Registration for The Consortium webinar on Jan. 15, 2015

Please join us for the next webinar in our HIT EDUCATIONAL SERIES on Thursday, January15, 2015 from 12:00 pm to 1:00 pm. 

In this webinar, we will discuss ICD-10, Meaningful Use, and changes to HIPAA and what it will look like navigating this HIT maze in 2015.

   

This webinar series is free to hospitals participating in the Colorado FY2014 SHIP grant program as well as CRHC members.  All other facilities will be invoiced $49 following the webinar.  

https://cc.readytalk.com/r/b9btkwp6moi3&eom

Medicare Part A and B News-Jurisdiction H for December 30th, 2014

The following information is provided by Novitas Solutions.

Holding of 2015 Date-of-Service Claims and DMEPOS Competitive Bidding Registration Reminder

CMS Provider Education Message:

Holding of 2015 Date-of-Service Claims for Services Paid Under the 2015 Medicare Physician Fee Schedule

On November 13, 2014, the CY 2015 Medicare Physician Fee Schedule (MPFS) final rule was published in the Federal Register. In order to implement corrections to technical errors discovered after publication of the MPFS rule and process claims correctly, Medicare Administrative Contractors will hold claims containing 2015 services paid under the MPFS for the first 14 calendar days of January 2015 (i.e., Thursday January 1 through Wednesday January 14). The hold should have minimal impact on provider cash flow as, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.

MPFS claims for services rendered on or before Wednesday Dec 31, 2014 are unaffected by the 2015 claims hold and will be processed and paid under normal procedures and time frames.

Registration Reminder for DMEPOS Competitive Bidding: Round 2 Recompete & National Mail-Order Recompete

CMS would like to remind all suppliers that registration is now open for those interested in participating in the Round 2 Recompete and/or the national mail-order recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. In order to submit a bid(s) for the Round 2 Recompete and/or the national mail-order recompete, you must first register in the Individuals Authorized Access to CMS Computer Services (IACS) online application. Once you have registered in IACS, you will receive a user ID and password to access the online DMEPOS Bidding System (DBidS). You must register even if you registered during a previous round of competition (Round 1 Recompete, Round 2, or the national mail-order competition). Only suppliers who have a user ID and password will be able to access DBidS; suppliers that do not register will not be able to submit a bid.

If you are a supplier interested in bidding, you must designate one individual listed as an authorized official (AO) on your organization’s CMS-855S enrollment application in the Provider Enrollment, Chain, and Ownership System (PECOS) to act as your AO for registration purposes. After an AO successfully registers, other individuals listed as an AO on the CMS-855S in PECOS may register as backup authorized officials (BAOs).The AO must approve a BAO’s request to register. The AO and BAOs can designate other individuals not listed as an AO on the CMS-855S in PECOS to serve as end users (EUs).BAOs and EUs must also register for a user ID and password in IACS in order to access DBidS. The name and Social Security number of the AO and BAO entered in IACS must match exactly with what is recorded on the CMS-855S and on file in PECOS to register successfully. Bidders are prohibited from sharing user IDs and passwords.

CMS strongly urges all AOs to register no later than January 6, 2015, to ensure that BAOs and EUs have time to register. We recommend that BAOs register no later than January 20, 2015, so that they will be able to assist AOs with approving EU registration before bidding begins on January 22, 2015.

Registration extends into the bidding period and will close on Tuesday, February 17, 2015 at 9pm prevailing ET– no AOs, BAOs, or EUs can register after registration closes. Bidding will close on Wednesday, March 25, 2015.

To register, go to the Competitive Bidding Implementation Contractor (CBIC) website, www.dmecompetitivebid.com, click on Round 2 & National Mail-Order Recompete, and then click on "Registration is Open” above the Registration clock. CMS strongly recommends that you:

• Review the IACS Reference Guide, 
• Watch the short and very helpful instructional video, “How to Register to Submit a Bid,” on your computer, tablet, or phone, and 
• Use the IACS: Getting Started Registration Checklist. 

CMS would also like to remind you to:

• Review and update your enrollment records. Suppliers must maintain accurate information on their CMS-855S enrollment application with the National Supplier Clearinghouse (NSC) and in PECOS. It is important to note that if your record is not current at the time of registration, you may experience delays and/or be unable to register and bid. We will also validate your bid data against your enrollment record in PECOS during bid evaluation. If it is not current or accurate, your bid(s) may be disqualified. 
• Get licensed. Supplier locations must be licensed as applicable by the state in which it furnishes, or will furnish, products and services under the DMEPOS Competitive Bidding Program. 
• Get accredited. Supplier locations must be accredited by a CMS-approved accrediting organization for the products and services it furnishes, or will furnish, under the DMEPOS Competitive Bidding Program. 

The CBIC is the official information source for bidders. All suppliers interested in bidding are urged to sign up for E-mail Updates on the home page of the CBIC website. For information about the Round 2 Recompete and the national mail-order recompete, please refer to the bidder education materials located under Round 2 & National Mail-Order Recompete > Bidding Suppliers on this website. The CBIC participates in numerous educational events to assist stakeholders in understanding the rules that govern the DMEPOS Competitive Bidding Program. Visit the CBIC website for a listing and schedule of educational events under the Educational Information section of the Round 2 & National Mail-Order Recompete page.

In addition to viewing the information on the CBIC website, suppliers are encouraged to call the CBIC customer service center toll-free, at 877-577-5331, with their questions. During registration and bidding periods, the customer service center will be open from 9am to 9pm ET.


Medicare News
Medicare Learning Network (MLN) Articles from CMS

New:

• MM9002 – Transcatheter Mitral Valve Repair (TMVR)-National Coverage Determination (NCD)
• MM9018 – 2015 Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List
• MM9028 – Calendar Year (CY) 2015 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

Revised

• SE1435 – FAQs – International Classification of Diseases, 10th Edition (ICD-10) End-to-End Testing

HPSA/MUA Shortage Designations 2.0 Webinar

HPSA/MUA Shortage Designations 2.0 Webinar

In 2014, HRSA's Bureau of Health Workforce began rolling out the Shortage Designation Management System (SDMS), a new online system for shortage designation applications such as HPSA and MUAs/MUPs. The SDMS leverages a number of federal data sources (Census, CDC, and NPI) to streamline the shortage designation application process. Join us for this important webinar where Bureau of Health Workforce officials will outline the data sources used, and discuss how the new application functionality works.

