, NCPDP Telecom D.0 and NCPDP Medicaid Subrogation 3.0 standards represent significant improvement over the current standard versions. NCPDP Telecom D.0 addresses certain pharmacy industry needs. NCPDP Medicaid Subrogation 3.0 allows state Medicaid programs to recoup payments for pharmacy services in cases where a third party payer has primary financial responsibility. Version 5010 in particular provides more functionality for transactions such as eligibility requests and health care claims status Implementation of Version 5010 also is a prerequisite for using the updated ICD-10 CM diagnosis and ICD-10-PCS inpatient procedure code set in electronic health care transactions effective October 1, 2013.
With this announcement we also strongly encourage all covered entities to determine how they must set up their software to allow generation of 5010 transactions for those payers who are ready on January 1st, and still allow 4010a transactions for non ready payers.
Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services Announces 90-Day Period of Enforcement Discretion for Compliance with New HIPAA Transaction Standards
Today the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS)announced that it would not initiate enforcement action until March 31, 2012, with respect to any HIPAA covered entity that is not in compliance with the ASC X12 Version 5010 (Version 5010), NCPDP Telecom D.0 (NCPDP D.0) and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards. Notwithstanding OESS’ discretionary application of its enforcement authority, the compliance date for use of these new standards remains January 1, 2012 (small health plans have until January 1, 2013 to comply with NCPDP 3.0). CMS’ Office of E-Health Standards and Services is the U.S. Department of Health and Human Services’ component that enforces compliance with HIPAA transaction and code set standards.
OESS encourages all covered entities to continue working with their trading partners to become compliant with the new HIPAA standards, and to determine their readiness to accept the new standards as of January 1, 2012. While enforcement action will not be taken, OESS will continue to accept complaints associated with compliance with Version 5010, NCPDP D.0 and NCPDP 3.0 transaction standards during the 90-day period beginning January 1, 2012. If requested by OESS, covered entities that are the subject of complaints (known as “filed-against entities”) must produce evidence of either compliance or a good faith effort to become compliant with the new HIPAA standards during the 90-day period. OESS made the decision for a discretionary enforcement period based on industry feedback revealing that, with only about 45 days remaining before the January 1, 2012 compliance date, testing between some covered entities and their trading partners has not yet reached a threshold whereby a majority of covered entities would be able to be in compliance by January 1. Feedback indicates that the number of submitters, the volume of transactions, and other testing data used as indicators of the industry’s readiness to comply with the new standards have been low across some industry sectors. OESS has also received reports that many covered entities are still awaiting software upgrades. Version 5010, NCPDP Telecom D.0 and NCPDP Medicaid Subrogation 3.0 standards represent significant improvement over the current standard versions. NCPDP Telecom D.0 addresses certain pharmacy industry needs. NCPDP Medicaid Subrogation 3.0 allows state Medicaid programs to recoup payments for pharmacy services in cases where a third party payer has primary financial responsibility. Version 5010 in particular provides more functionality for transactions such as eligibility requests and health care claims status Implementation of Version 5010 also is a prerequisite for using the updated ICD-10 CM diagnosis and ICD-10-PCS inpatient procedure code set in electronic health care transactions effective October 1, 2013.
Friday, November 25, 2011
Pediatric Environmental Health Resources for Community Health Professionals
Thursday, December 8, 2011 4:00 PM – 5:30 PM EST (2:00 PM – 3:30 PM MST)
This session will discuss resources and strategies for assisting primary care providers and other community health workers in addressing common pediatric environmental health issues. Topics will include taking an environmental exposure history; pediatric environmental health case studies; and how to access free medical consultation and training through the Rocky Mountain Region Pediatric Environmental Health Specialty Unit.
Agenda:
2:00 PM to 2:10 PM – Welcome and Introductions
Alicia Aalto, Children’s Environmental Health Coordinator, US Environmental Protection Agency, Region 8
Cherri Pruitt, Maternal and Child Health Regional Consultant, US Health Resources and Services Administration, Region VIII
2:10 PM to 2:25 PM – Pediatric Environmental Health Specialty (PEHSU) Units, A Network of Experts in Children’s
Environmental Health and other Agency for Toxic Substances and Disease Registry (ATSDR)’resources for health professionals
Michael T. Hatcher, DrPH Chief, Environmental Medicine and Education Services Branch Division of Toxicology and Environmental Medicine, ATSDR
2:25 PM to 3:10 PM – Pediatric Environmental Health
Taking an environmental exposure history
Case studies
How to access free medical consultation and training through the Rocky Mountain Region Pediatric Environmental Health Specialty Unit (PEHSU) Unit (PEHSU) Mark Anderson, MD, Director, Rocky Mountain Region PEHSU Director
3:10 PM to 3:25 PM – Answers to Questions Posted by Webinar Attendees
3:25 PM to 3:30 PM – Events/Initiatives/Updates/Opportunities for Collaboration
Facilitator: Alicia Aalto, Children’s Environmental Health Coordinator, US Environmental Protection Agency, Region 8
4:00 PM – 5:30 PM EST (2:00 PM – 3:30 PM MST)
This session will discuss resources and strategies for assisting primary care providers and other community health workers in addressing common pediatric environmental health issues. Topics will include taking an environmental exposure history; pediatric environmental health case studies; and how to access free medical consultation and training through the Rocky Mountain Region Pediatric Environmental Health Specialty Unit.
