CMS Rural Health Open Door Forum

Tuesday July 12, 2011 2:00 pm - 3:00 pm ET
The next CMS Rural Health Open Door Forum is scheduled for Tuesday, July12, 2011 from 2:00pm-3:00pmET. To participate, dial 1-800-837-1935 Conference ID 59683815. The Rural Health ODF addresses RHC, CAH and FQHC issues, as well as some inclusion of other questions and concerns that occur in clinical practice pertaining to other CMS payment systems that also extend into these settings.

Alere cordially invites you to join an educational webinar

Thursday, June 9, 2011  11:00 am - 12:00 pm EST

Speaker:

Howard J. Kirchick, Ph.D

Director, Scientific Affairs

Alere

Georgetown, Texas

 

 Upon completion of the program, the attendee will be able to:

• Review the history of ACS biomarkers
• Outline current guidelines for the diagnosis of chest pain patients
• Discuss the data supporting various strategies for the rapid triage of chest pain patients
•  

This program is acceptable for up to 1 credit hour by P.A.C.E. Alere is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E. Program.

 

RSVP:

Click here to register for this webinar.

Be sure to forward this invite to your staff, especially your clinical laboratory professionals.

Please note they will be eligible for 1 credit hour by P.A.C.E. upon completion.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are You Submitting a Handwritten Medicare Enrollment Application?

Medicare enrollment application forms are fillable on your computer. This means that you can fill out the information required by typing into the open fields while the form is displayed on your computer monitor. Filling out the forms this way before printing, signing and mailing means more easily-readable information – which means fewer mistakes, questions, and delays when your application is processed. Be sure to make a copy of the signed form for your records before mailing.

 

You’ll find the Medicare provider enrollment application forms available on the CMS website:

• CMS 855A – Application for Institutional Providers
• CMS 855B – Application for Clinics, Group Practices, and Certain Other Suppliers
• CMS 855I – Application for Physicians and Non-Physician Practitioners
• CMS 855R – Application for Reassignment of Medicare Benefits
• CMS 855S – Application for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers

Signatures are still required to be handwritten. Don’t forget to complete this important step prior to mailing your typed form(s).

 

Keep in mind that typed forms are easier for Medicare to process, but the most efficient method for submitting your enrollment application is to use the Internet –Based Provider Enrollment, Chain and Ownership System (PECOS). PECOS guides you through the enrollment application so you only supply information relevant to your application. PECOS also reduces the need for follow-up because of incomplete applications. Using Internet-based PECOS results in a more accurate application and saves you time and administrative costs. Visit Internet-Based PECOS to learn more.

340B Orphan Drug Proposed Rule

On May 20, HRSA published a Notice of Proposed Rulemaking concerning how the Orphan Drug exclusion will be implemented for certain eligible healthcare organizations participating in the 340B Drug Pricing Program. The proposed rule would prevent organizations from receiving 340B pricing on Orphan Drugs when they are used to treat the rare conditions that gave them orphan designations, but not when the drug is used for the treatment of other maladies – some of which are routinely and widely treated by designated Orphan Drugs. Affected health care organizations will be required to develop auditable systems to ensure that they are not using Orphan Drugs purchased under the 340B Drug Pricing program for orphan designated indications. HRSA encourages the submission of written comments during the 60-day comment period, and will carefully consider all of the comments received. Comments are due by July 19, 2011. For more information and to access the proposed rule, click here.

JAMA/IHI Author in the Room: Finances in the Older Patient With Cognitive Impairment: “He Didn't Want Me to Take Over”

June 15, 2:00 to 3:00 PM EST
Join the Institute for Healthcare Improvement (IHI) and The Journal of the American Medical Association (JAMA) for the Author in the Room® teleconference. The topic for this call is the JAMA article: Finances in the Older Patient With Cognitive Impairment: “He Didn't Want Me to Take Over”. Many patients with cognitive impairment and their families seek guidance from their primary care clinician for help with financial impairment, yet most clinicians do not understand their role or know how to help. Dr. Widera will discuss his JAMA article on the role of the primary care clinician in educating older adult patients and their families about the need for advance financial planning, recognizing signs of possible impaired financial capacity, assessing financial impairments in cognitively impaired adults, recommending interventions to help patients maintain financial independence, and knowing when and to whom to make medical and legal referrals. To register for the call, click here.

New Frequently-Asked-Questions Available about HIPAA Version 5010 Implementation

CMS has posted 18 new FAQs about HIPAA Version 5010 implementation, and one PDF document containing 27 Q&As specific to the Wed Mar 30 CMS-hosted 5010 national provider teleconference on provider testing and readiness. To review these FAQs, visit the CMS FAQ database click here and search for “5010” (or use a direct link to the “5010” search results) Please check the CMS FAQ database regularly for newly-posted or updated information related to 5010.

THE Consortium Webinar: ICD-10 and 5010 and your EHR Implementation

Wednesday, June 15th from 12:00-1:15 pm MT
Join us for the June Consortium webinar where we will discuss ICD-10 and 5010 and your EHR implementation.

In January the federal government will require all providers and health plans to begin to use the new HIPAA Standard Transaction formats for electronic transactions such as claims, remittance advices and eligibility verification. There will also be new code sets including the Health Plan Identification number. Shortly after this ICD10 becomes mandatory.

