The Centers for Medicare & Medicaid Services (CMS) has added new information to the Medicare Shared Savings Program (Shared Savings Program) website at www.cms.gov/sharedsavingsprogram.
A new webpage on Quality Measures and Performance Standards at http://www.cms.gov/sharedsavingsprogram/37e_Quality_Measures_Standards.asp has the latest information on Medicare Accountable Care Organization (ACO) quality measures. The 2012 ACO Narrative Quality Measures Specifications Manual provides guidance about the 33 required quality measures that are part of the quality performance standard.
Two crosswalks have been added to the Shared Savings Program Application webpage at http://www.cms.gov/sharedsavingsprogram/37_Application.asp. Organizations who submitted an application under the Pioneer ACO Model or have been participating in the PGP Transition Demonstration, who would like to submit a Shared Savings Program application, scroll down the page for links to these two application crosswalks.
Wednesday, January 4, 2012
CMS Announces Delay to the Prepayment Review and Prior Authorization for Power Mobility Devices (PMDs) Demonstration and the Recovery Audit Prepayment Review Demonstration
On November 15, 2011, the Centers for Medicare & Medicaid Services (CMS) announced the Prepayment Review and Prior Authorization for Power Mobility Devices (PMD) demonstration and the Recovery Audit Prepayment Review demonstration. These demonstrations were scheduled to begin on January 1, 2012. However, the CMS received many comments/suggestions regarding these demonstrations and the CMS is carefully considering these comments. Therefore, CMS will delay implementation of these demonstrations. CMS will provide at least 30 days notice before the demonstrations begin.
The Part A to Part B rebilling demonstration remains on schedule and will begin on January 1, 2012.
Please continue to check http://go.cms.gov/cert-demos for updated information.
The Part A to Part B rebilling demonstration remains on schedule and will begin on January 1, 2012.
Please continue to check http://go.cms.gov/cert-demos for updated information.
Tuesday, January 3, 2012
Patient Screening – TrailBlazer Live Web Training
January 10, 2012 – 9:00-10:30 MST
This TrailBlazer training will focus on the importance of patient screening. Topics discussed will include:
- Basic Medicare overview.
- The importance of patient screening.
- Medicare Secondary Payer (MSP) overview.
- Medicare Secondary Payer Questionnaire (MSPQ) overview.
For more information and to register, click here.
National Health Service Corps CAH Pilot Program
A message from the Office of Rural Health Policy...
The Health Resources and Services Administration has released its 2012 guidance for the National Health Service Corps (NHSC) Loan Repayment Program (LRP), which includes a pilot program that expands eligibility to Critical Access Hospitals (CAHs) and eligible clinicians working in CAHs: primary care physicians; psychiatrists; nurse practitioners; certified nurse midwives; and physician assistants. The NHSC CAH Pilot Program was created as part of the White House Rural Council (http://r20.rs6.net/tn.jsp?llr=lk7blccab&et=1109015216339&s=7345&e=001SE3UYvKOjLiCiAwM2_zKFfb2QP5NEefbQornvkp10nEDGSrZdcCtSBZLCDZ1W89stUqrWMUPFoiVBJbMOF6Q0CacCqT0lma_DD4y3zg9yhneB3cfie-JslQCvui6i3JHTzWw-kP7MHzg8pL7-HUunXnllx5gOwYVtS2W3yi9yU4=).
CAHs and interested clinicians should review the 2012 guidance. CAHs that want to become service sites have to be in a Health Professional Shortage Area (HPSA) and meet other basic program requirements (http://r20.rs6.net/tn.jsp?llr=lk7blccab&et=1109015216339&s=7345&e=001SE3UYvKOjLiaBKU8bsxv2IvpDk82MGGw6zicLhu6AXaOkgDZNbeEiPTFoXa0btJ18zIkdcYJ5zqqk8GdZWJYd0skSjGRLlSfH3ooSHPlTksfW1y-_rl-D5bsg-bNwSHWB_E-2x1xTKoz-4pTWmf3UUf-yuPpYNzAJWh5-q4yQdw=). Currently, approximately 64 percent of CAHs are located in HPSAs. Of these, 36 percent have HPSA scores of 14 or more.
Once they are approved as service sites, their clinicians can apply for loan repayment. The NHSC will pay up to $60,000 for an initial 2 years of full-time clinical practice to clinicians serving at an NHSC-approved service site with a HPSA score of 14 or higher. Applicants working at NHSC-approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 2 years of full-time clinical service.
The NHSC will pay up to $60,000 for an initial 4 years of half-time clinical practice to clinicians serving at an NHSC-approved service site with a HPSA score of 14 or higher. Applicants working at NHSC-approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 4 years of half-time clinical service.