The HPSA and MUA/MUP designation determines your access to additional reimbursement, participation in targeted programs and a threshold for grant applications. Knowing the changes that are taking place will give you a head's up on potential negative consequences and how to deal with same should it be necessary.

The faculty for this webinar is Kae Brickerd, Ph.D., MPH, Chief, and Melissa Ryan, MPH, Operations Director, both of the Bureau of Health Workforce, Shortage Designation Branch, Division of Policy and Shortage.

Date: Wednesday, January 7, 2015
Time: 3:00 pm ET

You can also register here:
https://attendee.gotowebinar.com/register/1912933991785270530

Novitas Solutions System Alert for December 29

The following is an announcement from Novitas Solutions 

Due to a systems problem at the CDS data center, there were no payments issued from the Part B shared systems cycle for Monday, December 29, 2014. The problem was resolved and the payments for December 29 will be combined with the payments from December 30 and issued in the December 30, 2014 batch cycle. We apologize for this inconvenience.

Treasury Finalizes Patient Protection Regulations for Tax-Exempt Hospitals

Monday, the U.S. Department of the Treasury took the final step to provide guidance on these provisions, many of which are already in effect, to protect consumers. As a condition of their tax-exempt status, charitable hospitals must take an active role in improving the health of the communities they serve, establish billing and collections protections for patients eligible for financial assistance, and provide patients with the information needed to apply for such assistance. Click here for more.

MLN Matters January 2015

Summary of Policies in the Calendar Year 2015: Click here

ACA Implementation News

The latest issue of the Department of Health Care Policy and Financing’s ACA Implementation News is now available online here. Please feel free to forward this along to your colleagues that may find the content of interest.

If you would like to receive ACA Implementation News or our ACA Communication Updates please click here.

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

The following information is provided by Novitas Solutions

Web Maintenance: Self-Service Tools

We will be preforming routine maintenance on several of our self-service applications tonight, December 18, 2014 from 6:30 PM EST - 9:30 PM EST. You may experience temporary outages with the applications listed below. We apologize for the inconvenience.

• Appeals Status Tool 
• Enrollment Status Tool 
• Fee Lookup Tool 
• MEDPARD Directory Search Tool 
• Credit Balance Status Tool 
• CERT Lookup Tool 

Medicare News

2015 January JH/JL Part A and B Calendar of Events

The January 2015 Calendar of Events for both Jurisdiction L and H is currently available for your viewing pleasure. Please take this opportunity to be the first in line for the January 2015 sessions! You don't want to miss any of them.

Register today!

MLN Connects Provider eNews for December 18th, 2014

View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

• Medicare Quality Reporting Programs: Data Submission Process — Registration Opening Soon 
• IRF PPS: New IRF-PAI Items Effective October 1, 2015 — Registration Now Open 
• ESRD QIP Payment Year 2017 and 2018 Final Rule — Registration Now Open 
• New MLN Connects™ National Provider Call Video Slideshow, Audio Recording, and Transcript 

CMS Events

• Volunteer for ICD-10 End-to-End Testing in April — Forms Due January 9 

Announcements

• CDC Continues to Recommend a Flu Vaccine as the Best Way to Protect Against the Flu 
• Revisions to Certain Patient’s Rights Conditions of Participation and Conditions for Coverage Overview 
• HIS Data Collection for FY 2016 Annual Payment Update Ends December 31 
• IRF-PAI Training Manual Updated with Information on New Items Effective October 1, 2015 
• Frequently Asked Questions on DMEPOS 2015 Medicare Payment Final Rule 
• Open Payments: Final Rule Changes Related to Continuing Education Events 
• Comparative Billing Report on Modifier 59: Dermatology 

Claims, Pricers, and Codes

• Reprocessing of IPPS Claims Assigned to DRG 410, 573 or 907 

Medicare Learning Network® Educational Products

• “FAQs – International Classification of Diseases, 10th Edition (ICD-10) End-to-End Testing” MLN Matters® Article — Released 
• “Medical Privacy of Protected Health Information” Fact Sheet — Revised 
• Medicare Learning Network Products® Available In Electronic Publication Format

Quick Tip for CREATE Grant Applications

There are several important pieces to a successful CREATE Grant Application. Explaining your request amount is critical. Providing as much detail and information as possible up-front strengthens your application and allows for a smoother overall application, award, and reimbursement process. As you are filling out your CREATE Grant Application, you will notice that you are asked to provide a break-down of each fee including description and amount. If you are applying for “fees”, you must explain what those fees provide and for what each portion of the fee pays (books, parking, etc.). As outlined in the July 2014 – June 2015 Grant Guidelines, CREATE does not cover the following expenses: (1) Vaccinations or personal protective equipment; (2) Background checks; (3) Meals including per diem allowance; (4) Uniforms and shoes; (5) Purchasing or leasing or training equipment; (6) Stethoscopes, sphygmomanometers or other durable medical equipment. Detailing the fee break-down may take some time and effort since you may need to track down that information from other individuals, agencies or organizations, so as always, start the application process early as possible.


If you have any questions about the CREATE Grant process, please contact Megan Lyda at ml@corurualhealth.org.

Helping Consumers Prepart for Tax Season Webinar

Marketplace Webinar Invitation – Friday, December 19 at 2pm ET – 3:30pm ET

Please join us for a webinar where we will discuss upcoming changes for tax season related to the Marketplace. We will also share guidance on special enrollment periods (SEPs). SEPs will be available for consumers who experience a gap in coverage as a result of certain circumstances related to the auto re-enrollment process in the Federally-facilitated Marketplace during the 2015 Open Enrollment period.