This webinar will provide the basics on these changes as well as KEY questions to ask your EHR vendors, practice management vendors, clearinghouses and other organizations to be sure they are ready. Readiness is essential to ensure you do not have cash flow problems when these changes take effect.

Registration Link: https://cc.readytalk.com/r/jy2qz7tf06bp

Instruct-Online Webinar: Critical Access Hospitals: Provider-Based Clinics

June 9, 2011; 1- 2:30 pm CST
CAHs are considered to be hospitals within the provider-based rule (PBR). In this webinar, the overall purpose and function of the provider-based rule relative to provider-based clinics is addressed as well as critical information concerning physician supervisory changes. CMS has recently made significant changes in the interpretation of physician supervision for on-campus (out of hospital) provider-based operations. Additionally, the overall compliance issues surrounding provider-based clinics and provider-based status will also be discussed. There is a site fee of $225 for this course. For registration and further information please contact Katie @ katie@instruct-online.com or 319.626.3295.

" The State and Future of HIV/AIDS" Webinar

June 15, 2011 3:00 p.m. EDT

This June we recognize 30 Years of AIDS and National HIV Testing Day. We encourage your participation in the events that will commemorate 30 years since the first reports of AIDS in the U.S. (June 5) and National HIV Testing Day (June 27) – mark your calendar:

• On May 31, NIH’s Dr. Anthony Fauchi, will present via videocast, “Thirty Years of AIDS: A Personal Journey”.
• On June 1, Jeff Crowley, Director of the White House Office of National AIDS Policy, will participate in a live video chat at 3:00 p.m. (EDT). Dr. Regina Benjamin, U.S. Surgeon General, will give opening remarks. Participants will be able to submit questions online before and during the chat. You can watch the chat on the AIDS.gov homepage.
•  AIDS.gov will host a webinar/conference call on “The State and Future of HIV/AIDS”.Speakers will include senior Federal HIV/AIDS leaders, and participants will have an opportunity to ask questions.

To learn more about these and additional events visit AIDS.gov 30 Years of AIDS page.

New Online Patient Safety Training Resources for Clinicians and Patient Advocates

The HHS Office of the Assistant Secretary for Health released Partnering to Heal: Teaming Up Against Healthcare-Associated Infections, an interactive learning tool for clinicians, health professional students, and family caregivers highlighting effective communication about infection control practices and what it means to help create a “culture of safety” in healthcare institutions. The training videos include information on basic protocols for universal precautions and isolation precautions to protect patient, visitors, and practitioners from the most common disease transmissions. The training promotes six key behaviors: teamwork, communication, hand washing, vaccination against the flu, appropriate use of antibiotics, and proper insertion, use, and removal of catheters and ventilators. Learn how five characters can contribute to—or prevent—risk of several healthcare-associated infections, including SSI, CLABSI, VAP, CAUTI, C.diff, and MRSA.

Program Integrity Initiative Webcast

Thursday, May 26th, 1-3 PM ET

Find out how HRSA has responded to the Secretary Sebelius’ challenge to improve the way HHS fulfills its critical mission to protect the health of all Americans and provide essential human services. The Program Integrity Workgroup is proud to present a webcast on the Program Integrity Initiative. The Program Integrity Initiative is designed to help grantees prevent and detect waste, fraud, and abuse in their program as well as communicate best practices.

 

The webcast will consist of a panel of speakers from offices and bureaus across HRSA who will discuss the following topics:

• HRSA’s activities in response to the Program Integrity Initiative
• The Program Integrity Initiative and how it relates to risk
• How to stay compliant with your grant’s legislative and programmatic requirements
• How to minimize risk in your programs
• How to access HRSA’s array of technical assistance resources

 HRSA employees from all departments will be available to answer questions pertaining to your grants and programs.

 

 Webcast access information: http://interspire.circlesolutions.com/link.php?M=2340860&N=1443&L=473&F=H

Dial in number: 1-888-323-9728 – Password: HRSA
(This webcast will be recorded and archived online.)

AHRQ Releases Tool to Help Consumers Reduce Medication Errors

Three out of four Americans are not following their doctor’s advice when it comes to taking prescription medication, according to U.S. Surgeon General Dr. Regina Benjamin. AHRQ and the National Council on Patient Information and Education have released a revised guide to help patients learn more about how to take medicines safely. “Your Medicines: Be Smart. Be Safe” is a booklet that includes a detachable, wallet-sized card that can be personalized to help patients keep track of all medicines they are taking, including vitamins and herbal and other dietary supplements. Available in English and Spanish, the guide includes questions that patients can ask their doctors about their medications. For more information, click here.

Do you have an up to date Policy & Procedures Manual?

RHC's must have a current P&P Manual that addresses all regulations and outlines how the practice operates and follows the regulations.  A variety of RHC P&P Manual resources are available including:

• A full CMS RHC P&P Manual
• Evaluation of current P& P Manual
• Non-Clinic Member of Annual Review Committee. CRHC can fulfill the annual non-clinic member role requirement and simultaneiously assist the clinic with effectively updating P&P's annually

If you do not have an up to date Policy and Procedures Manual for your clinic or would like help with the one you currently have, please contact Courtnay Ryan, programs assistant for the Hospitals and Clinics at cr@coruralhealth.org or 303.309.6807

$100 Million in Grants Available

The Affordable Care Act's Community Transformation Grants aim at helping communities implement projects proven to reduce chronic diseases. By promoting healthy lifestyles nationwide, especially among populations experiencing the greatest burden of chronic disease, these grants will help improve health, reduce health disparities and lower health care costs.

