Does Your Town Need a New Playground?

We are all aware that the obesity rate among children and adolescents has almost tripled from 1980 (CDC). However, did you know that from 2003 through 2010, the prevalence of obesity decreased slightly from 15.21% to 14.94% (CDC)? It’s a little step in the right direction.

These little steps are needed to bring the childhood obesity epidemic to an end. As communities become more aware of the effects of childhood obesity, not only on children, but also on society, they are looking for ways to promote healthier lifestyles for their communities as a whole. One reason credited for the increase in obesity among children and adolescents is a lack of outdoor play. Why not let your community’s little step be a new playground?

KaBOOM!, a non-profit dedicated to encouraging outdoor play among children, credits play as having a positive physical, emotional, social and cognitive impact on children that corresponds to having a better quality of life. They are currently offering grants to aid in the purchase of playground equipment that will be built using the KaBOOM! community-build model.

Some of the eligibility requirements include:

• Scope of the playground project must include a total playground equipment purchase between $24,000 and $40,000
• This grant is open to U.S.-based municipalities, neighborhood associations, schools, day care centers, and non-profit organizations without a playground or with existing equipment that is unsafe for children to use

For more information on the grant eligibility and how to apply, please click here.

ACA Resources for Veterans

With the Health Insurance Marketplace opening soon, many veterans are wondering how the Affordable Care Act (ACA) will impact them and their families. The U.S. Department of Veterans Affairs (VA) has provided a couple of resources that can help veterans and their families navigate their options when choosing between the Health Insurance Marketplace participation and receiving VA benefits. These resources will help veterans and their families understand what the ACA is and how it will affect their health benefits should they switch.

http://www.va.gov/health/aca/
http://www.va.gov/health/aca/FAQ.asp

Fall ICD-10 Workshops with RT Welter & Associates

Have you registered for the fall ICD 10 workshops with RT Welter & Associates?

Participants will learn about ICD 10 coding with an emphasis on common rural diagnosis. In addition we will review what documentation changes will need to be made and how providers can prepare. This year we are excited to include hands on exercises that will be tailored to your individual clinics! This educational activity is geared towards clinicians, billing and coding staff at rural hospitals and clinics. All healthcare providers, particularly physicians, are invited to attend. CEU’s will be available. Please register for a workshop at a location near you!

September 19th - Rifle, Colorado
September 24th - Lamar, Colorado
September 26th - Yuma, Colorado
October 1st - Webinar

Please contact Courtnay Ryan at cr@coruralhealth.org to register. Hope to see you there!

Implementing an Enhanced Home Health Program to Prevent Hospital Readmissions Webinar

Healthy Transitions Colorado -

 Implementing an Enhanced Home Health Program to Prevent Hospital Readmissions Webinar

Wednesday, September 18, 2013 12:30 - 1:30 pm (MT)
Register now

Join Healthy Transitions Colorado's first educational webinar to learn how a California hospital is partnering with their local home health agencies to drastically reduce 30-day readmissions. Hosted by operating partner CFMC, you'll hear lessons learned and best practice strategies from experts from Health Services Advisory Group and Cedars-Sinai Health System. Learn more.

Colorado County-Wide Immunization Recall Notice

Are you a primary care provider located in ADAMS, JEFFERSON, GRAND, LOGAN, OTERO, RIO GRANDE, WELD county? Does your practice participate in the state immunization registry (CIIS)? If so, your practice can opt to have your practice's name and telephone number included on a county-wide recall notice (phone calls and postcards) going out to parents of children 19-25 months old who need at least one shot according to CIIS. The recall program will be paid for by a grant and conducted centrally through the state. Each parent will receive up to two letters and/or phone calls reminding them that their child is in need of shots. Notices will appear to come from the local health department and CIIS. If you would like your practice name and information to be listed on the recall notice you must respond to this announcement. You will be identified as a patient's provider if you are listed as the default provider within CIIS. 