This session will discuss resources and strategies for assisting primary care providers and other community health workers in addressing common pediatric environmental health issues. Topics will include taking an environmental exposure history; pediatric environmental health case studies; and how to access free medical consultation and training through the Rocky Mountain Region Pediatric Environmental Health Specialty Unit.
Agenda:
2:00 PM to 2:10 PM – Welcome and Introductions
Alicia Aalto, Children’s Environmental Health Coordinator, US Environmental Protection Agency, Region 8
Cherri Pruitt, Maternal and Child Health Regional Consultant, US Health Resources and Services Administration, Region VIII
2:10 PM to 2:25 PM – Pediatric Environmental Health Specialty (PEHSU) Units, A Network of Experts in Children’s
Environmental Health and other Agency for Toxic Substances and Disease Registry (ATSDR)’resources for health professionals
Michael T. Hatcher, DrPH Chief, Environmental Medicine and Education Services Branch Division of Toxicology and Environmental Medicine, ATSDR
2:25 PM to 3:10 PM – Pediatric Environmental Health
Taking an environmental exposure history
Case studies
How to access free medical consultation and training through the Rocky Mountain Region Pediatric Environmental Health Specialty Unit (PEHSU) Unit (PEHSU) Mark Anderson, MD, Director, Rocky Mountain Region PEHSU Director
3:10 PM to 3:25 PM – Answers to Questions Posted by Webinar Attendees
3:25 PM to 3:30 PM – Events/Initiatives/Updates/Opportunities for Collaboration
Facilitator: Alicia Aalto, Children’s Environmental Health Coordinator, US Environmental Protection Agency, Region 8
4:00 PM – 5:30 PM EST (2:00 PM – 3:30 PM MST)
This session will discuss resources and strategies for assisting primary care providers and other community health workers in addressing common pediatric environmental health issues. Topics will include taking an environmental exposure history; pediatric environmental health case studies; and how to access free medical consultation and training through the Rocky Mountain Region Pediatric Environmental Health Specialty Unit.
Thursday, November 24, 2011
ICD-10: The Key to a Successful Transition
One-day training workshops for Colorado CAHs & Rural Hospitals
FY2011 SHIP grant participants: FREE (unlimited number of attendees)
Non-SHIP hospitals/CRHC Members: $49 per attendee
Non-SHIP hospitals/Non-CRHC Members: $99 per attendee
- February 21, 2012 - location tbd
- February 22, 2012 - CRHC Office – Aurora, CO
- February 23, 2012 - location tbd
Workshop Objectives:
- Demonstrate the conversion from ICD-9-CM to ICD-10 for the three most common inpatient diagnostic cases for all short term and acute care and critical access hospitals
- Gain an understanding of the productivity and documentation issues in the conversion
- Gain an understanding of the budget dollars needed to be incorporated into the hospital’s strategic plan
- Planning for your transition: budget, training, staffing, etc.
Workshop Includes:
- Printed course materials
- 6 hours of CEUs recognized by the AAPC and ARHPC for each participant
- 1 year membership to the Association of Rural Health Professional Coders (ARHPC) for each participant – i.e. access to consultants/specialists to answer your questions
Who Should Attend:
Everyone throughout the hospital who needs to know about the changes from ICD-9 to ICD-10 and the impacts it can have on your organization
For more information – contact Danette Swanson; 303-577-0357; ds@coruralhealth.org
To register – contact Courtnay Ryan; 303-309-6807; cr@coruralhealth.org
CRHC is the recipient of the Federal HRSA Small Rural Hospital Improvement Program (SHIP) Grant: CFDA 93.301;
Award 6 H3HRH00038-10-01
Wednesday, November 23, 2011
Primary Care Incentive Payment Program FAQs Posted to the CMS Website
Per Section 5501(a) of the Affordable Care Act, the Primary Care Incentive Payment (PCIP) program authorizes an incentive payment of 10 percent of Medicare's program payments to be paid to qualifying primary care physicians and non-physician practitioners for services rendered from Sunday, January 1, 2011 to Thursday, December 31, 2015.
CMS has published 22 FAQ items related to the PCIP program. These new FAQs can be found here. Alternatively, these FAQ items can be found by visiting the CMS Website and searching for “PCIP” or “Primary Care Incentive Payment.”
Tuesday, November 22, 2011
CMS Updates
Effective: January 1, 2012 Implementation: January 3, 2012
MM7533 – CY 2012 Medicare Rural Health Clinic and Federally Qualified Health Center Payment Rate Increases –
Change Request (CR) 7533 provides instructions for the Calendar Year (CY) 2012 payment rate increases for RHC and Federally Qualified Health Center (FQHC) services.
CMS is increasing the CY payment rates for RHCs and FQHCs effective for services on or after January 3, 2012, through December 31, 2012 (i.e., CY 2012) as follows:
RHC upper payment limit – Per visit is increased from $78.07 to $79.48. The 2012 RHC rate reflects a 1.8 percent increase over the 2011 payment limit in accordance with the rate of increase in the Medicare Economic Index (MEI).
FQHC upper payment limit – Per visit for urban FQHCs is increased from $126.22 to $128.49. The maximum Medicare payment limit per visit for rural FQHCs is increased from $109.24 to $111.21. The 2012 FQHC rates reflect a 1.8 percent increase over the 2011 rates in accordance with the rate of increase in the MEI.