Chronic diseases, such as heart disease, cancer, stroke and diabetes, are responsible for 7 of 10 deaths among Americans each year. Treatment for people with chronic conditions accounts for more than 75 percent of the more than $2 trillion spent on annual U.S. medical care costs; additionally, in 2008 approximately $147 billion of medical bills were obesity-related.

Community Transformation Grants will support prevention programs in up to 75 communities across the country over the next five years. State and local government agencies, tribes and territories, and state or local nonprofit organizations are eligible to apply. At least 20 percent of grant funds will be directed to rural and frontier areas. Click here to learn more about the grants and how to apply.

HRSA's new "Culture of Safety" Strategy

CRHC would like to let you know that HRSA supports EMS through a variety of programs and initiatives. For example, HRSA has partnered with the National Highway Traffic Safety Administration to develop a national EMS "Culture of Safety” strategy, which focuses on patient and EMS personnel safety. To learn more about this initiative and other EMS activities and opportunities at HRSA, please visit here

Facing Financial Struggles in Your Practice?

With the ever changing healthcare environment, it is crucial to have up to date and accurate financial management strategies.  The Colorado Rural Health Center offers an array of support services from coding, operations, and credentialing management to contract negotiations, start-up assistance, and a total access billing and revenue service. We offer rural practices an unparalleled level of experience, support, reporting and client access to real time data. We understand that cash flow is crucial and the life line of your practice and we are ready to assist you with strategies that ensure you the best chance at success and profitability. 

We also offer regional and customized billing, coding and documentation workshops at your facility, or via teleconference or webinar.  These educational activities are aimed toward clinicians, billing & coding staff, and can assist rural facilities in maximizing reimbursement and assuring timely receipt of revenues from the patient encounter though claims submission and accounts receivable follow up.  For more information on our Financial Revenue Management Services please contact Courtnay Ryan, Programs Assistant for the Hospitals and Clinics Department at cr@coruralhealth.org .

Medicare Learning Network Fact Sheet: “Medicare Shared Savings Program and Rural Providers”

The Medicare Learning Network® has released the “Medicare Shared Savings Program and Rural Providers” fact sheet, which is designed to provide education on how the Medicare Shared Savings Program (as proposed in the Notice of Proposed Rulemaking) impacts rural providers. To view, print, or download the fact sheet, please visit here

Immunization Essentials Webinar Series: Online Education for Health Care Professionals

The Colorado Children's Immunization Coalition (CCIC), the Colorado Immunization Program (CIP), and the Vaccine Advisory Committee for Colorado (VACC), announce a new bi-monthly webinar series: Immunization Essentials: Online Education for Health Care Professionals. This webinar series, featuring a different vaccine-related topic every other month, has been tailored for MAs, RNs, LPNs and health professionals new to the field of immunization. For more information, contact CCIC Deputy Director Erin Suelmann-Noonan at CCICOffice@tchden.org.

CMS National Provider Call on Medicare Shared Savings Program Proposed Rule Overview

Tue May 24, 1:30-3pm ET
On Thu Mar 31, 2011, CMS proposed new rules under the Affordable Care Act to help doctors, hospitals, and other healthcare providers better coordinate care for Medicare patients through Accountable Care Organizations. During this Tue May 24 national provider call, CMS subject matter experts will give an overview of the Medicare Shared Savings Program proposed rule; a question and answer session will follow the presentation. Registration will close at 1:30pm ET on Mon May 23, or when available space has been filled. To register for this informative session, please visit here

Kaiser IHI Travel Support Program

Through a generous grant from Kaiser Permanente, CRHC is pleased to offer funding to help rural clinic leaders attend Institute for Healthcare Improvement (IHI) conferences and seminars. IHI, world-renowned for their work to improve healthcare and patient safety, helps accelerate improvement by cultivating concepts for improving patient care, and helping health care facilities put those ideas into action. For more information about the Kaiser IHI Travel Support Program, contact jd@coruralhealth.org.

Primary Care Fund application released!

Primary Care Funding is now available for primary care clinics. The 2011-12 application is now online, and is due Monday, June 13th. Commonly asked and specific questions pertaining to the Primary Care Fund grant and/or completion of the application will be addressed during the Pre-Bid Conference on Wednesday, June 1, 2011. If you would like assistance with applying for this funding, CRHC’s Grants Research Opportunities and Writing (GROW) program can help! Please contact Erica Petramala, Grants Coordinator, for more information

4 Hours of Free Simulation Training Available to Colorado CAHs

A new initiative from the University of Colorado Hospital and Colorado Division of Labor and Employment provides customized, no-cost medical training to Colorado’s CAHs using highly sophisticated simulation training and technology from the WELLS Center. The WELLS Center provides education and training for health care workers using life-sized mannequins, known as human patient simulators. The center has the ability to recreate real-life situations to improve outcomes and hospital safety. The WELLS Center will provide four hours of training at no-cost to workers in CAHs to prepare for low-volume, high-risk events. The center can provide training at its facility on the Anschutz Medical Campus or on-site training focusing on interaction and communication at the hospital as well as that particular hospital’s processes and systems. For more information click here or contact Allen Wentworth at allen.wentworth@uch.edu or 720 848-7844.