What:

Helping Consumers Prepare for Tax Season // Special Enrollment Periods for Auto Re-enrollment Issues

When:
Friday, December 19, 2014 from 2:00 p.m. to 3:30 p.m. ET


RSVP:

To facilitate a quicker registration process on the day of the event, please register for the session by visiting the following link: https://goto.webcasts.com/starthere.jsp?ei=1049565

Space is limited – we strongly encourage individuals from the same organization to gather in a common room and participate as a group using a single computer or call-in line.

The audio portion of the webinar will be delivered via your computer. Please login 10 minutes before the webinar start time to check your computer settings.

Medical Necessity Benefits Collaborative

Dear Stakeholders:

The Department of Healthcare Policy and Financing has tentatively scheduled a public meeting to discuss consolidating various definitions of medical necessity into a single definition that may be applied across our programs. Anyone who wishes to participate in the meeting may do so.


More information will be forthcoming.

If you think you may plan to attend, please save the following date on your calendar:

Tuesday, January 13, 2015

2:30pm – 4:30pm

Department of Health Care Policy and Financing
225 E 16th Ave., Sixth Floor Conference Rooms A and B


Please note that the date and location of this meeting may be subject to change and meeting room space may be limited.

RSVPs will be required and can be emailed to BenefitsCollaborative@state.co.us or call 303-866-3977.

Reasonable accommodations will be provided upon request.

2nd Annual Suicide Prevention Event - Elevating the Conversation

Save the Date:


suicide to Hope is a one day workshop targeting the clinical workforce and other professional caregivers working with persons recently at risk of and currently safe from suicide.


Recovery and growth approaches have demonstrated significant positive impacts in mental health, substance abuse and trauma but have not been developed for use with those recovering from suicide. To meet this need, LivingWorks is developing suicide to Hope: A Recovery and Growth Workshop that will provide clinical workers and other professional caregivers with skills to help persons recently at risk identify opportunities for recovery and growth arising out of their experiences with suicide. Click here for more information on Suicide to Hope


February 27th: Elevate the Conversation Skills Training

8:00am - 5:00pm

"Learning through Lived Experience"

This is the 2nd annual Elevating the Conversation event featuring the most recent research, thought provoking perspectives, and skills-based training on suicide risk assessment, management, and grief support for:

• Healthcare professionals
• Behavioral health & mental health providers
• Peer supporters
• Bereavement support providers
• All those interested in learning more!

About this year's theme "Learning through Lived Experience:"


For far too many years suicide prevention has not engaged the perspectives of those who have lived through suicidal experiences. Because of social stigma and fear, as well as personal shame, a culture of silence prevailed. This year's event is an opportunity to benefit from the lived experience of suicide attempt survivors. Elevate the Conversation training will also help serve as a bridge to developing a conversation about suicide prevention between mental health policy makers and consumer advocates.


The workshop is collaboratively supported by the Carson J Spencer Foundation, Colorado Psychological Association, Judi’s House, Suicide Prevention Coalition of Colorado, and University of Denver’s School of Social Work and Graduate School of Professional Psychology.

For more information contact Sally Spencer-Thomas at Sally@CarsonJSpencer.org.


Learning Objectives:

• Appreciate the experience of suicidal intensity (thoughts, behaviors and loss) from people with personal and professional lived experience
• Articulate recommendations from suicide attempt survivors on differential effectiveness of mental health interventions
• Understand how best practices inform legal protections and reduce risk
• Learn about resources available to reduce suicide risk, help suicidal clients and improve self-care for professionals affected by suicide
• Apply intervention tools to specific populations of practice

(Intermediate level of instructional activity)


Pricing:

On or before January 31st

General - $99
Student - $45


Additional Training Opporunity:

suicide to Hope: A Recovery and Growth Workshop provides tools to help clinical workers and persons with experiences of suicide work together to develop achievable and significant recovery goals.

- Suicide to Hope (click here for more info) - (additional $100)

After January 31st

General - $125
Student - $65

Additional Training Opporunity

suicide to Hope: A Recovery and Growth Workshop provides tools to help clinical workers and persons with experiences of suicide work together to develop achievable and significant recovery goals.

- Suicide to Hope (click here for more info) - (additional $100)


*Cancellation Policy: No Refunds*

Colorado Rural Health Center Webinars

Visit the Colorado Rural Health Center's events page to register for upcoming webinars!

Medicare Part A and B News-Jurisdiction H for December 8th, 2014

The following information is provided by Novitas Solutions.

December 2014 Events Calendar Update

Updates have been made to the times of the following webinars: 

• 12/11/2014 New & Small Provider Education Part 2 - Part A Claim Overview (10:00am-11:30am ET, 9:00am-10:30am CT) 
• 12/12/2014 PC-ACE Pro32 (10:00am-11:00am ET, 9:00am-10:00am CT) 
• 12/17/2014 New & Small Provider Education Part 2 - Part B Claim Overview (10:00am-11:30am ET, 9:00am-10:30am CT) 
• 12/18/2014 Credit Balance (2:00pm-3:30pm ET, 1:00pm-2:30pm CT) 

Website Satisfaction Surveys

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

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




Medicare Learning Network (MLN) Articles from CMS

New:

• MM8969 – Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2015
• MM8994 – Claim Status Category and Claim Status Codes Update

Revised:

• MM8978 – Implementation of Changes in the End-Stage Renal Disease Prospective Payment System (ESRD PPS) for Calendar Year (CY) 2015

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

The following information is provided by Novitas Solutions.

Updates to IRIS Software

The Intern and Resident Information System (IRIS) software programs (IRISV3 and IRISEDV3) each have three updated files (medical school codes, residency type codes, and IRISV3 Operating Instructions) for collecting and reporting information on resident training in hospital and non-hospital settings. They are categorized as follows:

August 2014 IRISV3 Operating Instructions and Excerpts from IRISV3 Operating Instructions to Use with IRISEDV3 (mandatory for cost reporting periods beginning before July 1, 2014):

• CMS added nine new IRIS residency type codes to the IRIS Residency Type Code Table.
• CMS also added seven new IRIS medical school codes to the IRIS Medical School Code Table.
• Providers may begin using the new medical school and residency type codes in the IRIS programs for cost reporting periods ending on or after June 30, 2014.

