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. DMEPOS Supplier Accreditation Reminder



2. MLN Matters Article Now Available On DMEPOS Accreditation!



3. Five-Star Quality Rating System Updates



4. March 24th is Diabetes Alert Day



5. March Flu Shot Reminder



6. Extra Help for Beneficiaries Paying for Prescription Drugs



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1. DMEPOS Supplier Accreditation Reminder



Deadline is September 30, 2009



Time is running out for suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) who bill Medicare under Part B to obtain accreditation by the September 30, 2009 deadline or risk having their Medicare Part B billing privileges revoked on October 1, 2009. A new MLN Matters Special Edition articles on this subject is now available. This article outlines what you need to do if you have not yet complied with the Medicare Program’s supplier and quality standards to be come accredited. To view the article, go to: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0903.pdf on the CMS website.



While the accreditation process takes on average 6-7 months to complete, the process could take as long as 9 months to complete. Accordingly, DMEPOS suppliers should contact an accreditation organization right away to obtain information about the accreditation process and submit an application.



In order to retain or obtain a Medicare Part B billing number, all DMEPOS suppliers (except for exempted professionals and other persons as specified by the Secretary) must comply with the Medicare program’s supplier standards and quality standards to become accredited. The accreditation requirement applies to suppliers of durable medical equipment, medical supplies, home dialysis supplies and equipment, therapeutic shoes, parenteral/enteral nutrition, transfusion medicine and prosthetic devices, and prosthetics and orthotics.



Pharmacies, pedorthists, mastectomy fitters, orthopedic fitters/technicians and athletic trainers must also meet the September 30, 2009 deadline for DMEPOS accreditation. Certain eligible professionals and other persons as specified by the Secretary are exempt from the accreditation requirement.



Further information on the DMEPOS accreditation requirements, along with a list of the accreditation organizations and those professionals and other persons exempted from accreditation, may be found at the CMS website: http://www.cms.hhs.gov/MedicareProviderSupEnroll/03_DeemedAccreditationOrganizations.asp .

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2. MLN Matters Article Now Available On DMEPOS Accreditation!



This is a reminder that DMEPOS (durable medical equipment, prosthetics, orthotics and supplies) providers and suppliers enrolled in the Medicare Part B program are required to obtain accreditation by September 30, 2009. A new MLN Matters Special Edition article on this subject is now available. This article outlines what you need to do if you have not yet complied with the Medicare program’s supplier standards and quality standards to become accredited. To view the article, go to: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0903.pdf on the CMS website.

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3. Five-Star Quality Rating System Updates



1. The Five-Star provider preview reports are now available. Providers can access the report from the Minimum Data Set (MDS) State Welcome pages available at the state servers for submission of Minimum Data Set data.

Provider Preview access information:



· Visit the MDS State Welcome page available on the State servers where you submit MDS data to review your results.

· To access these reports, select the Certification and Survey Provider Enhanced Reports (CASPER) Reporting link located at the bottom of the login page.

· Once in the CASPER Reporting system:

i. Click on the 'Folders' button and access the Five Star Report in your 'st LTC facid' folder,

ii. Where st is the 2-digit postal code of the state in which your facility is located, and

iii. Facid is the state assigned facid of your facility.

2. The Five-Star Helpline will be open for providers from 9 AM to 5 PM ET beginning Wednesday, March 18 -Thursday, April 2, 2009 to address any March’s Five-Star data concerns.

3. Nursing Home Compare will update with March’s Five-Star data on Thursday, March 26, 2009.

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4. March 24th is Diabetes Alert Day



Diabetes is the sixth leading cause of death in the United States. However, early detection and treatment of diabetes can prevent or delay many of the complications associated with the disease.



In conjunction with Diabetes Alert Day, the Centers for Medicare & Medicaid Services (CMS) would like to remind health care professionals that Medicare provides coverage for several diabetes-related services, including:

· diabetes screening tests,

· diabetes self-management training,

· medical nutrition therapy, and

· certain other diabetes supplies and services.



CMS offers several educational products related to Medicare-covered preventive services, including diabetes services. Please visit the Medicare Learning Network (http://www.cms.hhs.gov/MLNGenInfo/) for more information, including the following diabetes-related pages:



o The MLN Preventive Services Educational Products Web Page ~ provides descriptions and ordering information for Medicare Learning Network (MLN) preventive services educational products and resources for health care professionals and their staff. http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp

o Diabetes-Related Services Brochure ~ This tri-fold brochure provides health care professionals with an overview of Medicare's coverage of diabetes screening tests, diabetes self-management training, medical nutrition therapy, and supplies and other services for Medicare beneficiaries with diabetes. http://www.cms.hhs.gov/MLNProducts/downloads/DiabetesSvcs.pdf

o To order copies of the brochure, go to the MLN Product Ordering System located at: http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident=kc0001&loc=5

o The CMS website provides additional information about the Medical Nutrition Therapy benefit at: http://www.cms.hhs.gov/MedicalNutritionTherapy/



For more information diabetes, please visit the National Diabetes Education Program website at http://www.ndep.nih.gov/ . This site contains several publications to help you educate your patients about diabetes prevention, including The Road to Health Toolkit, which contains resources specifically tailored for community health workers in Hispanic/Latino and African-American communities, who are at a higher risk for type 2 diabetes.

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5. March Flu Shot Reminder



It’s Not Too Late to Give and Get the Flu Shot!

In the US, the peak of flu season typically occurs anywhere from late December through March; however, flu season can last as late as May. Each office visit presents an opportunity for you to talk with your patients about the importance of getting an annual flu shot and a one time pneumococcal vaccination. Protect yourself, your patients, and your family and friends by getting and giving the flu shot. Don’t Get the Flu. Don’t Give the Flu.



Remember - Influenza and pneumococcal vaccinations plus their administration are covered Part B benefits. Note that influenza and pneumococcal vaccines are NOT Part D covered drugs.



Health care professionals and their staff can learn more about Medicare’s Part B coverage of adult immunizations and related provider education resources, by reviewing Special Edition MLN Matters article SE0838 http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0838.pdf on the CMS website.

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6. 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