Corrections Being Made to Claims for Certain Institutional Preventive Services Codes

CMS has identified a Medicare claims processing system issue that is causing certain preventive services rendered in an institutional setting to be processed incorrectly. The following information pertaining to CAHs provides the action that will be taken by Medicare claims administration contractors:

§ CAHs (85X TOB) claims with dates of service on and after Sat Jan 1, 2011, containing HCPCS codes Q0091, G0101, 77052, 77057, and G0202 are being processed and paid incorrectly due to coinsurance being incorrectly applied. Medicare contractors have been instructed to hold claims impacted by this problem until a correction is implemented. A software correction is scheduled for June 2011.

As the software corrections are made, Medicare contractors will release any suspended claims and automatically reprocess claims for preventive services that have not been paid or erroneously applied deductible or coinsurance. Reprocessing of claims that have been paid incorrectly for this issue will be completed by Wed Aug 31, 2011. Providers who are billing for other payable services on the same claim as services that have been suspended and do not wish for their entire claim to be suspended may request the contractor to return the claim may remove the preventive service charge that is suspending until software corrections are implemented and then rebill an adjustment claim adding the preventive service that was initially removed.

CDC Releases Guide to Infection Prevention in Outpatient Settings

The CDC has released a Guide to Infection Prevention in Outpatient Settings: Minimum Expectations for Safe Care. The transition of healthcare from acute care hospitals to outpatient (ambulatory care settings), along with ongoing outbreaks associated with breakdowns in basic infection prevention, has prompted the need for this guidance. Three-quarters of all operations in the U.S. are performed on an outpatient basis, and more than 1 million cancer patients receive OP chemotherapy, radiation therapy or both. It is critical that all of this care be provided under conditions that minimize or eliminate risks of healthcare-associated infections. The new guide distills existing infection prevention guidance from the CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC) recommendations and provides links to full guidelines. Specific sections are devoted to resources needed, staff education and training, monitoring and reporting of HAIs, as well as adherence to standard precautions including hand hygiene, personal protective equipment, injection safety, and cleaning and disinfection of environment and medical equipment.

Don't forget National HIV Vaccination Awareness Day is May 18th, 2011

Save the date for next Wednesday May 18th and make note of National HIV Vaccinne Awareness Day.  For more information please click here

Missed the CHA Conference last week?

Thanks to all who attended  and participated in the Colorado Hospital Association Conference last week in Colorado Springs.  There was a great turn out of people interested in learning how to enhance rural healthcare in the communities of Colorado.  Thank you to all of the speakers for their informative presentations and for helping to make this conference the success that it was. For those of you that were not able to participate in the conference,  we have made a couple of the speaker presentations available for you on our website.   Jeremy Kelley, a senior provider relations representative for TrailBlazers gave a Medicare Update on Issues Affecting Critical Access Hospitals and  JoNell Moore, R.N., principal with Eide Bailly spoke on the Importance of Charge Capture for Reimbursement and Rate Setting for Medicare Payments.  To view the Medicare Update presentation please visit our site by clicking here  .  To learn more about Chargemaster and Medicare Reimbursement please click here . 

Advancing Health in Rural America Live Webcast

Live Webcast June 13, 2011 9:00 - 11:30 a.m. ET ( 7:00 - 9:30 MT) An AARP Solutions Forum In Collaboration with the National Rural Health Association and the Robert Wood Johnson Foundation

How can we improve health care in rural America, where a shortage of providers limits access to primary and preventive services, reduces consumer choice and can raise costs?
Join policy experts, thought leaders and key stakeholders to examine important opportunities to improve rural health found in the recommendations of the recent Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health.

We will discuss problems facing rural health care, highlight cutting-edge rural health models that are making a difference, explore state and national nursing-based solutions, and discuss policy implications for state and federal policymakers.

Click here to register to attend in person.

Click here to register for the live webcast.

"Leading The Change" Training Course

May 13 - 15, 2011
The Colorado Area Health Education Center Program and SigmaMed Solutions are pleased to announce a training course designed to prepare IT and healthcare personnel to serve as healthcare improvement and change agents in the utilization of EMRs as tools for healthcare quality.Colorado Area Health Education Center Program and SigmaMed Solutions are pleased to announce a training course designed to prepare IT and healthcare personnel to serve as healthcare improvement and change agents in the utilization of EMRs as tools for healthcare quality.
Course participants will be instructed in key elements of:The Role of EMRs in Chronic Disease Management and Quality ImprovementThe Role of EMRs in Chronic Disease Management and Quality Improvement

• How to Lead Healthcare Quality Improvement and Practice Redesign EffortsHow to Lead Healthcare Quality Improvement and Practice Redesign Efforts
• Application of Core Lean Sigma Principles to Reducing Costs and Increasing QualityApplication of Core Lean Sigma Principles to Reducing Costs and Increasing Quality
• Using Lean Six Sigma to Guide a Healthcare Facility in Attesting to Meaningful UseUsing Lean Six Sigma to Guide a Healthcare Facility in Attesting to Meaningful Use
• How to be part of Accountable Care Organizations and the Patient Centered Medical Home

