Sunday --- October 12, 2008 ---------------------Medicare Information

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. New From the Medicare Learning Network



2. CMS Enhances Program Integrity Efforts to Fight Fraud, Waste and Abuse in Medicare



3. CMS Hosts National Conference to Promote Electronic Prescribing



4. CMS To Host Conference on Compliance with DMEPOS Quality Standards



5. Medicare’s Online Tools Will Help Beneficiaries with Prescription Drug and Health Plan Choices for 2009



6. Reminder:ICD-10-CM/PCS National Provider Conference Call for Hospital Staff - October 14, 2008, 12:30 p.m. – 2:30 p.m. EDT



7. “Information and Education Resources for Medicare Providers” PowerPoint Presentation



8. Inpatient PPS PC Pricers for FY 2008 and 2009



9. Fourth Quarter 2008 Hospital OPPS Pricer Downloads



10. Extra Help for Beneficiaries Paying for Prescription Drugs









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1. New From the Medicare Learning Network



The ICD-10-Clinical Modification/Procedure Coding System Bookmark is now available from the Centers for Medicare & Medicaid Services Medicare Learning Network. This bookmark explains the ICD-10-Clinical Modification/Procedure Coding System (CM/PCS) including the benefits of adopting the system, recommended steps to be taken in order to plan and prepare for implementation of the system, and where additional information about the system can be found. To place your order, visit http://www.cms.hhs.gov/MLNProducts/01_Overview.asp , scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.” If you have problems accessing this hyperlink, please copy and paste the URL into your Internet browser.

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2. CMS Enhances Program Integrity Efforts to Fight Fraud, Waste and Abuse in Medicare



The Centers for Medicare & Medicaid Services (CMS) recently announced aggressive new steps to find and prevent waste, fraud and abuse in Medicare. CMS is working closer with beneficiaries and providers; consolidating its fraud detection efforts; strengthening its oversight of medical equipment suppliers and home health agencies; and launching the national recovery audit contractor (RAC) program.



The new national RACs can be found at www.cms.hhs.gov/RAC/Downloads/RAC%20Expansion%20Schedule%20Web.pdf

For more information, visit the CMS RAC Website at: www.cms.hhs.gov/RAC

The CMS Press release issued 10/06/08, as well as the RAC fact sheet, are attached for your convenience.

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3. CMS Hosts National Conference to Promote Electronic Prescribing



Widespread Use of E-prescribing Would Eliminate Thousands of Annual Medication Errors



Boston, MA – October 7, 2008 – More than 1,400 health care professionals and industry leaders convened in Boston today at the National E‑prescribing Conference hosted by the Centers for Medicare & Medicaid Services (CMS) and 34 co-sponsoring organizations. Featuring U.S. Department of Health and Human Services Secretary (HHS) Mike Leavitt, CMS Acting Administrator Kerry Weems, Senator John Kerry (D-MA), Former House Speaker Newt Gingrich, Massachusetts Governor Deval Patrick, Rhode Island Governor Donald Carcieri, and Health Evolution Partners Chairman David Brailer, M.D., Ph.D., the conference addressed the potential of electronic prescribing (e-prescribing) to improve health care in the United States.



For more information, visit www.hhs.gov/valuedriven or www.cms.hhs.gov/pqri . National E-prescribing Conference presentations can be downloaded at www.e-prescribeconference.com.



To read the CMS press release issued 10/7/08, click here: http://www.cms.hhs.gov/apps/media/press_releases.asp

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4. CMS To Host Conference on Compliance with DMEPOS Quality Standards



JOIN THE CMS CONFERENCE!

Compliance with the DMEPOS Quality Standards: What You Need To Know

Tuesday, October 14, 2008
1:00-5:30 PM EST
CMS Auditorium, Baltimore, MD 21244



On October 14, the Centers for Medicare & Medicaid Services will conduct an on-site conference that will provide guidance to the DMEPOS suppliers on how to comply with the DMEPOS quality standards.



Goal

The goal of this conference is to provide non-accredited DMEPOS suppliers with technical guidance on the new DMEPOS quality standards.



Section I- Supplier Business Service Requirements
Section II- Supplier Product-Specific Service Requirements
Appendices A, B & C
Speaker
Sandra Bastinelli, Director,

Division of Medical Review & Education,

Program Integrity Group

Office of Financial Management, CMS

Target Audience
Non-accredited DMEPOS suppliers



Web Registration (on-site conference only)

CMS Website: http://www.cms.hhs.gov/apps/events/default.asp

Select “upcoming events,”

Find the conference (listed by name/date), and

Click on “Register”



Audio Line

Call-In-Number: 1-877-357-7851

Conference Id Number: 57781268

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5. Medicare’s Online Tools Will Help Beneficiaries with Prescription Drug and Health Plan Choices for 2009



The Centers for Medicare & Medicaid Services (CMS) today announced that beneficiaries, their caregivers, and family members can begin to review 2009 Medicare prescription drug plan and health plan information online through the Medicare Prescription Drug Plan Finder and Medicare Options Compare at www.medicare.gov.