Medicare contractors will not retroactively adjust individual RHC/FQHC bills paid at previous upper payment limits. However, they have the discretion to make adjustments to the interim payment rate or a lump sum adjustment to total payments already made to take into account any excess or deficiency in payments to date.
Education
RHC Policy and Billing Web-Based Training (WBT) – December 6, 2011.
(This Web-based training is intended to increase providers’ overall knowledge of RHC policy and billing)
Did You Know? TrailBlazer provides recorded versions of most WBT sessions. Many providers and their staff find it difficult to attend Medicare trainings while keeping up with the demands of work. Encore presentations are posted on our Web site within a week following the training and are available 24/7. This means that you can take the encore presentation at your convenience. Visit the Encore WBT page and take advantage of this training today!
ResourcesBookmark or add the RHC Web page to your favorites for a one-stop source of information. This page includes links to related notices, FAQs, upcoming events, publications and CMS resources.
MM7533 – CY 2012 Medicare Rural Health Clinic and Federally Qualified Health Center Payment Rate Increases –
Change Request (CR) 7533 provides instructions for the Calendar Year (CY) 2012 payment rate increases for RHC and Federally Qualified Health Center (FQHC) services.
CMS is increasing the CY payment rates for RHCs and FQHCs effective for services on or after January 3, 2012, through December 31, 2012 (i.e., CY 2012) as follows:
RHC upper payment limit – Per visit is increased from $78.07 to $79.48. The 2012 RHC rate reflects a 1.8 percent increase over the 2011 payment limit in accordance with the rate of increase in the Medicare Economic Index (MEI).
FQHC upper payment limit – Per visit for urban FQHCs is increased from $126.22 to $128.49. The maximum Medicare payment limit per visit for rural FQHCs is increased from $109.24 to $111.21. The 2012 FQHC rates reflect a 1.8 percent increase over the 2011 rates in accordance with the rate of increase in the MEI.
Medicare contractors will not retroactively adjust individual RHC/FQHC bills paid at previous upper payment limits. However, they have the discretion to make adjustments to the interim payment rate or a lump sum adjustment to total payments already made to take into account any excess or deficiency in payments to date.
Education
RHC Policy and Billing Web-Based Training (WBT) – December 6, 2011.
(This Web-based training is intended to increase providers’ overall knowledge of RHC policy and billing)
Did You Know? TrailBlazer provides recorded versions of most WBT sessions. Many providers and their staff find it difficult to attend Medicare trainings while keeping up with the demands of work. Encore presentations are posted on our Web site within a week following the training and are available 24/7. This means that you can take the encore presentation at your convenience. Visit the Encore WBT page and take advantage of this training today!
ResourcesBookmark or add the RHC Web page to your favorites for a one-stop source of information. This page includes links to related notices, FAQs, upcoming events, publications and CMS resources.
National Provider Call: CMS to Host its Twenty-first HIPAA Version 5010 and D.0 - Save the Date
Wednesday, December 7, 2011; 1:30-3pm ET
Please save the date for the twenty-first National Provider Call on Medicare FFS’ implementation of HIPAA Version 5010 and D.0 transaction standards on Wed Dec 7. The agenda and registration information will be provided soon. For more information on HIPAA 5010 and D.0 implementation, visit here.
Please save the date for the twenty-first National Provider Call on Medicare FFS’ implementation of HIPAA Version 5010 and D.0 transaction standards on Wed Dec 7. The agenda and registration information will be provided soon. For more information on HIPAA 5010 and D.0 implementation, visit here.
Wednesday, November 16, 2011
CAH Method II – Payment for Multiple Surgeries
On October 28, CMS issued a transmittal regarding clarifying payment for multiple surgeries in a Method II CAH effective April 2012. The article is based on Change Request (CR) 7587 which implements the multiple procedure payment reduction policy for CAH Method II providers. CR 7587 updates the “Medicare Claims Processing Manual” (Chapter 4, Section 250). To access the transmittal and MLN Article click here.
Tuesday, November 15, 2011
Using the IHI Global Trigger Tool for Measuring Adverse Events
The vast majority of adverse events (AEs) in hospitals are not detected even by commonly-used systems to measure patient safety. So how can hospital leaders know whether patient safety efforts are the right ones to apply, as Goethe suggests, or if those efforts lead to improvement? The Institute for Healthcare Improvement (IHI) Global Trigger Tool (GTT) is a proven method of reviewing patient records using triggers to detect possible AEs. In a recent study, the IHI GTT detected ten times more confirmed and serious events than other methods.*
IHI is pleased to announce that the developers of the original IHI GTT will be leading a new training on how to use this tool for improvement in the upcoming Web&ACTION: Using the IHI Global Trigger Tool for Measuring Adverse Events. These esteemed faculty members have refined the IHI GTT over time, based on experience in both using the tool and training thousands of reviewers. This three-part, web-based virtual program begins on February 14, 2012.
Designed for team participation, this training will teach the proper use of this tool and accurate ways to measure the effectiveness of ongoing efforts to improve patient safety. Don’t miss this opportunity for your team to make significant strides in detecting and reducing AEs. Register for this program today.
"Knowing is not enough - one must apply"
-Johann Wolfgang von Goethe
IHI is pleased to announce that the developers of the original IHI GTT will be leading a new training on how to use this tool for improvement in the upcoming Web&ACTION: Using the IHI Global Trigger Tool for Measuring Adverse Events. These esteemed faculty members have refined the IHI GTT over time, based on experience in both using the tool and training thousands of reviewers. This three-part, web-based virtual program begins on February 14, 2012.