The course balances group lectures with hands-on application in small groups and earns an average

 score of 9.2 on a scale of 10 on participant’s belief that they can immediately apply learning to their 

work. Following the Course, participants will have the opportunity to conduct mentored Lean Sigma

 Healthcare projects, at an additional cost, to certify as a Lean Sigma Healthcare Green or Blackbelt.How to be part of Accountable Care Organizations and the Patient Centered Medical Home. The course balances group lectures with hands-on application in small groups and earns an average score of 9.2 on a scale of 10 on participant’s belief that they can immediately apply learning to their work. Following the Course, participants will have the opportunity to conduct mentored Lean Sigma Healthcare projects, at an additional cost, to certify as a Lean Sigma Healthcare Green or Blackbelt. For more information and to register please click here .  To view the course syllabus please click here

Medicare Primary Care Incentive Payment Program

A 10 percent incentive payment is available to primary care practitioners for primary care services furnished on or after January 1, 2011, and before January 1, 2016 through the Primary Care Incentive Payment Program (PCIP). CMS has provided all contractors with a list of National Provider Identifiers (NPIs) of the primary care practitioners eligible to receive the incentive payments. A tool on the TrailBlazer website may be used to search your NPI to determine if you are eligible for the incentive. The 10 percent PCIP payment is payable to a CAH billing under the optional method for the primary care professional services of eligible primary care physicians and non-physician practitioners who have reassigned their billing rights to the CAH. Information is available on the TrailBlazer website or in CMS MLN Matters Article MM7115.

New AHRQ Resources: Health Care Needs of Underserved Women

AHRQ has several new resources addressing the health and health care needs of underserved women including women living in rural areas. Join AHRQ on May 19 for a free webinar on Meeting the Health Care Needs of Underserved Women. For more information and to register click here. AHRQ has recently posted two online quality tools addressing ways to improve health for underserved women in rural areas. To access the tools, click here.

2011 Annual CRHC CAH Advisory Council Meeting – Save the Date!

Save the date for the 2011 Annual CRHC CAH Advisory Council Meeting November 3-4. This year’s meeting, geared towards CAH CEOs, CFOs, and Quality Directors, will provide participants the opportunity to discuss key accomplishments and goals and get updates and information on issues affecting Colorado’s CAHs. More details will be available soon.

Don't forget to Register for the CMS-ICD 10 Conversion Teleconference

Wednesday, May 18, 2011  1:00 p.m. – 2:30 p.m. ET
The Centers for Medicare & Medicaid Services (CMS) will host a national provider teleconference on "CMS ICD-10 Conversion Activities". Subject matter experts will discuss the ICD-10 conversion process currently taking place within CMS, including a case study from the CMS Coverage and Analysis Group on their transition to ICD-10 for the lab national coverage determinations (NCDs). A question and answer session will follow the presentations.

Target Audience: Medical coders, physician office staff, provider billing staff, health records staff, vendors, educators, system maintainers and all Medicare fee-for-service (FFS) providers

The following topics will be discussed:

• ICD-10 overview
• Lab NCDs conversion process from ICD-9-CM to 1CD-10-CM
• Home health conversion
• OASIS and procedure code reporting
• Update on claims spanning the implementation date
• National ICD-10 implementation issues

Registration information: To register for this informative session, please go here on the CMS website. Registration will close at 1:00 p.m. ET on May 17, 2011, or when available space has been filled. No exceptions will be made. Please register early.

Part A and Part B Reprocessing Claims Information Per Affordable Care Act

Providers may view the TrailBlazer Part A Claims Reprocessing and Part B Claims Reprocessing tables for information regarding reprocessing of claims to comply with the Affordable Care Act (ACA) provisions. This includes corrections to the 2010 Medicare Physician Fee Schedule (MPFS).

The Part A Claims Reprocessing and Part B Claims Reprocessing tables indicate:

• The ACA provision.
• A description of the provision.
• The effective date of the provision.
• The implementation date of when TrailBlazer initiated the reprocessing of the claims (this includes information on previously processed claims).
• The adjustment status and any specific identifiers on the claim and/or Medicare Remittance Advice (MRA).

This information is being furnished to assist providers with identifying the specific ACA-related adjustments on the MRA as well as the time frame for completing the adjustments

How to Update a Patient’s Medicare Secondary Payer Information

Medicare processes claims based on many eligibility factors, which are taken from the Common Working File (CWF). Medicare Secondary Payer (MSP) and supplemental insurance information are updated to CWF by the Coordination of Benefits Contractor (COBC).

The COBC:

• Is contracted by CMS to consolidate the activities that support the collection, management and reporting of all other health insurance coverage for Medicare beneficiaries.
• Identifies health benefits available to Medicare beneficiaries and coordinates payment processes to prevent or minimize overpayments of Medicare benefits.
• Controls a central file for all insurance coverage, and Medicare claims are processed based on that information.

 The COBC needs the patient’s as well as the provider’s assistance in data collection to gather potential insurance information not on the Medicare patient’s file or to potentially update the information that is on file. Potential MSP situations, changes in a beneficiary’s insurance coverage, changes in employment and general MSP questions or concerns should be directed to the COBC.