Allowing CAHs to be eligible for loan repayment will enhance health care access and flexibility. Most providers working for these hospitals staff clinical settings across the CAH, ranging from outpatient clinics, skilled nursing care and emergency services, as well as providing limited inpatient hospital services.
Please help us get the word out about this program to CAHs and interested clinicians so they can take advantage of this opportunity.
The Office of Rural Health Policy (ORHP) and the NHSC have conducted Webinars related to this change (http://r20.rs6.net/tn.jsp?llr=lk7blccab&et=1109015216339&s=7345&e=001SE3UYvKOjLgtzp4cvJnqSyc8juhML6RCiDIa0BelZwXfrvTgU0W-qqf399ijFD5fQICGGJL5SJHzApYySq9gJYk0QeSTn01txQP2HHwHtm8C5-DWq4vtYBQu17sU74gwqjWcQ5JUU_Ot9lrK0o77kPDbYXxGAH3vkSXQa28NR60=). The NHSC has a contact available to answer questions: Lindsey Toohey (ltoohey@hrsa.gov). Additional contacts include your State Offices of Rural Health. You may also Contact your State PCO for assistance, or your ORHP project officer or regional liaison.
For additional program details, please see the 2012 NHSC Loan Repayment Program At-A-Glance Fact Sheet , the NHSC Loan Repayment Program Announcement Flyer and the complete Application and Program Guidance.
ORHP believes there will be significant interest among CAHs in becoming NHSC service sites to help address the ongoing access challenges these facilities face. The flexibility for loan repayors to divide service time between inpatient and outpatient care will be attractive to program applicants.
The Health Resources and Services Administration has released its 2012 guidance for the National Health Service Corps (NHSC) Loan Repayment Program (LRP), which includes a pilot program that expands eligibility to Critical Access Hospitals (CAHs) and eligible clinicians working in CAHs: primary care physicians; psychiatrists; nurse practitioners; certified nurse midwives; and physician assistants. The NHSC CAH Pilot Program was created as part of the White House Rural Council (http://r20.rs6.net/tn.jsp?llr=lk7blccab&et=1109015216339&s=7345&e=001SE3UYvKOjLiCiAwM2_zKFfb2QP5NEefbQornvkp10nEDGSrZdcCtSBZLCDZ1W89stUqrWMUPFoiVBJbMOF6Q0CacCqT0lma_DD4y3zg9yhneB3cfie-JslQCvui6i3JHTzWw-kP7MHzg8pL7-HUunXnllx5gOwYVtS2W3yi9yU4=).
CAHs and interested clinicians should review the 2012 guidance. CAHs that want to become service sites have to be in a Health Professional Shortage Area (HPSA) and meet other basic program requirements (http://r20.rs6.net/tn.jsp?llr=lk7blccab&et=1109015216339&s=7345&e=001SE3UYvKOjLiaBKU8bsxv2IvpDk82MGGw6zicLhu6AXaOkgDZNbeEiPTFoXa0btJ18zIkdcYJ5zqqk8GdZWJYd0skSjGRLlSfH3ooSHPlTksfW1y-_rl-D5bsg-bNwSHWB_E-2x1xTKoz-4pTWmf3UUf-yuPpYNzAJWh5-q4yQdw=). Currently, approximately 64 percent of CAHs are located in HPSAs. Of these, 36 percent have HPSA scores of 14 or more.
Once they are approved as service sites, their clinicians can apply for loan repayment. The NHSC will pay up to $60,000 for an initial 2 years of full-time clinical practice to clinicians serving at an NHSC-approved service site with a HPSA score of 14 or higher. Applicants working at NHSC-approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 2 years of full-time clinical service.
The NHSC will pay up to $60,000 for an initial 4 years of half-time clinical practice to clinicians serving at an NHSC-approved service site with a HPSA score of 14 or higher. Applicants working at NHSC-approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 4 years of half-time clinical service.
Allowing CAHs to be eligible for loan repayment will enhance health care access and flexibility. Most providers working for these hospitals staff clinical settings across the CAH, ranging from outpatient clinics, skilled nursing care and emergency services, as well as providing limited inpatient hospital services.
Please help us get the word out about this program to CAHs and interested clinicians so they can take advantage of this opportunity.
The Office of Rural Health Policy (ORHP) and the NHSC have conducted Webinars related to this change (http://r20.rs6.net/tn.jsp?llr=lk7blccab&et=1109015216339&s=7345&e=001SE3UYvKOjLgtzp4cvJnqSyc8juhML6RCiDIa0BelZwXfrvTgU0W-qqf399ijFD5fQICGGJL5SJHzApYySq9gJYk0QeSTn01txQP2HHwHtm8C5-DWq4vtYBQu17sU74gwqjWcQ5JUU_Ot9lrK0o77kPDbYXxGAH3vkSXQa28NR60=). The NHSC has a contact available to answer questions: Lindsey Toohey (ltoohey@hrsa.gov). Additional contacts include your State Offices of Rural Health. You may also Contact your State PCO for assistance, or your ORHP project officer or regional liaison.