Designed for team participation, this training will teach the proper use of this tool and accurate ways to measure the effectiveness of ongoing efforts to improve patient safety. Don’t miss this opportunity for your team to make significant strides in detecting and reducing AEs. Register for this program today.
"Knowing is not enough - one must apply"
-Johann Wolfgang von Goethe
Register Now for the 2012 Credentialing Network
Credentialing of physicians and other healthcare practitioners has become a key risk management function for facilities, both large and small. Further, it has become a complex and seldom understood process. The CRHC Colorado Rural Credentialing Network assists hospitals and clinics with credentialing issues specific to accreditation requirements, significant legislation, and civil litigation. For more information and to register, click here.
Monday, November 14, 2011
Provider Capacity Demand Study
If you have a backlog of work in your team or you find that your team is constantly in catch up mode you will find that by measuring demand, capacity and backlog, you are likely to find opportunities to make things better. Measuring demand, capacity, activity, and backlog enables capacity problems to be resolved at the appropriate point of the system. By clearly understanding these four measures and identifying the bottleneck and it's constraint you can manage and plan, increase throughput, and focus improvement. For more information on this quality improvement service please contact Courtnay Ryan at cr@coruralhealth.org
CAH Capacity Building Award – Apply Online!
The guidance and online application for the CRHC 2011/2012 CAH Capacity Building Awards is now available. Through these awards, Colorado CAHs are eligible for up to $5,000 in funding. Click here to access the guidance. Click here to apply online. Applications are due by December 2, 2011. If you have any questions, please contact Jen Dunn at jd@coruralhealth.org.
Friday, November 11, 2011
CMS Education Resources - Update
Please click on the link here to view the newly updated CMS Education Resources Page.
Thursday, November 10, 2011
Now Available Online: List of Providers sent a Revalidation Request
In response to provider requests, CMS has posted a listing of providers who have been sent a request to revalidate their Medicare enrollment information. The listing contains the name and national provider identifier (NPI) of each provider sent a letter, as well as the date the letter was sent. To see the listing, click on “Revalidation Phase 1 Listing” in the Downloads section of the Medicare Provider Supplier Enrollment Revalidation Page. NOTE: You must widen each column in the spreadsheet to view the contents. CMS will be updating this list monthly. If you are listed, and have not received the request, please contact your Medicare contractor. Their toll free number may be found at Medicare Fee-For-Service Contact Information.
For more information on revalidation of Medicare provider enrollment, see MLN article 1126 Further Details on the Revalidation of Provider Enrollment Information
For more information on revalidation of Medicare provider enrollment, see MLN article 1126 Further Details on the Revalidation of Provider Enrollment Information
Two Upcoming Opportunities to Discuss Medicare ACOs and Advance Payment Model
Tuesday November 15, 11:30am -1pm
The Centers for Medicare & Medicaid Services (CMS) is hosting a call on Tuesday, November 15, 2011 from 11:30-1 pm MT to discuss the application process for the Medicare Shared Savings Program (to create Accountable Care Organizations) and the Advance Payment Model. The Advance Payment Model is intended to provide additional support through upfront resources to physician-owned and rural providers. In order to receive the call-in information, you must register for the call. Registration will close at 10:00 pm on Tuesday, November 15 or when available space has been filled. No exceptions will be made. Please register early. Please click here for more details and instructions on registering for the National Provider Call.
Wednesday, November 16, 5:00-6:30pmJoin CMS Director of Performance Based Payment Policy Staff John Pilotte for a discussion about the key features of the Medicare Shared Savings Program final rule on Wednesday, November 16 from 5:00-6:30pm at Colorado Medical Society/COPIC, 7351 E. Lowry Boulevard – Mile High Room – 2nd Floor, Denver, Colorado 80230. Teleconference information will be available for those who cannot attend in person. Please RSVP via email notification to CMSDenRegistration@cms.hhs.gov by close of business Friday, November 11, 2011. Include the following information in your email: (1) Name; (2) Title; (3) Organization; (4) Email address; and (5) Phone number. Following submission of your registration, you will receive a confirmation email. Advanced submission of questions is encouraged and can be included with your RSVP information. Time permitting, additional questions and comments will be accepted during the meeting.
A Notice of Intent to Apply memo is currently available on the Shared Savings Program Application page and the program application will be posted to this website prior to the call. Call participants are encouraged to review the application prior to the call.
The Centers for Medicare & Medicaid Services (CMS) is hosting a call on Tuesday, November 15, 2011 from 11:30-1 pm MT to discuss the application process for the Medicare Shared Savings Program (to create Accountable Care Organizations) and the Advance Payment Model. The Advance Payment Model is intended to provide additional support through upfront resources to physician-owned and rural providers. In order to receive the call-in information, you must register for the call. Registration will close at 10:00 pm on Tuesday, November 15 or when available space has been filled. No exceptions will be made. Please register early. Please click here for more details and instructions on registering for the National Provider Call.