September 2014 IRISV3 Operating Instructions and Excerpts from IRISV3 Operating Instructions to Use with IRISEDV3 (mandatory for cost reporting periods beginning on or after July 1, 2014):
• CMS renumbered IRIS residency type codes in the IRIS Residency Type Code Table; CMS removed obsolete IRIS residency type codes from this table.
• CMS removed obsolete IRIS medical school codes from the IRIS Medical School Code Table.
• Providers must use the renumbered IRIS residency type codes in the IRIS programs for cost reporting periods beginning on or after July 1, 2014.

The IRIS programs are available for downloading via the IRIS website (http://go.usa.gov/Grw3).



Medicare Learning Network (MLN) Articles from CMS

New:
SE1434 – Provider Enrollment Requirements for Writing Prescriptions for Medicare Part D Drugs



Medical Policy Updates

The following JH Local Coverage Determinations (LCDs) which were posted for notice on October 9, 2014 are now effective:

• Cardiac Event Detection Monitoring (L32679) 
• Cardiac Rhythm Device Evaluation (L30529) 
• Intravenous Immune Globulin (IVIG) (L32712) 
• Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (L32610) 
• Pharmacokinetic (PK) Testing for Chemotherapy Dosing (L35269) 
• Routine Foot Care (L27486) 
• Services That Are Not Reasonable and Necessary (L31686) 
• Transoral Incisionless Fundoplication (L32932) 
• Treatment of Varicose Veins and Venous Stasis Disease of the Lower Extremities (L32678) 

The following JH Local Coverage Article has been added:

• Routine Foot Care (A51184)

The following JH LCDs have been retired effective December 3, 2014:

• Category III Codes (L32691) 
• Extracorporeal Shock Wave Therapy (ESWT) (L32729) 
• Lumbar Matrix Scan (L32609) 
• Off Label Use Autologous Cellular Immunotherapy Treatment of Malignancy of Prostate (L32615) 
• Routine Foot Care (L32669) 
• Transoral Incisionless Fundoplication (L32620) 

Customer Contact Center Survey "How are we doing?"

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

Reminder: 2015 Medicare Part B Fee Schedules Available Now
If you haven't already had a chance to download the new 2015 fee schedules, now is your chance! You can access our new Fee Search & Download Tool that offers a quick, convenient way to download the files or search by a single code.

MLN Connects Provider eNews for December 4th, 2014

MLN Connects™ Provider eNews for December 4, 2014
View this editions as a PDF

In This Edition:
MLN Connects™ National Provider Calls
• National Partnership to Improve Dementia Care in Nursing Homes — Last Chance to Register
• Certifying Patients for the Medicare Home Health Benefit — Register Now

MLN Connects™ Videos

• Monthly Spotlight: Physician Feedback Program/Value-based Payment Modifier

CMS Events

• Webinar for Comparative Billing Report on Modifier 25: Family Practice

Announcements

• National Influenza Vaccination Week – December 7-13
• CMS Releases New Proposal to Improve Accountable Care Organizations
• Efforts to Improve Patient Safety Result in 1.3 Million Fewer Patient Harms, 50,000 Lives Saved and $12 Billion in Health Spending Avoided
• Provider Enrollment Application Fee Amount for CY 2015
• CMS is Accepting Suggestions for Potential PQRS Measures

Claims, Pricers, and Codes

• ICD-10 MS-DRGs v32 Software Now Available
• Inpatient PPS FY 2014.8 PC Pricer Updated
• Clarification of Specialty Care Transport Payment Policy for Ambulance Transportation Services

Medicare Learning Network® Educational Products

• “Affordable Care Act Provider Compliance Programs: Getting Started” Web-Based Training Course — Released
• “Complying With Medical Record Documentation Requirements” Fact Sheet — Released
• “Hospital Reclassifications” Fact Sheet — Revised
• Medicare Learning Network® Product Available In Electronic Publication Format

Medicare Part A and B News-Jurisdiction H for December 8th, 2014

The following information is provided by Novitas Solutions.

Medicare News
November 2014 Medicare Part A Newsletter
The November 2014 Medicare Part A Newsletter is now available! Please take a moment to review.

Part A Top Claim Submission Errors
The Top Claim Submission Errors and resolutions for November 2014 are now available. Please take time to review these errors and avoid them on future claims.

Revalidation for Jurisdiction H (JH) Providers and Suppliers
Novitas has updated the Revalidation Request Mailing Schedule on our website. As outlined in the Schedule, mailings began on December 16, 2014 and will continue through January 8, 2015. These mailings comprise approximately 9,700 providers/suppliers. The Centers for Medicare and Medicaid Services (CMS) will publish the listing of providers/suppliers included in these mailings on their website approximately 3-4 weeks after all contractors have provided their mailing information for the months of December – January. You may also use our Provider Enrollment Status Inquiry Tool to determine if a revalidation notice was issued.

If you have questions related to the revalidation initiative, please visit our Enrollment Center for more information.

Coding for ICD-10-CM

Coding for ICD-10-CM: More of the Basics MLN Connects™ Video

In this MLN Connects™ video on Coding for ICD-10-CM: More of the Basics, Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) provide a basic introduction to ICD-10-CM coding. The objective of this video is to enhance viewers’ understanding of the characteristics and unique features of ICD-10-CM, as well as similarities and differences between ICD-9-CM and ICD-10-CM. The video covers:

• How to assign a diagnosis code using ICD-10-CM 
• ICD-10-CM code structure 
• Coding process and examples: Combination codes, 7th character, placeholder “x,” excludes notes, unspecified codes, external cause codes 
• Resources for coders 

Keep Up to Date on ICD-10
Visit the Medicare Fee-For-Service Provider Resources web page for a complete list of MLN Connects videos on ICD-10. To receive announcements for MLN Connects videos and the latest Medicare program information, subscribe to the weekly MLN Connects Provider eNews.

