Saturday November 29 --- A Medicare Update

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. National Medicare Training Program Update



3. Reminder – Medicare Part B Drug Competitive Acquisition Program (CAP): Feedback About the CAP ~ A Special Open Door Forum Teleconference



4. Important Information on Medicare Payment and Supplier Requirements for Oxygen and Oxygen Equipment



5. Physicians and Other Health Professionals Value-Based Purchasing Issues Paper Posted



6. Continuing Education Available on E-Prescribing Topics



7. Medicare Publishes New Information on Quality of Care at Dialysis Facilities



8. November Flu Shot Reminder



9. Extra Help for Beneficiaries Paying for Prescription Drugs









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1. New From the Medicare Learning Network



The Centers for Medicare & Medicaid Services (CMS) has released an MLN Matters article that is based on Change Request (CR) 6223, which announces expanded coverage of the Initial Preventive Physical Examination (IPPE) also know as the “Welcome to Medicare Visit” of “Welcome to Medicare Physical Exam”. This expanded coverage applies to IPPEs performed on or after January 1, 2009. The article, MM6223 Update to the Initial Preventive Physical Examination (IPPE) Benefit, is available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6223.pdf on the CMS website.



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Flu Season Is Here! Medicare provides coverage of the flu vaccine without any out-of-pocket costs to Medicare patients. No deductible or copayment/coinsurance applies. For quick information to assist with filing claims for the influenza vaccine and it’s administration, the Centers for Medicare & Medicaid Services (CMS) has prepared The Quick Reference Information: Medicare Part B Immunization Billing Chart (Feb. 2008) - This two-sided laminated reference chart gives Medicare fee-for-service physicians, providers, suppliers, and other health care professionals a quick reference to coding and billing information. To view, download, and print the quick reference chart, go to http://www.cms.hhs.gov/MLNProducts/downloads/qr_immun_bill.pdf on the CMS website. To order a copy, free of charge, go to the MLN Products Ordering web page at http://cms.meridianksi.com/kc/pfs/pfs_lnkfrm_fl.asp?lgnfrm=reqprod&function=pfs . Get Your Flu Shot – Not the Flu.

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2. National Medicare Training Program Update



SAVE THE DATE!
My Health. My Medicare. Audio-conference training session

When: Tuesday, December 2, 2008

Time: 2:30 - 3:30 p.m. EST

Topic: Open Enrollment Season Q&A

Dial toll free: 800-369-3155

Pass code: NMTP

Subject matter experts will be available to provide updates and answer questions on Open Enrollment. Feel free to submit questions in advance to NMTP@cms.hhs.gov.

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3. Reminder – Medicare Part B Drug Competitive Acquisition Program (CAP): Feedback About the CAP ~ A Special Open Door Forum Teleconference



Medicare Part B Drug Competitive Acquisition Program (CAP): Feedback about the CAP – A Special Open Door Forum (ODF) Teleconference on the 2009 CAP Postponement and How to Submit E-mail Comments



The Centers for Medicare & Medicaid Services (CMS) is soliciting public feedback about the CAP. CMS is interested in hearing about a range of issues, including, but not limited to:

§ the categories of drugs provided under the CAP

§ the distribution of areas that are served by the CAP

§ procedural changes that may increase the program's flexibility and appeal to potential vendors and physicians.



On December 3, 2008, CMS will host a Special ODF Teleconference to obtain feedback about the program. This teleconference will be a listening session and is intended for current and former participating CAP physicians, potential Approved CAP Vendors, and any other interested parties. CMS will assess the information that it receives as it considers implementing changes to the CAP.



Call Details:



Date and Time: December 3, 2008 from 2:00-3:30PM EST

Toll Free Call Number: (800) 837-1935

Conference ID: 66307647



Interested parties can also submit comments to the CAP e-mailbox at MMA303DDrugBid@cms.hhs.gov

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4. Important Information on Medicare Payment and Supplier Requirements for Oxygen and Oxygen Equipment



The Centers for Medicare & Medicaid Services (CMS) has released an MLN Matters article that emphasizes important information on Medicare payment and supplier requirements for oxygen and oxygen equipment. To assure proper implementation of these policies, the MLN Matters article focuses on significant supplier requirements for furnishing oxygen and oxygen equipment to our beneficiaries. The article (# SE0840 entitled, Changes in Medicare Payment for Oxygen and Oxygen Equipment) is available on the CMS website at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0840.pdf .



CMS has also released questions and answers to address beneficiary concerns regarding the changes in payment and supplier requirements for oxygen and oxygen equipment. To view these questions and answers visit questions.medicare.gov on the Internet.

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5. Physicians and Other Health Professionals Value-Based Purchasing Issues Paper Posted



The Centers for Medicare & Medicaid Services (CMS) has posted the Issues Paper that is part of the development of a Plan to transition to a Medicare Value-Based Purchasing Program for physician and other professional services, as required by Section 131(d) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). The Issues Paper is posted on the CMS Website Physician Center Spotlights at: http://www.cms.hhs.gov/center/physician.asp.