Wednesday, November 16, 5:00-6:30pmJoin CMS Director of Performance Based Payment Policy Staff John Pilotte for a discussion about the key features of the Medicare Shared Savings Program final rule on Wednesday, November 16 from 5:00-6:30pm at Colorado Medical Society/COPIC, 7351 E. Lowry Boulevard – Mile High Room – 2nd Floor, Denver, Colorado 80230. Teleconference information will be available for those who cannot attend in person. Please RSVP via email notification to CMSDenRegistration@cms.hhs.gov by close of business Friday, November 11, 2011. Include the following information in your email: (1) Name; (2) Title; (3) Organization; (4) Email address; and (5) Phone number. Following submission of your registration, you will receive a confirmation email. Advanced submission of questions is encouraged and can be included with your RSVP information. Time permitting, additional questions and comments will be accepted during the meeting.
A Notice of Intent to Apply memo is currently available on the Shared Savings Program Application page and the program application will be posted to this website prior to the call. Call participants are encouraged to review the application prior to the call.
Wednesday, November 9, 2011
TrailBlazer Medicare Education Listserv
TrailBlazer Provider Outreach and Education develops and promotes educational opportunities that enhance the Medicare knowledge of our providers and their staffs. All upcoming educational opportunities are posted on the Calendar of Events Web page.
Web-Based Training:
11/09/2011 – Ambulance Overview – Part 2.
11/10/2011 – Provider Enrollment Revalidation Resources.
11/15/2011 – Short Inpatient Hospital Stays.
11/22/2011 – MSP Questionnaire.
11/29/2011 – Top Billing Errors.
12/06/2011 – RHC Policy and Billing.
12/20/2011 – ESRD Overview.
12/20/2011 – Medical Review/Appeals Process.
Web-Based Training:
11/09/2011 – Ambulance Overview – Part 2.
11/10/2011 – Provider Enrollment Revalidation Resources.
11/15/2011 – Short Inpatient Hospital Stays.
11/22/2011 – MSP Questionnaire.
11/29/2011 – Top Billing Errors.
12/06/2011 – RHC Policy and Billing.
12/20/2011 – ESRD Overview.
12/20/2011 – Medical Review/Appeals Process.
THE Consortium November Webinar: 5010 Readiness & Medicaid Incentive Program Update
Join us for the November Consortium webinar, 5010 Readiness & Medicaid Incentive Program Update on Thursday, November 17th from 12:00pm-1:15pm MT where we will update you on the Medicaid Incentive Program for Colorado and where we will help you get ready for 5010.
5010 transactions will be upon us in less than six weeks and for some providers could result in significant cash flow problems. This webinar (a repeat of one we did earlier) will give you tools and information to ensure you are as prepared as possible.
To register, click here.
5010 transactions will be upon us in less than six weeks and for some providers could result in significant cash flow problems. This webinar (a repeat of one we did earlier) will give you tools and information to ensure you are as prepared as possible.
To register, click here.
CoverColorado Soliciting Feedback from Providers
CoverColorado, the insurance plan for individuals with pre-existing conditions, is soliciting feedback from all health care providers caring for CoverColorado members on its provider fee schedule that was implemented April 1, 2011. CoverColorado seeks provider input to evaluate the effectiveness of the present schedule and inform any potential changes to the 2012 fee schedule. Written comments are due by December 20, 2011 and can be emailed or submitted to: CoverColorado Attn: Executive Director, Fee Schedule, 425 South Cherry Street, Suite 160, Glendale, CO 80246. CoverColorado is also holding an open meeting on Tuesday, December 13 from 4:00 pm - 6:00 pm in the Molly Blank Auditorium at Denver's National Jewish Hospital where comment will be taken.
Tuesday, November 8, 2011
FREE Webinar on helping pregnant women quit smoking available
Dear partners in health,
A recording of last month's webinar on helping pregnant women quit smoking is now available by clicking HERE and selecting the "Training" tab. Please share this with your colleagues through your networks or by clicking the "Forward Email" link below.
The Webinar, "Tools to Help Pregnant Women Quit Smoking: Motivational, Pharmacological, and Behavioral Strategies," was originally presented Oct. 19 by Dr. Heather LaChance for the Colorado Department of Public Health and Environment.
This webinar provides essentials of smoking cessation for prenatal and postpartum women. This seminar discusses how smoking impacts mothers' and infants' health, and details the dangers of secondhand smoke. It reviews the treatment options for smoking cessation, including pharmacotherapy, best practices and brief motivational counseling options. You will learn specific counseling strategies to motivate smokers and the tools to work with smokers who are ready to quit. Finally, you will learn about the prenatal tobacco cessation campaign and see materials designed to inspire smokers to engage in smoking cessation.
We hope those of you who could not attend the original Webinar find the archived recording and resources useful.
A recording of last month's webinar on helping pregnant women quit smoking is now available by clicking HERE and selecting the "Training" tab. Please share this with your colleagues through your networks or by clicking the "Forward Email" link below.
The Webinar, "Tools to Help Pregnant Women Quit Smoking: Motivational, Pharmacological, and Behavioral Strategies," was originally presented Oct. 19 by Dr. Heather LaChance for the Colorado Department of Public Health and Environment.
This webinar provides essentials of smoking cessation for prenatal and postpartum women. This seminar discusses how smoking impacts mothers' and infants' health, and details the dangers of secondhand smoke. It reviews the treatment options for smoking cessation, including pharmacotherapy, best practices and brief motivational counseling options. You will learn specific counseling strategies to motivate smokers and the tools to work with smokers who are ready to quit. Finally, you will learn about the prenatal tobacco cessation campaign and see materials designed to inspire smokers to engage in smoking cessation.
We hope those of you who could not attend the original Webinar find the archived recording and resources useful.