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

President Obama signed into law H.R. 4067

President Obama signed into law H.R. 4067, which will extend to all of calendar year 2014 the enforcement moratorium on the outpatient therapeutic services “direct supervision” policy for Critical Access Hospitals (CAHs) and rural prospective payment system hospitals with 100 or fewer beds.

H.R. 4067 was introduced by Senator Jerry Moran (R-KS) and Congresswoman Jenkins (R-KS) and passed both the House and Senate. The National Rural Hospital applauds the leadership of Sen. Moran and Rep. Jenkins for this important bill for CAHs and small rural hospitals.

View article here

Rural Access to Emergency Devices (RAED) Training Funds

Colorado Rural Health Center has limited funding available through the Health Resources and Services Administration’s federal Office of Rural Health Policy RAED grant, to train first responders, as well as community members in CPR/AED courses. Entities eligible for this funding must be located in rural Colorado counties (contact Ron Seedorf for questions on eligibility) and courses must have been completed between 6/01/14 and 3/1/15. For more information, please follow this link: RAED Training and Education Funds

For all questions regarding this funding contact:
Ron Seedorf at 970-302-9021 or rs@coruralhealth.org

Best Practices for Health Insurance Marketplace Outreach and Enrollment in Rural Areas

Best Practices for Health Insurance Marketplace Outreach and Enrollment in Rural Areas

The Affordable Care Act provided coverage through the Health Insurance Marketplace to nearly seven million people during the first open enrollment period. Yet, research suggests that the enrollment rates for eligible individuals living in rural areas was less than enrollment rates for those living in urban areas. That may be due, in part, to specific challenges in rural communities, including lack of internet access, low population density, travel barriers to obtaining help, or strong political opposition to “Obamacare.”

Among rural communities, there was considerable variation in the enrollment rate. Key informant interviews were conducted of navigators, health centers, Certified Application Counselors, and other partner organizations to try to identify best practices for marketing, outreach and education, in-reach (identifying eligible current clients), and enrollment in rural communities. The fact sheet highlights some of the best practices identified through these interviews.

Contact Information:

Pam Silberman, JD, DrPH
North Carolina Rural Health Research and Policy Analysis Center
Phone: 919-966-4525
pam_silberman@unc.edu 

Additional Resources of Interest:

• Successful Health Insurance Outreach, Education, and Enrollment Strategies for Rural Hospitals
• More information about the North Carolina Rural Health Research and Policy Analysis Center
• More information from the Rural Assistance Center, Health Insurance Outreach and Enrollment topic guide

FAQ for the CREATE Application Process

How long should I give myself to apply for a CREATE grant?

Applying for a CREATE grant should not be left until the last minute. In order to receive a grant number and access to the application, you must first complete the five pre-application steps outlined in the grant guidelines. Because of this, it is not advised to start the pre-application process right before the application deadline. Once all five pre-application steps have been completed successfully and these items have been verified by CRHC CREATE grant staff, a confirmation email is sent to the applicant within 3 business days that includes login instructions to access the grant application.  Once you have access to the application, it is to your advantage to allow ample time to craft a well-written application, seek feedback from others, and ultimately submit a grant that accurately reflects the needs of your organization. 

If you have any questions about this, please contact Liz Kelman at lk@coruralhealth.org

Medicare Part B News-Jurisdiction H for December 2nd, 2014

The following information is provided by Novitas Solutions.

Appeals Status Tool - NOW AVAILABLE

UPDATE: The Appeals Status tool is now back up and running. We apologize about the delay.

UPDATE 12/1/2014 @ 3:50 PM: We have identified the root cause of the problem and are working to restore functionality as soon as possible. We apologize about the inconvenience to you.

ISSUED 12/1/2014 @ 9:15 AM: We are currently experiencing problems with our online appeals status tool. Certain browsers are becoming unresponsive when using the tool. We are looking into these technical issues and will post an update as soon as possible.


Medicare News

New Novitas Medicare Learning Center FAQ - Waitlisting
A new Novitas Medicare Learning Center Frequently Asked Question (FAQ) about waitlists for educational events has been added to the website. Please take a moment to review for more information about what it means to be placed on a waitlist and what happens to your registration for the event.


2014 Fourth Quarter Medicare Report
The 2014 Fourth Quarter JL and JH Part B Medicare Report is now available for your review.


Medicare Learning Network (MLN) Articles from CMS

Rescinded:

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

MLN Connects Provider eNews for November 26th, 2014

MLN Connects™ Provider eNews for November 26, 2014
View this edition as a PDF

In This Edition:

MLN Connects™ National Provider Calls

• 2015 Physician Fee Schedule Final Rule: Changes to Physician Quality Reporting Programs — Last Chance to Register 
• National Partnership to Improve Dementia Care in Nursing Homes — Register Now 
• Certifying Patients for the Medicare Home Health Benefit — Register Now 

CMS Events

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

Announcements

• In Observance of World AIDS Day — Remember HIV Screenings 
• CMS Creates New Chief Data Officer Post 
• Get Ready for DMEPOS Competitive Bidding 
• EHR Incentive Programs: Hardship Exception Applications due November 30 
• New EHR Attestation Deadline for Eligible Hospitals: December 31 

Claims, Pricers, and Codes

• Hospice Notices Returned to Provider 
• MA Claims Issue for FQHCs that Bill Under the AIR System 

Medicare Learning Network® Educational Products

• “Hospice Related Services – Part B” Podcast — Revised 
• New Medicare Learning Network® Educational Web Guides Fast Fact 
• Submit Your Feedback on the Medicare Learning Network® Learning Management System and Product Ordering System 
• Medicare Learning Network® Product Available in Electronic Format

Medicare Part A and B News-Jurisdiction H for December 3rd, 2014

The following information is provided by Novitas Solutions.