 

Providers should contact the COBC to update a Medicare patient’s MSP information. Providers should also instruct Medicare patients to contact the COBC directly or to call 1-800-MEDICARE for MSP issues. Medicare patients should never be referred to TrailBlazer’s Provider Contact Center (PCC) toll-free number to update MSP situations.

 

COBC Contact Information

 Toll-Free: (800) 999-1118

 

Effective June 30, 2011 – Revised Electronic Funds Transfer (EFT) Authorization Agreement (CMS-588)

Note: The necessary changes have been made to the Provider Enrollment, Chain and Ownership System (PECOS). Therefore, CMS has changed the time frame for which Medicare contractors can accept the previous version of the Electronic Funds Transfer (EFT) Authorization Agreement from July 31, 2011, to June 30, 2011. This notice has been updated to indicate this change.

CMS has received approval from the Office of Management and Budget to reissue the Electronic Funds Transfer Authorization Agreement (CMS-588). The revised EFT authorization agreement is available on the CMS Forms Web site .

Providers and suppliers are reminded that they should begin using the revised EFT form immediately. Medicare contractors will continue to accept the previous versions of the EFT authorization agreement until June 30, 2011.

Making Health Homes Person-Centered - Free Webinar

Monday, May 16, 2011 2:00-3:30 PM Eastern

This webinar will provide an overview of the history and components of the Person-Centered Health Home model with its strong emphasis on person-centeredness, whole health, and inclusion. Presenters Chuck Ingoglia and Larry Fricks will discuss the core elements of a health home approach and provide examples of implementation. Further, webinar participants will learn how to integrate person-centered planning into health home design and implementation.
Target Audience: Primary and behavioral health providers, individuals in recovery from mental health and substance use conditions, health home administrators, and policy makers.

Webinar Objectives :
-Identify the key components of a person-centered health home
-Explain the concept and importance of “person-centeredness” and how health homes can be established around this concept
-Identify real-world examples and existing literature on health homes and how that information can be applied to design and implementation

CLICK HERE TO REGISTER *Space is limited

Medicare Finalizes Rule for Credentialing and Privileging of Telemedicine Services

The Centers for Medicare & Medicaid Services (CMS) has announced that it has finalized a rule for telemedicine services to ensure that patients in rural or remote areas will continue to receive the most cutting-edge medical care from many of their local hospitals. The final rule aims to reduce the burden of the traditional credentialing and privileging process for Medicare-participating hospitals and CAHs, both those that provide telemedicine services and those that use such services. In particular, the rule extends the option of a streamlined credentialing and privileging process to those small hospitals and CAHs that use the telemedicine services of practitioners from distant-site telemedicine entities, both Medicare- and non-Medicare-participating, in order to improve access to specialty services for patients while further reducing the regulatory burden imposed on hospitals and CAHs. A hospital or CAH that furnishes telemedicine services to its patients via an agreement with a “distant” hospital or telemedicine entity may now rely upon information furnished by the distant hospital (often a larger medical center) or telemedicine entity when making credentialing and privileging decisions for the physicians and practitioners at the distant site that will furnish the services. More information is available on the CMS Website - click here.

Start thinking now about ICD-10

May 18, from 11 a.m. to 12:30 p.m. Mountain (Colorado) time.
The healthcare industry will be required to use the ICD-10 code set beginning on Oct. 1, 2013. That may seem like a long way off, but it's important for practices to begin thinking about and preparing for this major shift now.

 

AMA has compiled multiple resources on its ICD-10 website. These include an ICD-10 timeline, which will take you through the various steps you will need to take to meet the compliance deadline, as well an ICD-10 checklist and information on the differences between ICD-9 and ICD-10. Access the website here.

 

 The American Health Information Management Association (AHIMA) has recorded a free, on-demand webinar, titled "From Point A to ICD: Successfully Implementing ICD-10." It is available here.

 

Also, the Centers for Medicare and Medicaid Services will host a free provider call to discuss the conversion process currently taking place within CMS. The agenda will include:

• ICD-10 overview
• Lab national coverage determination (NCD) conversion process from ICD-9-CM to 1CD-10-CM
• Home health conversion
• OASIS and procedure code reporting
• Update on claims spanning the implementation data
• National ICD-10 implementation issue
• A Q&A session

 For more information and to register, click here.

 

CRHC Begins Search for New CEO

The Colorado Rural Health Center has released a job description for the open Chief Executive Officer position. Applications will be accepted through the end of May.

General Description
The Chief Executive Officer is directly responsible for the viability and performance of the organization. The CEO provides strategic direction and leadership toward the achievement of the organization's mission, strategic plan, and annual goals and objectives. The CEO establishes the organization’s culture, builds and leads the senior management team, supports the Board of Directors in carrying out governance functions, and represents the organization externally by establishing and maintaining key relationships and partnerships to enhance the organization’s visibility and success.

To read a full job description and learn how to apply, click here.