“This year it is especially important, now and throughout the upcoming open enrollment period, for beneficiaries to use our online tools to compare their current drug and health plan coverage to the options available for 2009 and take action to choose a plan that best meets their needs,” said CMS Acting Administrator Kerry Weems. “Some beneficiaries may see significant premium increases or changes, such as reduced coverage in the gap, if they stay in the same prescription drug plan in 2009. Yet, almost 97 percent of beneficiaries enrolled in a stand-alone prescription drug plan (PDP) will have access to Medicare drug and health plans in 2009 whose premiums would be the same or less than their coverage in 2008.”





Beneficiaries will find contact information for their state’s SHIPs in their handbook or at http://www.medicare.gov/Contacts/Include/DataSection/Results/Results.asp?language=English&Organizations=F%7CSHIP+--+State+Health+Insurance+Assistance+Program&State=Select+All+States&Type=ORGANIZATION.



For more information and to view the plan finder tool please visit:

http://www.medicare.gov/MPDPF.



The LIS Outreach Toolkit can be accessed at: http://www.cms.hhs.gov/limitedincomeandresources/



To read more of the CMS press release issued 10/10/08, click here: http://www.cms.hhs.gov/apps/media/press_releases.asp

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6. Reminder:ICD-10-CM/PCS National Provider Conference Call for Hospital Staff - October 14, 2008, 12:30 p.m. – 2:30 p.m. EDT



CMS asks that you share this important information with all of your association members and State and local chapters. Thanks!



The Centers for Medicare & Medicaid Services (CMS) will host a series of national provider calls that will provide an overview of ICD-10 and how it differs from ICD-9-CM. The presentations will include the major impacts providers should consider when planning to update any systems with ICD-10 codes. Issues such as differences in code length, alpha-numeric characters, and increased details captured by the codes will be explained. For the provider, payer, vendor, and publishing community, this overview will help them think about future reporting, system updates, and training, considering that ICD-10 may be implemented in the future.



The presenters will include members of the Cooperating Parties for ICD-9-CM, a formal coalition that has been working together on ICD-10 issues. The role of each will be explained, along with a similar role they will play should ICD-10 be implemented. The Cooperating Parties include CMS, Centers for Disease Control and Prevention (CDC), American Health Information Management Association (AHIMA), and American Hospital Association (AHA).



A PowerPoint slide presentation has been posted in the Downloads Section of the ICD­10 CMS Sponsored Calls Web Page at http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp for you to download prior to the conference call so that you can follow along with the presentation. This PowerPoint slide presentation has been revised (October 2008).



To register go to http://www.cms.hhs.gov/ICD10/downloads/ICD10_hospital.pdf.

For those who are unable to attend, a transcript will be posted on the ICD-10 CMS Sponsored Calls Web Page at shortly after the conference call.

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7. “Information and Education Resources for Medicare Providers” PowerPoint Presentation



The latest version of the Provider Communications Group’s “Information and Education Resources for Medicare Providers” PowerPoint Presentation has been posted and is available for use. This revised edition includes updated information on:





A/B MAC Award Update
DMEPOS Competitive Acquisition
The Physician Quality Reporting Initiative
ICD–10 Clinical Modification/Procedure Coding System




The PowerPoint Presentation is posted at:

http://cmsnett.cms.hhs.gov/hpages/cmm/pcg/pcg_outreach_support.asp as well as

http://www.cms.hhs.gov/ContractorLearningResources/ .



Please remember that the “Information and Education Resources for Medicare Providers” PowerPoint Presentation was developed to assist CMS staff and Medicare Contractors who are giving presentations to provider audiences regarding Medicare education and outreach information. The first and last slides should be edited to include the speaker’s name and title. The presentation also includes many website addresses that make it a useful tool when navigating through the CMS Website. Therefore, it may be helpful to print and distribute the slides to attendees. The presentation is updated regularly to ensure that it contains the most current and relevant provider-related information. If you have any questions, please contact robin.sutton@cms.hhs.gov .

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8. Inpatient PPS PC Pricers for FY 2008 and 2009



Due to an issue with Medicare provider data, the Inpatient PPS PC Pricers for FY 2008 and FY 2009 have been updated. If you use the INP PPS PC Pricers, visit the CMS web page at http://www.cms.hhs.gov/PCPricer/03_inpatient.asp#TopOfPage and download the FY 2008 and FY 2009 versions posted on 10/02/2008.

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9. Fourth Quarter 2008 Hospital OPPS Pricer Downloads



The Fourth Quarter 2008 Hospital Outpatient PPS Pricer downloads have been posted on the CMS website. You may go to http://www.cms.hhs.gov/PCPricer/08_OPPS.asp#TopOfPage to view the latest update in the Downloads section.

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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