Invitation to Join the Centers for Medicare & Medicaid Services for an Accountable Care Organizations Discussion
November 16, 2011 5:00 P.M. – 6:30 P.M. (MST)
Please join us on November 16, 2011 for an in-person meeting with the Centers for Medicare & Medicaid Services’ (CMS) Director of Performance Based Payment Policy Staff, John Pilotte, to learn about the key features of the Medicare Shared Savings Program final rule. Mr. Pilotte will discuss new initiatives that will assist providers in working together through Accountable Care Organizations when caring for people with Medicare and new tools that will improve the quality of care for all patients.
REGISTRATION REQUIRED: Please RSVP via email notification to CMSDenRegistration@cms.hhs.gov by close of business Wednesday, November 9, 2011.
Include the following information in your email:
(1) Name; (2) Title; (3) Organization; (4) Email address; and (5) Phone number
Following submission of your registration, you will receive a confirmation email. If you are unable to attend in-person, we will provide you with teleconference information.
This meeting is intended to outline the CMS’ goals in implementing various Medicare ACO initiatives. It will be held at the Colorado Medical Society/COPIC, located at: 7351 E. Lowry Boulevard –
Mile High Room – 2nd Floor, Denver, Colorado 80230
.
Please join us on November 16, 2011 for an in-person meeting with the Centers for Medicare & Medicaid Services’ (CMS) Director of Performance Based Payment Policy Staff, John Pilotte, to learn about the key features of the Medicare Shared Savings Program final rule. Mr. Pilotte will discuss new initiatives that will assist providers in working together through Accountable Care Organizations when caring for people with Medicare and new tools that will improve the quality of care for all patients.
REGISTRATION REQUIRED: Please RSVP via email notification to CMSDenRegistration@cms.hhs.gov by close of business Wednesday, November 9, 2011.
Include the following information in your email:
(1) Name; (2) Title; (3) Organization; (4) Email address; and (5) Phone number
Following submission of your registration, you will receive a confirmation email. If you are unable to attend in-person, we will provide you with teleconference information.
This meeting is intended to outline the CMS’ goals in implementing various Medicare ACO initiatives. It will be held at the Colorado Medical Society/COPIC, located at: 7351 E. Lowry Boulevard –
Mile High Room – 2nd Floor, Denver, Colorado 80230
.
Innovation Advisors Program - Apply Today
Want a front row seat for exciting work going on at the Center for Medicare and Medicaid Innovation (CMMI)? Interested in expanding your skills around system improvement? Applications are now available for the Innovation Advisors Program which aims to help professionals deepen skills that will drive improvements to patient care and reduce costs.
More information and the program background can be found here. The deadline to submit applications is Tuesday, November 15, 2011. Applications for the Innovation Advisors Program can be accessed here. Interested parties may obtain answers to questions by emailing IAP@orau.org.
For more information about the CMS Innovation Center, please visit: the innovations site.
More information and the program background can be found here. The deadline to submit applications is Tuesday, November 15, 2011. Applications for the Innovation Advisors Program can be accessed here. Interested parties may obtain answers to questions by emailing IAP@orau.org.
For more information about the CMS Innovation Center, please visit: the innovations site.
Monday, November 7, 2011
Join CAH MBQIP – Tell Your Story
The Health Resources and Services Administration’s Office of Rural Health Policy (ORHP) recently kicked off a new Critical Access Hospital initiative, MBQIP, the Medicare Beneficiary Quality Improvement Project. With more national attention on quality and reporting, this initiative takes a proactive and visionary approach to ensure CAHs are well-equipped and prepared to measure and demonstrate quality. Through this voluntary program, CAHs agree to give ORHP access to the data their hospital is submitting to CMS. This data will be aggregated to benchmark, demonstrate improvements, share best practices, and to generate reports to aid CAHs and states in their quality improvement activities. There is additional information about MBQIP in this YouTube video from HRSA’s Senior Health Policy Advisor, Paul Moore. To join MBQIP, contact Jen Dunn at jd@coruralhealth.org. Additionally, through CRHC’s iCARE Program (Improving Communication and Readmission) your facility has access to free technical assistance to help your hospital make improvements in many of the same areas ORHP is focusing on. For more information and to join iCARE, click here. If you have any questions, please feel free to contact mm@coruralhealth.org or jd@coruralhealth.org.
2011/2012 CAH Capacity Building Award – Apply Online by December 2!
CRHC has released the guidance and application for the 2011/2012 CAH Capacity Building Awards. Through these awards, Colorado CAHs are eligible for up to $5,000 in funding. Click here to access the guidance. Click here to apply online. Applications are due by December 2, 2011. If you have any questions, please contact Jen Dunn at jd@coruralhealth.org.
November is National Diabetes Month and Diabetic Eye Disease Month
Please join the Centers for Medicare & Medicaid Services (CMS) this November during National Diabetes Month and Diabetic Eye Disease Month in raising awareness about diabetes, diabetic eye disease, the importance of early disease detection, and the related preventive health services covered by Medicare.
Diabetes can lead to severe complications such as heart disease, stroke, vision loss, kidney disease, nerve damage, and amputation among others, and it’s a significant risk factor for developing glaucoma. People with diabetes are more susceptible to many other illnesses such as pneumonia and influenza and are more likely to die from these than people who do not have diabetes. Among U.S. residents aged 65 years and older, 10.9 million (or 26.9%) had diabetes in 2010. Currently, 3.6 million Americans age 40 and older suffer from diabetic eye disease. Education and early detection are major components to combating this disease.