Get ready for HRSA's Patient Safety and Clinical Pharmacy Services Collaborative (PSPC) Learning Session #2 (LS2)

The PSPC is achieving dramatic results in delivering patient-centered care at the community level. PSPC 3.0 includes 128 teams representing over 300 organizations — community-based health care providers around the nation that are positively impacting high-risk patients. All of the PSPC teams include a HRSA supported entity along with their safety net partners. To date, PSPC teams are bringing 40% of patients under control across a range of health conditions and reducing these patients’ rate of adverse drug events by 38%.

PSPC 3.0 teams have generated so much progress in their quality improvement efforts that we could not cover the contents of LS2 in just one event. LS2 will be a special four-part series designed to help teams and partners build and enhance their delivery systems to improve health outcomes and patient safety! Join us for all four events as we learn from community-based teams that are producing outstanding outcomes in this national quality improvement effort.

PART 1 – May 10, 2011 (12-1:30pm EDT)
Get ready for action!
This webinar helps set the stage for this powerful four-part series, as we get ready for action with teams and partners across the country.
PART 2 – MAY 24, 2011 (12-4:00pm EDT)
National broadcast – Building a system that works
A four-hour broadcast streamed over the internet with live video that will feature teams as we celebrate their success and hear their insights on how they are building and enhancing systems that work to improve health outcomes and patient safety. CE credits are offered. This is an event you don’t want to miss!

Check  here for more information and how to register.

PART 3 – Week of May 31st
Reflecting on the national broadcast
This will be a series of calls to engage in an open dialogue with teams sharing insights among peers with the same population of focus and generating action to help take their quality improvement work to the next level.

PART 4 – June 14, 2011 (12-1:30pm EDT)
“Building the PSPC Performance Story”
This webinar will conclude the series as we get into action on building and sharing the PSPC performance story.
 No registration is required.

It might be time for a Mock Survey!

Sightings of state surveyors have been noted out in the rural communities of Colorado this week. They will be conducting new surveys as well as re-surveys in the clinics.  What better way to prepare for this state conducted study then to utilize CRHC services in giving your clinic a comprehensive evaluation of compliance requirements for certified RHC's.  This service includes on site clinic inspection and basic review of RHC Policy and Procedures, review of the clinic's annual evaluation processes and review of medical charts. A professional follow up summary, recommendations and report of findings is included. To schedule your mock survey today please contact your CRHC QI specialist or send an e-mail to cr@coruralhealth.org. 

safetyNETworking Free Educational Event

Wednesday, June 1, 2011 1:00 PM to 4:00 PMsafetyNETworking is a free educational event for providers; faith-based groups; and health, social services, and community-based organizations. This event will provide you an opportunity to learn about Federal and State programs and benefits that may be available to your clients. In addition, you can meet the people who directly administer these programs and network with other organizations/agencies who may also interact with your clients. Representatives from participating Federal and State agencies will conduct breakout sessions on programs for low- to moderate-income individuals and families and will host exhibits to share important publications and resources with you.
Agencies participating in this event include:

U.S. Department of Health and Human Services, (Office of the Assistant Secretary for Health; Administration on Aging; Administration for Children & Families; Office of Civil Rights; Health Resources and Services Administration; Centers for Medicare & Medicaid Services ; Office of the Regional Director)

U.S. Department of Housing and Urban Development
Social Security Administration
U.S. Department of Agriculture (Food and Nutrition Service)
Colorado Health Care Policy & Financing (Colorado Medicaid & SCHIP)
 And many others

Location: Clarion Hotel
314 West Bijou Street
Colorado Springs, CO 80905
(Take exit #142 off I-25 )

If you plan to attend, you may RSVP to here.

Professional Patient Advocate Institute – Webinar Series

New Models to Ensure Patient-Centered Care: The Evolving Role of Hospital Patient Advocacy
May 17, 2011, at 12:00-1:30 p.m. (EST)                      Earn 1.5 CEUs
Healthcare is at a turning point. The industry is under intense scrutiny to improve quality, ensure safety and reduce costs. The Joint Commission and Centers for Medicare and Medicaid both require that organizations have processes and staff in place that can meet concerns patients and their families may have regarding their stay. How is your organization responding to this call to action?
Today with the emphasis on patient and family centered care, the hospital patient advocate is viewed as the voice of the patient and the family when they are in an acute care hospital, a specialty hospital, a skilled care facility or another in-patient setting.
Join your peers and gather your staff to attend our next webinar to learn about improving the patient care experience through the model of the hospital patient advocate. We have brought together a seasoned faculty who will share their diverse expertise as hospital patient advocates and provide information you can utilize to improve your own practice and organizations performance - whether that is a hospital, clinic, rehab center, social service organization, private practice or any organization where you are advocating on behalf of patients
PPAI Member Price: $145, Non-Member Price: $329

By attending the webinar you will:

Learn why there is a call to action to improve the patient care experience.

Learn about the role and function of the hospital patient advocate.

Understand how other members of the care coordination team can collaborate with the hospital patient advocate to improve processes.

Learn about the issues and concerns patient advocates handle on a day-to-day basis.

Share how patient advocates can assist organizations in implementing the six aims recommended by the Institute of Medicine.

Learn how patients and families find comfort in having a designated professional who is responsible for recognizing patient’s challenges and concerns

Learn how patient advocates can ensure a safe encounter for patients and families.

Understand what requirements organizations must follow to ensure patient- and family-centered care.

Learn the competencies that patient advocates need to have to be able to be proficient in their role.

