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. Electronic Health Records and the 21st Century Health Care System
2. Vice President Biden Announces Availability of Nearly $1.2 Billion in Grants to Help Hospitals and Doctors Use Electronic Health Records
3. REGISTRATION IS NOW OPEN FOR SUPPLIERS INTERESTED IN COMPETITIVE BIDDING FOR DMEPOS
4. Special Open Door Forum on DMEPOS Competitive Bidding: Learn the Rules to Submit a Bid Successfully!
5. Get Ready for DMEPOS Competitive Bidding!
6. 5010: Taking EDI to the Next Level - Third National Medicare Fee-For-Service (FFS) Education Call on HIPAA Version 5010
7. CMS Seeks Public Comments on Cardiac Outcomes Measures -- Comments Accepted through August 25, 2009
8. REMINDER: Second National Medicare Fee-For-Service (FFS) Education Call on HIPAA Version 5010
9. Medicare Demonstrations Show Paying For Quality Health Care Pays Off
10. Nursing Home Five-Star Quality Rating System – August News
11. Pricer Updates for Home Health PPS and Inpatient Psychiatric Facility PPS
12. New from the Medicare Learning Network
13. Extra Help for Beneficiaries Paying for Prescription Drugs
~~~~~~~~~~~~~~~~~~~~
1. Electronic Health Records and the 21st Century Health Care System
A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology
In my role as National Coordinator for Health IT, I have the privilege to be part of a transformative change in health care that will help to extend the benefits of health information technology (HIT) to all Americans. With the passage earlier this year of the Health Information Technology for Economic and Clinical Health (HITECH) Act, we have the tools to begin a major transformation in American health care made possible through the creation of a secure, interoperable nationwide health information network.
Of course, this system is not an end in itself. Rather, it will enable countless other improvements in the quality and efficiency of health care that will make Americans healthier and their economy stronger.
My personal belief in this transformation is not based on theory or conjecture. As a primary care physician for over 30 years, I spent the first twenty shuffling papers in search of missing studies and frequently hoping, during middle-of-the-night emergencies, that I knew enough about patients’ medical histories to make good decisions. All that changed when I began to have access to patients’ electronic medical records. It made me a much better doctor. I would never go back, and neither would the vast majority of American physicians who have made the leap into the electronic age.
In fact, it would be hard for any health professional today to escape the conclusion that the antiquated, paper-dominated system we now have in place isn’t working well for patients, creates added costs and inefficiencies, and isn’t sustainable. As we look at our nation’s annual health care expenditures of approximately $2.5 trillion, there are many ways our current system fails both patients and providers. It is clear that change is necessary.
But how and why is nationwide electronic health information exchange so critical to achieving such change? Most importantly, because it provides the best opportunity for each patient to receive optimal care. The technology will make patients’ complete medical information securely and reliably available to health care providers where and when it is needed – when clinician and patient are together facing medical decisions that can make a lasting difference.
Better, faster, more reliable and efficient care also ultimately reduces system-wide costs by delivering results that help to avoid expensive or prolonged hospitalization from delayed or ineffective treatment, avert costly and sometimes fatal adverse events and unnecessary procedures, and can help to eliminate the onset of disease by better informed management of each patient’s health.
The goal of assuring an electronic health record for every American is daunting. We at the Office of the National Coordinator for Health Information Technology (ONC) do not pretend otherwise. We know this will be hard for some clinicians and hospitals, and we stand ready to help with resources provided by the Congress and the Administration.
We also recognize that we cannot achieve the benefits of a nationwide health information system unless we can assure all Americans that their personal health information will remain private and secure when this system exists. Putting into place safeguards for the privacy and security of this information, when it is in electronic form, will be an ongoing priority that influences and guides all of our efforts.
In the days, weeks, and months ahead, we will be rolling out a number of pivotal initiatives called for under the HITECH Act. I urge you to join and support us as we lay the foundation for every American to benefit from an electronic health record, as part of a modernized, interconnected, and vastly improved system of care delivery. We at ONC will be making every effort to keep you updated and fully engaged in all the steps of this national journey.
Sincerely,
David Blumenthal, M.D., M.P.P.