Medicare News

Medicare Learning Network (MLN) Articles from CMS
New:

• MM8983 – Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) Rule - Update from CAQH CORE
• MM8908 - Quarterly Update to the Correct Coding Initiative (CCI) Edits, Version 21.1, Effective April 1, 2015

Clarification of Specialty Care Transport (SCT) Payment Policy for Ambulance Transportation Services:

Specialty Care Transport (SCT) under the Fee Schedule for Ambulance Services is defined in 42 CFR §414.605 as an interfacility transportation of a critically injured or ill beneficiary by a ground ambulance vehicle, including medically necessary supplies and services, at a level of service beyond the scope of the Emergency Medical Technician (EMT)–Paramedic. SCT is necessary when a beneficiary’s condition requires ongoing care that must be furnished by one or more health professionals in an appropriate specialty area, for example, nursing, emergency medicine, respiratory care, cardiovascular care, or a paramedic with additional training.

In the December 1, 2006 Final Rule (71 FR 69716), CMS expanded the definition of “interfacility” to include both hospitals and skilled nursing facilities (SNFs). CMS considers a “facility” to include only a SNF or a hospital that participates in the Medicare program, or a hospital-based facility that meets our requirements for provider-based status as specified at 42 CFR §413.65. Medicare hospitals include, but are not limited to, rehabilitation hospitals, cancer hospitals, children’s hospitals, psychiatric hospitals, Critical Access Hospitals (CAHs), inpatient acute care hospitals, and Sole Community Hospitals (SCHs).

Webinar: Prevention Strategies to Protect Women Working in Agriculture

Prevention Strategies to Protect Women Working in Agriculture

Date: Wednesday, December 10, 2014
Time: 12:00pm - 1:00pm Central Time

Summary:

The range of farm activities compound the problem of assuring a safe worksite for farm women who have their own inherent contraindications. Safety education for the agricultural population is often aimed at men in farming operations resulting in farm women being an underserved population.

Upon completion of this webinar, participants will be able to:

• List a minimum of four factors related to women's health and safety in agriculture. 
• Discuss potential solutions that would address the unique safety and health challenges to women engaged in agriculture. 
• Locate a minimum of three recommended clinical and community health resources that address women's agricultural health and safety needs. 

To register, click here.

Treatment of Ebola in the Digital Age

The following article was posted in the Arizona Telemedicine Program Blog:

"The boy's eyes are captivated by the voice of the woman in the white starched coat. She seems to be speaking directly to them from the television screen. His mother's face relaxes for the first time in weeks as she holds him and repeats in a soft voice as if to convince herself, "The quarantine is over."

Although not a current reality, medicine has entered the digital age, and this scene may be tomorrow's reality.

Telecommunication technologies impact almost all medical specialties with tools ranging from "full-service" telemedicine systems that allow a near-complete physical exam to be conducted at a distance, to tele-home health units, to self-monitoring devices partnered with mobile technologies.

Digital tools may serve as critical missing puzzle pieces towards the primary goal of Ebola preparedness efforts: control of disease transmission."

To read the rest of the article, click here.

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

SAMHSA Health Insurance Enrollment Kickoff Event: 2014-2015 Affordable Care Act Open Enrollment
December 4, 2014; 1:00-2:30 p.m. EST
The Substance Abuse and Mental Health Services Administration (SAMHSA) invites you to join us for an important webinar on Thursday, December 4, 2014 from 1:00-2:30 p.m. EST. This webinar will discuss health insurance enrollment during the 2014-2015 open enrollment period for the state Health Insurance Marketplaces. Specific attention will be given to strategies for enrolling individuals with behavioral health conditions, and outreach efforts for vulnerable populations. The webinar will draw upon the expertise of several national and community organizations to discuss the ways in which they are addressing the specific needs of individuals with mental health and substance use conditions, with the goals of helping individuals understand and enroll in health insurance coverage to gain access to needed care.
Learn more and register...

“There’s Nothing Wrong With Me”—A Culturally Sensitive Approach to Soldiers’ Resistance to Counseling
December 11, 2014; 1:00-2:00 p.m. EST
Upon returning from deployment, service members are likely to experience a host of challenges. Be it reintegrating with loved ones, recalibrating to life outside the combat zone, or struggling with moral injury or self-medicating behaviors, these individuals often have difficulties reaching out for help. Given the military culture of strength, honor and self-discipline, the idea of admitting to a problem is often foreign, which can result in service members avoiding treatment. Therefore, counselors must recognize and honor the unique aspects of military culture in order to both navigate resistance and bolster resiliency. Presented by a former combat Marine, this presentation will offer the necessary tools to connect with service members and veterans.
Learn more and register…

DCoE Webinar: Evidence Base for Using Technology Solutions in Behavioral Health Care
December 17, 2014; 1:00-2:30 p.m. EST
Recent advances in the evidence base for technology-based behavioral health applications have provided clinicians a better understanding and guidance on the integration of these tools into clinical care. Participants will learn about research findings on current technologies in use in clinical practice, such as audio conferencing, video conferencing, and virtual reality, in addition to tools available for use between patients, such as the use of websites and mobile applications and wearable sensors. Clinicians will leave this training with a review of the evidence base for using technology solutions in behavioral healthcare that will inform their clinical practice.
Learn more and register...

VA Expands Eligibility for VA Health Care Related to Military Sexual Trauma
The Department of Veterans Affairs (VA), under authority from the Veterans Access, Choice, and Accountability Act of 2014 (“VACAA”), announced expanded eligibility for veterans in need of mental health care due to sexual assault or sexual harassment that occurred during their military service. This trauma is commonly known as military sexual trauma (MST).
Read more...

At Wyoming VA, No Veteran Dies Alone
“The thing I’m most worried about,” actress Anne Hathaway once said, “is just being alone without anybody to care for or someone who will care for me.” Well, Anne, the nice folks at the Cheyenne VA Medical Center in Wyoming sort of feel the same way you do, which is why they launched a program called "No Veteran Dies Alone," where volunteers from the VA — as well as the local community — spend time with veterans who are in their final days or hours.
Read more...

'Dogs of War:' New A&E Series Captures 'Intense' Journey of PTSD Military Veterans As They're Matched With Shelter Dogs
The A&E network will soon debut "Dogs of War," a new docu-series about war veterans suffering from Post Traumatic Stress Disorder (PTSD) and the service dogs that help them adjust back into life after combat.
Read more...