Discover the various reporting structures patient advocates adhere to.

Learn about the patient satisfactions surveys and the impact on an organization’s performance.

Program Objectives

• Define the role and function of the hospital patient advocate.
• Describe the value the patient advocate brings to organizations.
• Share best practices achieved by hospital patient advocates to transfer these ideas to other groups and organizations.

Who should attend?

Administrators

Behavioral Health Professionals

Case/Care Managers

Clinical Nurses

Patient Advocates

Risk Managers

Quality and Safety Professionals

Social Workers

Others members of the healthcare team

Register Today

Join the CMS' Director of Performance-Based Payment Policy to Discuss New Efforts to Improve Care for Medicare Beneficiaries

May 9th, 1:00 - 2:00 MDTPlease join the Centers for Medicare & Medicaid Services (CMS) on May 9 1:00-2:00 MDT for a conference call with John Pilotte, CMS Director of Performance-Based Payment Policy, to discuss proposed new rules to help doctors, hospitals, and other health care providers offer better coordinated care for Medicare patients through ACOs. This call is intended to help the public understand what the CMS is proposing to do and to ensure that the public understands how to participate in the formal comment process. To join the call, dial 888-989-4351, conference ID, 5320738.

CMS PROPOSES TO EXPAND ACCESS TO SEASONAL INFLUENZA IMMUNIZATION

The Centers for Medicare & Medicaid Services (CMS) proposed new requirements designed to expand access to seasonal influenza vaccination. The proposed rule would require many Medicare providers and suppliers to offer all patients an annual influenza vaccination during flu season, unless medically contraindicated. As always, any patient would retain the right to decline any vaccination. This proposed requirement would extend to Medicare-certified:

• Hospitals, including Short-term Acute Care, Psychiatric, Rehabilitation, Long-Term Care, Children’s, and Cancer;
• CAHs 
• RHCs;
• FQHCs and;
• ESRD Facilities that offer dialysis services.

The proposed rule would update the conditions of participation and conditions for coverage for all of the provider types above. CMS will accept public comments on the proposed rule until July 5, 2011, and will respond to comments in a final rule to be published in the coming months. To submit comments, please visit http://links.govdelivery.com/track?type=click&enid=bWFpbGluZ2lkPTEzMzUxMDUmbWVzc2FnZWlkPVBSRC1CVUwtMTMzNTEwNSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2MTY2OTkmZW1haWxpZD1qZEBjb3J1cmFsaGVhbHRoLm9yZyZ1c2VyaWQ9amRAY29ydXJhbGhlYWx0aC5vcmcmZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&101&&&http://www.,regulations.gov/ and search for rule “CMS-3213-P.” The proposed rule is available online, click here. A press release about the proposed rule is also available on the CMS website by clicking here.

The March to Accountable Care Organizations—How Will Rural Fare

Rural provider participation in ACOs will require collaboration
among rural providers and with larger, often urban, health care systems. Rural
providers should strengthen their negotiation capacities by developing rural
provider networks, understanding large health system motivations, and adopting
best practices in clinical management. Rural communities should generate
programs that motivate their populations to achieve and maintain optimum
health status. Policy makers should develop rural-relevant ACO-performance
measures and provide necessary technical assistance to rural providers and
organizations. To read entire article please click here

Free Educational Webinar - "Acute Stroke: Thrombolysis for the Emergency Physician"

Tuesday May 24, 2011 12:30-1:30 p.m. CST
The SouthWest Affiliate of the American Heart Association invites you to join us for a free educational webinar, “Acute Stroke: Thrombolysis for the Emergency Physician” Join AHA staff, volunteers and guest lecturer Joshua N. Goldstein, MD, PhD as we take an in-depth look at acute care of patients with cerebrovascular emergencies who may benefit from receiving tPA in the ED setting.

Currently, less than 85 percent of eligible stroke patients receive tPA. Dr. Goldstein is a board certified emergency physician, specializing in training and administration of tPA. He is currently on staff at Massachusetts General Hospital and is an Assistant Professor at Harvard Medical School. Dr. Goldstein manages a research program aimed at improving the care of patients with neurologic emergencies and has published numerous original research articles, chapters and reviews.
Space is limited so reserve your Webinar seat now.
Continuing education credits have been applied for and may be available. Physicians, nurses and EMS providers must preregister to receive CE credit.
Call in information: 866-510-8815, Pass code: Participant 8667704

Part A and Part B Reprocessing Claims Information Per Affordable Care Act

Providers may view the TrailBlazer Part A Claims Reprocessing and Part B Claims Reprocessing tables for information regarding reprocessing of claims to comply with the Affordable Care Act (ACA) provisions. This includes corrections to the 2010 Medicare Physician Fee Schedule (MPFS).

• The Part A Claims Reprocessing and Part B Claims Reprocessing tables indicate:
• The ACA provision.
• A description of the provision.
• The effective date of the provision.
• The implementation date of when TrailBlazer initiated the reprocessing of the claims (this includes information on previously processed claims).
• The adjustment status and any specific identifiers on the claim and/or Medicare Remittance Advice (MRA).

This information is being furnished to assist providers with identifying the specific ACA-related adjustments on the MRA as well as the time frame for completing the adjustments.