Help protect the health of your Medicare-covered patients by informing them that Medicare covers several diabetes-related preventive services for eligible beneficiaries including diabetes screening tests, diabetes self-management training, medical nutrition therapy, diabetes supplies, glaucoma screening, and vaccinations for pneumonia and influenza. Advise them that the early detection and treatment of diabetes can prevent or delay many associated illnesses and complications. Encourage utilization of these important preventive services as appropriate. And remember, many of these services require an order or referral for coverage by Medicare. Please ensure that you provide your Medicare patients with the appropriate documentation so they can receive the services needed to help prevent, treat, and manage the disease.
Diabetes can lead to severe complications such as heart disease, stroke, vision loss, kidney disease, nerve damage, and amputation among others, and it’s a significant risk factor for developing glaucoma. People with diabetes are more susceptible to many other illnesses such as pneumonia and influenza and are more likely to die from these than people who do not have diabetes. Among U.S. residents aged 65 years and older, 10.9 million (or 26.9%) had diabetes in 2010. Currently, 3.6 million Americans age 40 and older suffer from diabetic eye disease. Education and early detection are major components to combating this disease.
Help protect the health of your Medicare-covered patients by informing them that Medicare covers several diabetes-related preventive services for eligible beneficiaries including diabetes screening tests, diabetes self-management training, medical nutrition therapy, diabetes supplies, glaucoma screening, and vaccinations for pneumonia and influenza. Advise them that the early detection and treatment of diabetes can prevent or delay many associated illnesses and complications. Encourage utilization of these important preventive services as appropriate. And remember, many of these services require an order or referral for coverage by Medicare. Please ensure that you provide your Medicare patients with the appropriate documentation so they can receive the services needed to help prevent, treat, and manage the disease.
Friday, November 4, 2011
Has Your Facility Joined the Partnership for Patients?
A new public-private partnership that will help improve the quality, safety, and affordability of health care for all Americans, the Partnership for Patients brings together leaders of major hospitals, employers, physicians, nurses, and patient advocates along with state and federal governments in a shared effort to make hospital care safer, more reliable, and less costly. The 2 major goals of the partnership are to: keep patients from getting injured or sicker; and help patients heal without complications. Nearly 4500 organizations – including more than 2000 hospitals – have pledged their support for the Partnership for Patients. For more information and to pledge your support, click here.
CRHC Webinar: Reducing Costs and Improving Effectiveness...You Really Can Do Both at the Same Time
November 15, 2011, 11:00am-12:00pm
CRHC is pleased to announce a webinar Tuesday November 15 from 11:00am to 12:00pm to discuss recent successes and techniques Colorado CAHs have used to improve their care and business processes through the application of a new CRHC service offering, Lean Sigma Healthcare (LSH). Rather than adding another layer of complexity to your already overloaded staff, LSH provides them with a project management framework that ensures the projects you are now doing are completed on time, within budget, and have the staying power to achieve their objectives over the long run. For more information and to register, click here.
CRHC is pleased to announce a webinar Tuesday November 15 from 11:00am to 12:00pm to discuss recent successes and techniques Colorado CAHs have used to improve their care and business processes through the application of a new CRHC service offering, Lean Sigma Healthcare (LSH). Rather than adding another layer of complexity to your already overloaded staff, LSH provides them with a project management framework that ensures the projects you are now doing are completed on time, within budget, and have the staying power to achieve their objectives over the long run. For more information and to register, click here.
Frontier Focus: CMS Email Box for Questions Re Medicare Provider Enrollment Revalidation
On October 27, 2011, CMS conducted a national provider call to discuss the revalidation of Medicare provider enrollment information. Prior to the call and during the call, attendees were given an email address to submit their questions regarding the revalidation initiative.
The email address given at the time was not the correct email address. The correct email address to submit questions related to the provider enrollment revalidation is listed below. Please share this email address with your members and other stakeholders who may have attended the call. Please feel free to contact me if you have any questions.
The correct email address is nationalprovidercalls@cms.hhs.gov .
Thursday, November 3, 2011
ICD 10 Billing & Coding Webinar - Next Week!! Register NOW!!
Thursday November 10th from 9am - 12pm MT
\Susan Whitney with R.T. Welter & Associates, Inc. will be leading a webinar on ICD 10 Billing & Coding. Participants will learn about ICD 10 Documentation as well as Billing & Coding updates. Susan will identify practical ways to be proactively prepared for the future and discuss the November Coding Bootcamps scheduled around the state. This educational activity is geared towards clinicians, billing and coding staff at rural hospitals and clinics. Registration is now open for this educational opportunity provided by CRHC and RT Welter and Associates. For more information and to register please contact Courtnay Ryan at cr@coruralhealth.org or by phone at 303.309.6807. Don't miss out, register today!! All healthcare providers, particularly physicians, are invited to attend.
\Susan Whitney with R.T. Welter & Associates, Inc. will be leading a webinar on ICD 10 Billing & Coding. Participants will learn about ICD 10 Documentation as well as Billing & Coding updates. Susan will identify practical ways to be proactively prepared for the future and discuss the November Coding Bootcamps scheduled around the state. This educational activity is geared towards clinicians, billing and coding staff at rural hospitals and clinics. Registration is now open for this educational opportunity provided by CRHC and RT Welter and Associates. For more information and to register please contact Courtnay Ryan at cr@coruralhealth.org or by phone at 303.309.6807. Don't miss out, register today!! All healthcare providers, particularly physicians, are invited to attend.