This Issues Paper will be the basis of a Listening Session to be held at the CMS Central Facility on December 9, 2008, from 10 AM EST to 4 PM EST. The notice for this meeting was published in the Federal Register on October 24, 2008. Physicians and other professionals, their associations, health care purchasers, consumers, and all other interested parties are invited to participate, in person or by calling in to the teleconference. The issues identified and discussed during this meeting will assist CMS in developing options for the Plan. The meeting is open to the public, but attendance is limited to space and teleconference lines available.



Interested parties are reminded that to participate, either in person or by teleconference, on‑line registration is required via the CMS website at: http://registration.intercall.com/go/cms2. Registration will close at 5 PM EST on Tuesday, December 2, 2008.



Written comments or statements on the Issues Paper are welcome and may be sent via email to PhysicianVBP@cms.hhs.gov; faxed to 410-786-8005; or sent via regular mail to: Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244-1850, Mail Stop C5-15-02, Attn: Physician VBP Comments. All persons planning to make a statement in person at the Listening Session are urged to submit statements in writing during the Listening Session and should subsequently submit the information electronically. The deadline for receipt of comments is 5 PM EST on Tuesday, December 16, 2008.



For further information regarding the December 9, 2008 Listening Session, contact Robin Phillips, at 410-786-3010 in the Provider Communications Group. Inquiries may also be sent via e‑mail to mpf@cms.hhs.gov



Listening Session Format

The Listening Session will consider the key design issues raised in the Issues Paper. The session will begin at 10 AM EST with an overview of the objectives for the session and a brief summary of the approach to developing the Plan. Beginning at approximately 10:30 AM EST, the remainder of the meeting will be devoted to presenting and receiving comments on key design and policy issues for each of the major components for the Plan: (1) measures, (2) incentive structure, (3) data strategy and infrastructure, and (4) public reporting. The agenda will provide opportunities for brief 2-minute comments on each of the key issues from on-site session attendees. As time allows, telephone participants will also have the opportunity to provide brief 2-minute comments. A lunch break will occur from approximately 12:15 to 1 PM EST. The meeting will conclude by 4 PM EST with brief comments on next steps.



The final Agenda and copies of the PowerPoint slides to be used in the Listening Session will be posted by 5 PM EST Friday, December 5, 2008, on the CMS Website Physician Center Spotlights at: http://www.cms.hhs.gov/center/physician.asp.

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6. Continuing Education Available on E-Prescribing Topics



In 2009 the Centers for Medicare & Medicaid Services (CMS) will provide incentives for health care providers who use e-prescribing. In October 2008, CMS and 34 partner organizations hosted a meeting about the mechanics of implementing an e-prescribing program in a practice. Audiotapes and slides are now archived online for continuing education credit. The Massachusetts Medical Society and the American Pharmacist Association are pleased to provide Continuing Medical Education (a maximum of 22.5 AMA PRA Category 1 Credits™, (risk management study for MA Physicians) and Continuing Education for pharmacists (up to 13.25 hours of continuing education credit (1.325 CEUs)). Simply go to www.massmed.org/cme/CMS_eprescribing to view the presentations and hear the audiotapes of the program. There are no registration or certificate fees.

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7. Medicare Publishes New Information on Quality of Care at Dialysis Facilities



Changes to Web Site Will Help Consumers Compare Care and Make

Informed Health Care Choices



The Centers for Medicare & Medicaid Services (CMS has announced important additions to the Dialysis Facility Compare consumer Web site (http://www.medicare.gov/dialysis) that will give consumers even better insight into the quality of care provided by their local dialysis patient facilities.



The improvements include two new quality measures that demonstrate how well dialysis patients are treated for anemia (low red blood cell count) as well as updated information that will help patients better understand survival rates by facility.



To view the entire Press Release, please see: http://www.cms.hhs.gov/apps/media/press_releases.asp

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8. November Flu Shot Reminder



“Flu season is here! Medicare patients give many reasons for not getting their annual flu shot, including—“It causes the flu"; "I don’t need it"; "It has side effects"; "It’s not effective"; "I didn’t think about it"; "I don’t like needles!” The fact is that every year in the United States, on average, about 36,000 people die from influenza. Greater than 90 percent of these deaths occur in individuals 65 years of age and older. You can help your Medicare patients overcome these odds and their personal barriers through patient education. Talk with your Medicare patients about the importance of getting an annual flu shot--and don’t forget to immunize yourself and your staff. Protect yourself, your patients, and your family and friends. Get Your Flu Shot – Not the Flu. 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 and their staff, please go to http://www.cms.hhs.gov/MLNProducts/Downloads/flu_products.pdf on the CMS website. To download the Medicare Part B Immunization Billing quick reference chart, go to http://www.cms.hhs.gov/MLNProducts/downloads/qr_immun_bill.pdf on the CMS website. A copy of this quick reference chart can be ordered, free of charge, by going to the MLN Products web page and clicking on “MLN Product Ordering Page” in the Related Links Inside CMS section of the web page.

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9. 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