Sunday- October 19, 2008 -- Medicare

Hello Everyone,

Please enjoy the information contained in this edition of Frontier Focus. Please be sure to share it with your members, colleagues, providers and office billing staff. Thank you for your continued efforts to broadcast Medicare information to the providers in Region VIII.





Table of Contents



1. Upcoming Training for the Medicare Part B Drugs Competitive Acquisition Program (CAP)



2. ICD-10-CM/PCS National Provider Conference Call for Other Part A and Part B Providers



3. Your Latest NPI Update



4. MLN Learning Management System Now Available!



5. CMS Announces Updates to the Physician Quality Reporting Initiative Web Page



6. Availability of an Interim Study of Alternative Payment Localities Under the Medicare Physician Fee Schedule



7. Medicare Remit Easy Print (MREP) Software Version 2.5 is Now Available!



8. Availability of Valuable Resources In Preparation for a Potential Influenza Pandemic



9. Your October Flu Shot Reminder



10. Extra Help for Beneficiaries Paying for Prescription Drugs









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1. Upcoming Training for the Medicare Part B Drugs Competitive Acquisition Program (CAP)



Noridian Administrative Services, the designated carrier for the CAP, offers interactive, online workshops about the CAP for Part B Drugs and Biologicals. These workshops train CAP vendors and elected physicians on a variety of CAP topics, including how to transition out of the CAP at the end of 2008 due to the postponement of the program for 2009. NAS staff will also be available to answer questions. Interested parties may view additional information about and register for these workshops on the Noridian website at:

https://www.noridianmedicare.com/cap_drug/train/schedule.html

Upcoming workshops will be held on the following dates:

10/22/08 at 2:00 pm CST
11/24/08 at 2:00 pm CST
Additional information about the CAP and the 2009 postponement is available at: http://www.cms.hhs.gov/CompetitiveAcquisforBios/01_overview.asp

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2. ICD-10-CM/PCS National Provider Conference Call for Other Part A and Part B Providers



Other Part A and Part B providers may now register for the Centers for Medicare & Medicaid Services (CMS)

ICD-10-CM/PCS National Provider Conference Call that will be conducted on November 12, 2008, from

12:30 p.m. – 2:30 p.m. EST. To register for this call, go to http://www.cms.hhs.gov/icd10/Downloads/ICD10_otherproviders.pdf. For additional information about this conference call and to access the ICD-10 Overview Presentation that will be discussed during the call, go to http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp.

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3. Your Latest NPI Update



NPPES - Keeping It Safe and Keeping it Updated



This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES). The Centers for Medicare & Medicaid Services (CMS) recommends that each health care provider, including individual physicians and non-physician practitioners:



Know and maintain their NPPES User Ids and passwords.
Reset their NPPES passwords at least once a year. See the NPPES Application Help page regarding the ‘Reset Password’ rules. Those rules indicate the length, format, content and requirements of NPPES passwords.
Review their NPPES records in order to ensure that the information reflects current and correct information.


Maintaining NPPES Account Information for Safety and Accessibility

Health care providers, including physicians and non-physician practitioners, should maintain their own NPPES account information (i.e., User ID, Password, and Secret Question/Answer) for safety and accessibility purposes.



Viewing NPPES Information

Health care providers, including physicians and non-physician practitioners, can view their NPPES information in one of two ways:



(1) By accessing the NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created. *



* If the health care provider has forgotten the password, enter the User ID and click the “Reset Forgotten Password” button to navigate to the Reset Password Page. If the health care provider enters an incorrect User ID and Password combination three times, the User ID will be disabled. Please contact the NPI Enumerator at 1-800-465-3203 if the account is disabled or if the health care provider has forgotten the User ID.



OR



(2) By accessing the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do. The NPI Registry gives the health care provider an online view of Freedom of Information Act (FOIA)-disclosable NPPES data. The health care provider can search for its information using the name or NPI as the criterion.



Updating NPPES Information

Health care providers, including physicians and non-physician practitioners, can correct, add, or delete information in their NPPES records by accessing their NPPES records at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.



Please note: Required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information. Certain information is inaccessible via the web, thus requiring the change/update to be made via paper application. The paper NPI Application/Update Form can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.



Need More Information?

Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. Having trouble viewing any of the URLs in this message? If so, try to cut and paste any URL in this message into your web browser to view the intended information.



Note: All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage.

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4. MLN Learning Management System Now Available!



The Medicare Learning Network’s (MLN) Learning Management System (LMS) that hosts our web-based training courses and product ordering page is now available and has a new look. All of your certificates and product ordering history is still available and you can use your same user id and password. There is no need to register again. If you have any questions, please send them to MLN@cms.hhs.gov .



To access the system go to http://www.cms.hhs.gov/MLNProducts and click on web-based training modules or MLN product ordering page at the bottom of the page.



Thank you for your patience while we were upgrading the system.

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5. CMS Announces Updates to the Physician Quality Reporting Initiative Web Page



The Centers for Medicare & Medicaid Services (CMS) is pleased to announce a new E-Prescribing Incentive Program section page on the Physician Quality Reporting Initiative (PQRI) webpage at www.cms.hhs.gov/pqri/03_EPrescribingIncentiveProgram.asp#TopOfPage on the CMS website. This new section page will provide information about the new E-Prescribing incentive program that was authorized by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).



Included on this page in the Downloads section is an “Introduction to E-Prescribing Incentive Program” Fact Sheet that describes the MIPPA provisions for the E-Prescribing incentive program. Additional information about the E-Prescribing incentive program and how to qualify for the E-Prescribing incentive for the 2009 reporting year will be posted in early November.



Information is continually being added, so please visit the Physician Quality Reporting Initiative webpage at https://www.cms.hhs.gov/PQRI on the CMS website often.