For additional program details, please see the 2012 NHSC Loan Repayment Program At-A-Glance Fact Sheet , the NHSC Loan Repayment Program Announcement Flyer and the complete Application and Program Guidance.
ORHP believes there will be significant interest among CAHs in becoming NHSC service sites to help address the ongoing access challenges these facilities face. The flexibility for loan repayors to divide service time between inpatient and outpatient care will be attractive to program applicants.
Monday, January 2, 2012
CMS Open Door Forum
Review of the Advance Payment Accountable Care Organizations (ACO) Model; Thursday, January 5, 2012 2:30pm-4pmET. Earlier this fall, CMS announced a new Advance Payment Model for physician-based and rural Accountable Care Organizations (ACOs) participating in the Shared Savings Program. ACOs selected to participate in the Advanced Payment Model will receive upfront payments that will be recouped from the shared savings they earn. This Open Door Forum will review the Advance Payment ACO Model and the application template. If you wish to participate, dial 1-800-837-1935 & Conference ID: 39623933. For more information, click here.
Reminder: Technical Component of Advanced Diagnostic Imaging Accreditation Requirements Effective Sunday, January 1, 2012
Suppliers of the technical component of Advanced Diagnostic Imaging that are billing with a service date on or after Sunday, January 1, 2012 must evidence an active accreditation date for diagnostic imaging of CPT codes attached to an MRI, CT, and Nuclear Medicine claim. The professional component claims are not affected by the accreditation requirements and must be processed as usual. Refer to Transmittal #380, http://www.cms.gov/transmittals/downloads/R380PI.pdf or MLN Matters 7177, http://www.cms.gov/MLNMattersArticles/downloads/MM7177.pdf for further information on claims processing.
Improving Long Term Services and Supports Delivery System
Last month the CCT Operational Protocol (OP), the official roadmap to implementation for the Money Follows the Person (MFP) program, was officially approved by CMS. The OP serves as the policy and procedures manual for the grant. You can access the OP by visiting our Web site at Colorado.gov/hcpf/CCT.
The Department was awarded $400,000 in MFP supplemental funding by The Administration on Aging (AoA) and CMS to facilitate and strengthen the roles of Colorado‟s Aging and Disability Resource Centers (ADRCs) in supporting transitions from nursing homes. The funding will be targeted to ADRCs in three counties (Larimer, Mesa and Pueblo). The capacity of these ADRCs will be expanded to provide counseling to nursing facility residents who wish to learn more about their options for returning to the community. A grant-funded staff position will be hired to establish data and reporting systems to monitor these efforts and to produce performance reports as part of the overall MFP program.
The Department worked with a marketing and communications consultant and focus groups to create a Colorado-specific brand for the MFP program. The most popular name was Colorado Choice Transitions (CCT) with the tag line of „Your Path to Independence.‟ Our new logo and collateral materials for the program will be distributed soon. The Long Term Care Advisory Committee, Steering Committee for Colorado Choice Transitions and the Communication, Training and Outreach Workgroup (CTO) helped in developing and approving the materials.
The CCT project team is currently in the benefit design process.
If you want to participate in the benefit design process or for more information about Colorado Choice Transitions, please contact Nicole Storm at 303-866-2858.
The Department was awarded $400,000 in MFP supplemental funding by The Administration on Aging (AoA) and CMS to facilitate and strengthen the roles of Colorado‟s Aging and Disability Resource Centers (ADRCs) in supporting transitions from nursing homes. The funding will be targeted to ADRCs in three counties (Larimer, Mesa and Pueblo). The capacity of these ADRCs will be expanded to provide counseling to nursing facility residents who wish to learn more about their options for returning to the community. A grant-funded staff position will be hired to establish data and reporting systems to monitor these efforts and to produce performance reports as part of the overall MFP program.
The Department worked with a marketing and communications consultant and focus groups to create a Colorado-specific brand for the MFP program. The most popular name was Colorado Choice Transitions (CCT) with the tag line of „Your Path to Independence.‟ Our new logo and collateral materials for the program will be distributed soon. The Long Term Care Advisory Committee, Steering Committee for Colorado Choice Transitions and the Communication, Training and Outreach Workgroup (CTO) helped in developing and approving the materials.
The CCT project team is currently in the benefit design process.
If you want to participate in the benefit design process or for more information about Colorado Choice Transitions, please contact Nicole Storm at 303-866-2858.
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