Pentagon Expo to Feature Art Therapy for ‘Invisible Wounds’
Art therapy has evolved in the last several years as treatment to help service members express what they want to “symbolize about themselves” after suffering the invisible wounds of the wars in Iraq and Afghanistan, a Defense Department art therapist said.
Read more...

Resource for Treating Rural Veterans

As a leader in your state’s rural health initiatives, you know that Veterans and Service members have unique experiences, which often lead to unique health needs.

Last week, RAND released a comprehensive report that found that few community-based providers met criteria for military cultural competency or used evidence-based approaches to treat problems commonly seen among our nation’s 20+ million veterans. Understanding military culture can greatly improve the treatment experience for Veterans and there is evidence demonstrating improved outcomes when Veterans believe a healthcare professional understands their military experience.

Having been aware of these issues, the Departments of Veterans Affairs and Defense developed and recently launched a free, online course entitled, Military Culture: Core Competencies for Healthcare Professionals to address these issues. Through the course, providers can:

· assess their own competence with military culture,
· educate themselves on military ethos and organizational structure,
· identify unique stressors and the impact on a patient’s health and assessment and treatment issues,
· access resources and tools for both providers and patients,
· and gain free Continuing Education Credit for the following: ACCME, ACCME-NP, ANCC, APA, ASWB, CA BBS, NBCC.

Information in the course stems from research, surveys and hundreds of hours of interviews with Service members and Veterans. It is designed as a comprehensive training in military culture for seasoned practitioners as well as for those less familiar with military populations. The interactive course includes a self-assessment, a variety of vignettes and candid video testimonials to highlight the meaning of military cultural competence.

We need your help to spread the word about this course to your members. We have developed a variety of materials including blog posts, social media posts, fact sheets and other promotional materials. Also, please consider adding the course to your resources section of your website.

Ebola - Preparation and response in U.S. healthcare settings

Tuesday, December 9, 2014
2-3:30 p.m. ET / 1-2:30 p.m. CT / Noon-1:30 p.m. MT /
11 a.m.-12:30 p.m. PT

Speakers

· Tom Talbot, MD, chief hospital epidemiologist, Vanderbilt University Medical Center
· Daniel Varga, MD, chief clinical officer and senior executive vice president, Texas Health Resources
· Neil Fishman, MD, associate chief medical officer, University of Pennsylvania Health System
· David Henderson, MD, hospital epidemiologist and director for quality assurance, National Institutes of Health Clinical Center
· Michael Bell, MD, deputy director of division of healthcare quality promotion, Centers for Disease Control and Prevention
· Jeffrey Ashkenase, senior vice president, Greater New York Hospital Association
· MODERATOR: Gina Pugliese, RN, MS, vice president, Premier Safety Institute®

Description

You're invited to this live presentation to hear from experts who have cared for patients with Ebola and developed comprehensive programs to prepare for and respond to their first case. The conversation topics will include:

· Ebola designated treatment centers
· Triage and handling patients in ED, ambulatory and outpatient settings
· Coordinating supply needs and sources
· Special situations, including OB and pediatrics
· Managing sewage and waste
· Partnerships with health departments
· Using tabletop exercises, simulations and drills to prepare
· Donning and doffing PPE

This event is open to the public. Follow the conversation on Twitter at #AdvisorLive.

Submit a question to the panel

In order to answer as many questions as possible during the program, please email your questions by Friday December 5 to: Safety_Institute@premierinc.com

Resources

Visit the Premier Safety Institute website for Ebola resources, tools and links to on-demand educational programs from the CDC and others: www.premierinc.com/ebola

Register

Register for the live webinar here.

Can't make the live event on December 9? That's OK. Register anyway and we'll send you a link to the recording and slides.

Questions

For technical questions, please email advisorlive@premierinc.com or call the Premier Solution Center at 877.777.1552.

Learn More about Clinical Documentation Improvement to Support ICD-10 Readiness

With less than one year until the October 1, 2015, ICD-10 compliance date, now is the time to focus on clinical documentation improvement (CDI).

ICD-10 offers greater specificity than ICD-9, allowing documentation to be translated into an accurate and clear clinical picture. Find out how to be sure that your documentation practices are ready for ICD-10.

The Centers for Medicare & Medicaid Services (CMS) is collaborating with the American Health Information Management Association (AHIMA) to provide an ICD-10 and CDI webinar on Wednesday, December 10, from 12:00 p.m. to 1:30 p.m. ET. Join CMS and AHIMA to learn about:

• Why detailed clinical documentation is important for the ICD-10 transition 
• Steps for training your staff 
• Additional resources and information 

A portion of the webinar will be dedicated to Q&A.

Registration Information
Space is limited. Register now to secure your spot for this eHealth Provider Webinar. Once your registration is complete, you will receive a follow-up email with step-by-step instructions on how to log-in to the webinar.

Previous webinar presentations and recordings can be accessed on the Events page of the CMS eHealth website.

Want more information about CMS ehealth?
Make sure to visit the CMS eHealth website for the latest news and updates.

Updates:Medicare enrollment forms CMS-40B and CMS-L564

The Centers for Medicare & Medicaid Services (CMS) would like to notify you of updates made to two Medicare enrollment forms: Form CMS-40B (Application for Enrollment in Medicare Part B (Medical Insurance)) and Form CMS-L564 (Request for Employment Information), which is required when a beneficiary is seeking a special enrollment period to enroll in Medicare Part B or premium Part A.

The CMS updated the forms to be more user-friendly by including information about when to use the forms and providing step-by-step instructions to assist Medicare beneficiaries in completing them. Beneficiaries can now obtain the enrollment forms online in English and Spanish, alleviating the need to contact the Social Security Administration (SSA) to obtain the forms by mail or in person.

This change especially helpful for beneficiaries living in Puerto Rico, who previously did not have access to the enrollment forms in Spanish. Additionally, for those beneficiaries who SSA automatically enrolls in Medicare Part A, they may now obtain and complete the Part B enrollment form prior to or in place of visiting their local SSA field office.

CMS worked with SSA to update these forms to be accessible and user-friendly to all Medicare beneficiaries.