Lodging Incentive – Economic Impact of Healthcare Training –– Limited Availability
Colorado Rural Health Center’s Colorado STRIDES program is hosting a national training on:
(1) economic impact analyses of healthcare
(2) mapping and spatial data analysis
(3) the new IRS-mandated community health needs assessment for nonprofit hospitals
(4) budget studies for new or expanded health services
Participants will learn to measure the economic impacts of the health sector on regions, counties, or zip codes in Colorado.Colorado Rural Health Center is hosting this year’s U.S. Western Regional Rural Health Works training! This 1-day national training event – held here in Aurora – is a great opportunity to take local, regional, and state attention to the importance of healthcare to economic development to the next level!
This national training takes place here at Colorado Rural Health Center in Aurora, Colorado, on Tuesday, Dec 13, from 9 a.m. to 4 p.m. The registration fee is only $49.
Please note that participation is limited to the first 20 to register. For more information, or to register now, click here.
As an additional incentive for the first 6 qualifying* attendees who contact Clint Cresawn, Colorado STRIDES Program Manager** after their registration, we can offer 1 night’s lodging as an extra incentive. You may contact Clint at ccr@coruralhealth.org.
*In order to qualify for the offer of 1 night’s lodging, you must be from rural Colorado, provide proof of registration, and be a professional or committed volunteer in one of the following areas: Health, healthcare, or healthy living; economic development; community development; local or regional government.
(1) economic impact analyses of healthcare
(2) mapping and spatial data analysis
(3) the new IRS-mandated community health needs assessment for nonprofit hospitals
(4) budget studies for new or expanded health services
Participants will learn to measure the economic impacts of the health sector on regions, counties, or zip codes in Colorado.Colorado Rural Health Center is hosting this year’s U.S. Western Regional Rural Health Works training! This 1-day national training event – held here in Aurora – is a great opportunity to take local, regional, and state attention to the importance of healthcare to economic development to the next level!
This national training takes place here at Colorado Rural Health Center in Aurora, Colorado, on Tuesday, Dec 13, from 9 a.m. to 4 p.m. The registration fee is only $49.
Please note that participation is limited to the first 20 to register. For more information, or to register now, click here.
As an additional incentive for the first 6 qualifying* attendees who contact Clint Cresawn, Colorado STRIDES Program Manager** after their registration, we can offer 1 night’s lodging as an extra incentive. You may contact Clint at ccr@coruralhealth.org.
*In order to qualify for the offer of 1 night’s lodging, you must be from rural Colorado, provide proof of registration, and be a professional or committed volunteer in one of the following areas: Health, healthcare, or healthy living; economic development; community development; local or regional government.
Wednesday, November 2, 2011
Affordable Care Act Program to help healthcare professionals improve care for patients and reduce costs in their communities
Today, the Centers for Medicare & Medicaid Services announced that it was accepting applications for a new Innovation Advisors program to help health professionals deepen skills that will drive improvements to patient care and reduce costs. These health care improvements will benefit people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Made possible by the Affordable Care Act, this initiative will be managed by the Center for Medicare and Medicaid Innovation (Innovation Center).
“We seek to support and expand the number of health care leaders with the knowledge and the vision to find innovative ways to improve care for patients and use our healthcare dollars more wisely,” said CMS Administrator Don Berwick, M.D. “The CMS Innovation Center is an ideal host for this network of experts. It will support their work on efforts that can strengthen public-private partnerships and ensure patients can spend more time with their doctor and get higher-quality care and lower costs.”
Under the new program, there will be up to 200 Innovation Advisors, including clinicians, allied health professionals, health administrators and others. They will attend in-person meetings as well as remote sessions to expand their skills and knowledge, and apply what they learn in their organizations and areas.
After an initial, intensive orientation phase, Innovation Advisors will work with the Innovation Center to test new models of care delivery in their own organizations and communities. They will also create partnerships to find new ideas that work and share them regionally and across the United States.
Innovation Advisors will be expected to commit up to 10 hours per week to the Innovation Advisor Program during the initial six months of the program, with part of that time devoted to seminars and instruction. The rest of that time will be devoted to implementing the improvement project they propose in their initial application. The Innovation Advisors who are selected will meet regularly to exchange insights, report on successes and discuss common challenges.
This initiative is just one of a number of efforts made possible by the Affordable Care Act to help bring better health and better health care not just to Medicare beneficiaries, but also to all Americans, while helping use healthcare dollars more wisely. Already, more than 5,000 organizations have joined the Partnership for Patients and pledged to reduce hospital-acquired conditions and improve transitions in care. The Bundled Payments for Care Improvement initiative will give providers flexibility to work together to coordinate care for patients over the course of a single episode of an illness. The Comprehensive Primary Care Initiative will allow CMS and other payers, such as employer-based health plans, to align strategies designed to strengthen primary care services delivered to Medicare beneficiaries.
Applications for the Innovation Advisors program are due on November 15, 2011. Applications will be reviewed and Innovation Advisors will be notified of their selection by mid-December 2011.
More information, including a fact sheet, frequently asked questions, application and terms and conditions can be found at: http://innovations.cms.gov/innovation-advisors-program.
Subscribe to:
Posts (Atom)