Please contact Dennis Gurfinkel at Dennis.Gurfinkel@ucdenver.edu or 303-724-6948 by October 1, 2013.

Regulatory Updates

Inpatient Prospective Payment System/Long Term Care Hospital Final Rule
On August 2, the Centers for Medicare and Medicaid Services (CMS) issued a FY 2014 final rule. Highlights include: 

• Clarified that critical access hospitals (CAHs) must be able to provide inpatient care on-site 
• Establishes a "two midnights" policy regarding inpatient admissions 
• Hospitals may no longer claim full-time equivalent (FTE) residents training at a CAH for graduate medical education (GME) purposes. CAHs training residents may receive payment based on 101% of Medicare share of reasonable costs 
• Implements Affordable Care Act (ACA) Medicare disproportionate share hospital (DSH) payment adjustment. DSH hospitals will receive 25% of their current payments, with the remaining 75% adjusted for decreases in uninsured rate 
• Expiration of the Medicare-Dependent Hospital Program 
• A 2% payment reduction for hospitals with excess readmissions. Adds conditions subject to the payment reduction 
• Finalizes the Hospital-Acquired Condition Reduction program framework for implementation in FY 2015, including a 1% payment reduction for the lowest-performing hospitals 
• Mandated payment adjustment to recoup prior years' documentation and coding overpayments 

Outpatient Prospective Payment System/ASC
CMS issued a CY 2014 proposed rule. CMS proposes to: 

• Enforce direct supervision requirement for hospital outpatient therapy services at CAHs and other small rural hospitals 
• Amend conditions of participation (CoPs) for hospital and CAH "incident to" therapeutic outpatient services and supplies to require that individuals furnishing them do so in compliance with applicable state law 
• Implement Medicare Electronic Health Record (EHR) Incentive Program changes to allow participation by eligible professionals at Method II CAHs 
• Package seven new categories of supporting items and services with primary services 
• Replace five levels of outpatient visit codes with a single healthcare common procedure coding system (HCPCS) code for each type of outpatient hospital visit, one for clinic, and one for each type of emergency department visit (24 hour and non-24 hour) 
• Add five new measures for the Outpatient Quality Reporting (OQR) program, affecting CY 2016 payment with data collection beginning in CY 2014 
• Set performance (2014) and baseline (2012) periods for the CY 2016 value-based purchasing 
• Change the contracting process and regulations governing eligibility for quality improvement organizations (QIOs) 

Physician Fee Schedule
CMS issued a CY 2014 proposed rule. CMS proposes to: 

• Apply the outpatient therapy cap on CAHs (using physician fee schedule payment rates to calculate) 
• Redefine a rural health professional shortage area (HPSA) for purposes of telehealth originating site eligibility by using the ORHP rural definition 
• Require compliance with state law as a CoP for "incident to" services 
• Implement a process to change clinical laboratory fee schedule payment amounts based on changes in technology 
• Continue implementation of the physician value modifier 
• Applicable to physicians in groups of 10 or more eligible professionals 
• Increase payment risk from 1% to 2% 
• Align quality measures and reporting mechanisms with PQRS 
• Update Physician Quality Reporting System, electronic prescribing, Medicare Shared Savings Program/accountable care organization, and Physician Compare 
• Update the Ambulance Fee Schedule 
• Rural ground ambulance payment increases 3% 
• Non-emergency end stage renal disease patient transport payment reduced 10% 
• Beginning studies of ambulance service data 

Transitional Care Management Services Fact Sheet

The “Transitional Care Management Services” Fact Sheet (ICN 908628) was released and is now available in hard copy format. This fact sheet is designed to provide education on Transitional Care Management (TCM) services. It includes the requirements for TCM services, health care professionals who may furnish TCM services, TCM services settings, components included in TCM, billing TCM services, and Frequently Asked Questions. To access a new or revised product available for order in hard copy format, go to MLN Products and click on “MLN Product Ordering Page” under “Related Links” at the bottom of the web page.