Ebola 101: Accessing Federal Guidance & Information Resources

Ebola 101 – Accessing Federal Guidance & Information Resources Webinar
December 11, 2014
11:00 a.m. – 12:30 p.m. ET

Centers for Disease Control and Prevention Presenters:
Tasha Stehling-Ariza, PhD, Epidemic Intelligence Service Officer
Molly Gaines-McCollom, MPH, CHES, Health Communication Specialist
Moderator: Anne Fidler, PhD Project Director Regional Public Health Training Center, Boston University School of Public Health

The Health Resources and Services Administration joins the Centers for Disease Control and Prevention (CDC) State Coordination Task Force and the Joint Information Center to host “Ebola 101 – Accessing Federal Guidance & Information Resources.”

This timely webinar will:

• Provide an overview of Ebola Virus Disease and the CDC’s current outbreak response activities 
• Highlight important information resources that can be found on the CDC website 
• Discuss guidance to academic institutions regarding students and faculty arriving to U.S. campuses from countries where Ebola outbreaks are happening 
• Provide time for Q & A 

To log into the webinar, please use the following information:
Online Presentation: https://hrsaseminar.adobeconnect.com/ebola101/
Enter your first and last name in the “guest” field when prompted.

To log into the audio conference line, please use the information below:
Dial-in number: 1-888-957-9878
Participant passcode: 5256022

2014 Webinar Series-Mental and Emotional Well-Being of Communities

2014 Webinar Series
Improving the Mental and Emotional Well-Being of Communities through the National Prevention Strategy Presented by Region VIII Federal Partners


Prescription Drug Abuse: Why Does it Matter and What Can We Do?
Thursday, December 11, 2014, 2:00 – 3:30 pm, MT (4:00-5:30 ET)
2:00-2:05 Welcome and Adobe Connect Logistics

Speaker: Cherri Pruitt, U.S. Department of Health and Human Services, Health Resources and Services Administration, Region VIII Maternal and Child Health Consultant

2:05-2:20 What IS the National Prevention Council’s Mental and Emotional Well-Being Strategy

Speaker: Charles H. Smith, MA, PhD, U. S. Department of Health and Human Services, Regional Administrator-Region VIII, Substance Abuse and Mental Health Services Administration

2:20-2:40 Got Drugs? An Overview of DEA Disposal of Controlled Substances Final Rule

Speaker: Lynette Wingert, US Drug Enforcement Agency Group Supervisor whose area of responsibility includes Utah, Wyoming, and Montana

2:40-3:00 Prescription for Prevention: A Community’s Collective Impact - This presentation will give an overview of the collective, intentional, and collaborative prevention efforts being utilized in Missoula, MT to reduce the misuse and abuse of Prescription medication.

Speaker: Brandee Tyree, Coordinator Missoula Underage Substance Abuse Prevention Coalition

3:00-3:20 Colorado’s Prescription Drug Abuse Initiatives – This presentation looks at the current initiatives taking place in Colorado around prescription drug abuse. Highlights will include the Prescription Drug Abuse Prevention Program, a statewide initiative funded through the Colorado Office of Behavioral Health, creation and implementation of the state strategic plan through the Governor’s Office, creation of the Colorado Consortium for Prescription Drug Abuse Prevention, and efforts targeting youth through Rise Above Colorado.

Speaker: Laurie Lovedale, Manager of the Colorado Prescription Drug Abuse Prevention Program

3:20-3:30 Questions & Answers and Additional Resources

TO REGISTER, PLEASE GO TO: https://www.mymeetings.com/emeet/rsvp/index.jsp?customHeader=mymeetings&Conference_ID=9564151&passcode=4923803

Conference number: 956415; Passcode: 4923803

Some Internet Explorer users may experience difficulty accessing the site and will need to use a different browser (Google, Firefox, etc.)

Please contact: RegionVIIIFedPartners@HHS.GOV with any questions or to request a written transcript of this event.

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

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

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

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

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

For more information and registration instructions go to

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

November Edition of At a Glance Newsletter

Please find the link to the November edition of At a Glance below. This Department of Health Care Policy and Financing publication provides information on major initiatives including policy changes and program updates.

2014 At a Glance Newsletters

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

The following information is provided by Novitas Solutions.

Medicare News
Medicare Learning Network (MLN) Articles from CMS

New:

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

Revised:

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

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

The following information is provided by Novitas Solutions.

Medicare News

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

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


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

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

Phase 3 Revalidation (requests dated after September 20, 2013) Mailing Address:

Novitas JH Provider Enrollment
P.O. Box 44137
Jacksonville, FL 32231

Note that although Internet-based PECOS instructs providers to send hardcopy certification statements/supporting documentation to a specific Novitas address, please mail all Phase 3 revalidation documents to the address immediately above.

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

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

Click here to read the full article.

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

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


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

The Untold Story of ICD-10

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

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

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

Learning Objectives:

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

Learn more and register now.

AgriSafe Webinar: Understanding OSHA's Agricultural Exemptions & Standards

Understanding OSHA's Agricultural Exemptions & Standards

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

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

Participants will be able to:

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

Register Here!

Telehealth Webinar: Impact of Social Media in Health Care

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

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

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

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

For more information and registration instructions go to

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

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

The following information is provided by Novitas Solutions.

Medicare News

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


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



Medicare Learning Network (MLN) Articles from CMS

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

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


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

MLN Connects Provider eNews for November 13th, 214

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

In This Edition:

MLN Connects™ National Provider Calls

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

CMS Events

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

Announcements

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

Claims, Pricers, and Codes

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

Medicare Learning Network® Educational Products

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

New CMS 855R

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

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

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

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

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

ICD-10 Testing Drop-in Article

Medicare ICD-10 Acknowledgement Testing

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

·         March 2 – 6, 2015

·         June 1 – 5, 2015

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

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

Key points of the testing process:

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

·         Claims will be subject to existing NPI validation edits.

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

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

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

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

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

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

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

End-to-End Testing

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

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

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

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

·         Accurate Remittance Advices are produced.

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