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6. Availability of an Interim Study of Alternative Payment Localities Under the Medicare Physician Fee Schedule



Medicare is statutorily required to adjust payments for physician fee schedule services to account for differences in costs due to geographic location. There are currently 89 different localities which have not been revised since 1997. In the CY 2009 Physician Fee Schedule notice of proposed rulemaking which was released on June 30, 2008, we indicated that we would post on the CMS website a preliminary study of several options for revising the payment localities. The report entitled: “Review of Alternative GPCI Payment Locality Structures”, which was produced by Acumen, LLC under contract to CMS, may currently be found at the following link:

http://www.cms.hhs.gov/PhysicianFeeSched/downloads/ReviewOfAltGPCIs.pdf .



Our study of possible alternative payment locality configurations is in the early stages of development. At this time we are not proposing to make any changes to the payment localities. We encourage interested parties to submit comments on the options presented in the report as well as suggestions for other options. These comments will be considered in the development of possible future notice and comment rulemaking. When we are ready to propose any changes to the locality configuration, we will provide extensive opportunities for public comment (for example, a town hall meeting or open door forum) on specific proposals before implementing any change.



Electronic comments on the interim report may be submitted to MPFS@cms.hhs.gov until November 3, 2008. (Note: Address for sending comments has been corrected, and comment period extended).

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7. Medicare Remit Easy Print (MREP) Software Version 2.5 is Now Available!



Attention Medicare Fee-for-Service Professional Providers and Suppliers:



Version 2.5 of the MREP software is available for download at http://www.cms.hhs.gov/AccesstoDataApplication/02_MedicareRemitEasyPrint.asp on the CMS website. For a description of the changes in this version, see the “What’s New” section of the MREP User Guide – Version 2.5 at http://www.cms.hhs.gov/AccesstoDataApplication/Downloads/EasyPrintUserGuide.pdf.



Note: The latest Codes.ini file is now available. This file is necessary when the MREP software is distributed.

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8. Availability of Valuable Resources In Preparation for a Potential Influenza Pandemic



The Centers for Medicare & Medicaid Services (CMS) wants to alert providers to a valuable resource in the preparation for a potential influenza pandemic. "Community Pan-Flu Preparedness: A Checklist of Key Legal Issues for Healthcare Providers," is a scalable tool designed to assist providers along the continuum of care, as well as the broader healthcare and public health communities, in taking concrete steps to prepare for an influenza pandemic. The Checklist was informed by a public interest dialogue session convened by the American Health Lawyers Association, Office of Inspector General of the U.S. Department of Health and Human Services, and the U.S. Centers for Disease Control and Prevention. Participants from federal and state agencies, the provider and payor communities, academia, and other stakeholders discussed the role of the healthcare sector in community pan-flu preparedness. They also shared their best thinking regarding the challenges to pan-flu preparedness and practical solutions to such challenges. These ideas and recommendations were incorporated into the Checklist in order to make the resource as practical and relevant as possible.



CMS encourages hospitals and other health care providers to review the Checklist as they consider the legal impediments and implementation challenges to community pan-flu preparedness and practical solutions to such challenges.



This publication can be found at: http://www.healthlawyers.org/panfluchecklist



Also note that on October 22, 2008, AHLA also is sponsoring a teleconference entitled “The Sneeze Heard 'Round the World: Pandemic Influenza Preparedness Strategies to Adopt Now.” The teleconference will focus on the considerations unique to preparedness planning for influenza pandemics, including protection of employees and maintaining operations, implementation of altered clinical pathways, and strategies for successful public health and provider coordination that need to be addressed at the present time to ensure an adequate level of preparedness. One of the country’s leading experts, Dr. Michael T. Osterholm, and three experts in the emerging specialty of emergency preparedness law will discuss practical preparedness steps that healthcare entities, providers and payors can implement now. To learn more about the teleconference, go to http://www.healthlawyers.org/pi/teleconference

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9. Your October Flu Shot Reminder



Flu Season Is Upon Us! Begin now to take advantage of each office visit as an opportunity to encourage your patients to get a flu shot. It’s still their best defense against combating the flu this season. (Medicare provides coverage of the flu vaccine without any out-of-pocket costs to the Medicare patient. No deductible or copayment/coinsurance applies.) And don’t forget, health care personnel can spread the highly contagious flu virus to patients. Protect Yourself. Don’t Get the Flu. Don’t Give the Flu. Get Your Flu Shot.

Remember - Influenza vaccine plus its administration are covered Part B benefits. Note that influenza vaccine is NOT a Part D covered drug.



For information about Medicare’s coverage of the influenza virus vaccine and its administration as well as related educational resources for health care professionals, please go to http://www.cms.hhs.gov/MLNProducts/Downloads/flu_products.pdf on the CMS website.

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10. Extra Help for Beneficiaries Paying for Prescription Drugs



Do You Know Someone Who Is Having Trouble Paying For Prescription Drugs?

Medicare Can Help!



· If an individual has limited income and resources, they may qualify for extra help from Medicare. It could be worth over $3,300 in savings on prescription drug costs per year.

· Encourage people with Medicare to file for Extra Help online: https://s044a90.ssa.gov/apps6z/i1020/main.html or by calling Social Security at 1-800-772-1213 to apply over the phone.

· State Health Insurance Information Program (SHIP) offices can assist with the application. Find contact information for a local SHIP Counselor at http://www.medicare.gov/contacts/static/allStateContacts.asp or by calling

1-800-MEDICARE.

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Lucretia James

Centers for Medicare & Medicaid Services

Region VIII

1600 Broadway, Suite 700

Denver, CO 80202

(303) 844-1568

lucretia.james@cms.hhs.gov