National Coordinator for Health Information Technology
U.S. Department of Health & Human Services
~~~~~~~~~~~~~~~~~~~~
2. Vice President Biden Announces Availability of Nearly $1.2 Billion in Grants to Help Hospitals and Doctors Use Electronic Health Records
For Immediate Release
August 20, 2009
Vice President Biden Announces Availability of Nearly $1.2 Billion in Grants to Help Hospitals and Doctors Use Electronic Health Records
CHICAGO, IL – Vice President Joe Biden today announced the availability of grants worth nearly $1.2 billion to help hospitals and health care providers implement and use electronic health records. The grants will be funded by the American Recovery and Reinvestment Act of 2009 (ARRA) and will help health care providers qualify for new incentives that will be made available in 2010 to doctors and hospitals that meaningfully use electronic health records.
“With electronic health records, we are making health care safer; we’re making it more efficient; we’re making you healthier; and we’re saving money along the way, ”said Vice President Biden. “These are four necessities we need for healthcare in the 21st-century.”
“Expanding the use of electronic health records is fundamental to reforming our health care system,” said HHS Secretary Sebelius. “Electronic health records can help reduce medical errors, make health care more efficient and improve the quality of medical care for all Americans. These grants will help ensure more doctors and hospitals have the tools they need to use this critical technology.”
The grants made available today include:
Grants totaling $598 million to establish approximately 70 Health Information Technology Regional Extension Centers, which will provide hospitals and clinicians with hands-on technical assistance in the selection, acquisition, implementation, and meaningful use of certified electronic health record systems.
Grants totaling $564 million to States and Qualified State Designated Entities (SDEs) to support the development of mechanisms for information sharing within an emerging nationwide system of networks.
The Extension Center grants will be awarded on a rolling basis, with the first awards being issued in fiscal year 2010. Grants to States will be made in fiscal year 2010. Those interested in applying for these grants may visit http://HealthIT.HHS.gov for more information.
“With these programs, we begin the process of creating a national, private and secure electronic health information system. The grants are designed to help doctors and hospitals acquire electronic health records and use them in meaningful ways to improve the health of patients and reduce waste and inefficiency,” said Dr. David Blumenthal, National Coordinator for Health Information Technology. “They will also help states lead the way in creating the infrastructure for health information exchange, which enables information to follow patients within and across communities, wherever the information is needed to help doctors and patients make the best decisions about medical care.”
The Department of Health and Human Services will also provide additional assistance to health care providers through the Health Information Technology Research Center (HITRC). The HITRC will gather relevant information on effective practices from a wide variety of sources across the country and help the Regional Extension Centers collaborate with one another and with relevant stakeholders to identify and share best practices in EHR adoption, effective use, and provider support.
Attached are two fact sheets on the Health Information Technology Extension Program and the State Health Information Exchange Cooperative Agreement Program.
###
The activities described in this release are being funded through the American Recovery and Reinvestment Act (ARRA). To track the progress of HHS activities funded through the ARRA, visit www.hhs.gov/recovery. To track all federal funds provided through the ARRA, visit www.recovery.gov.
Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser.
~~~~~~~~~~~~~~~~~~~~
3. REGISTRATION IS NOW OPEN FOR SUPPLIERS INTERESTED IN COMPETITIVE BIDDING FOR DMEPOS
Registration is now open and available to all suppliers interested in participating in the Round 1 Rebid of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. Interested suppliers will submit their bids using an on-line internet application. To help ensure bid security and privacy, suppliers must first register to obtain a user ID and password. Only suppliers that have a user ID and password will be able to use the on-line bidding system; suppliers that do not register will not be able to bid.
If you are a supplier interested in bidding, register now – don’t wait. Designate one Authorized Official (AO) listed on the CMS-855S enrollment form to act as your AO for registration purposes. The AO must register first and must approve other supplier employee requests to register. The AO’s user ID and password will be sent by mail and should be delivered within 10 days after successful registration. After an AO successfully registers, the AO may designate other supplier employees to serve as Backup Authorized Officials (BAO) and/or End Users (EU). BAOs and EUs must also register in order to be able to use the on-line bidding system. The legal name, date of birth, and Social Security number (SSN) of the AO and BAOs must match exactly with what is on file with the National Supplier Clearinghouse in order to register successfully. Legal names, dates of birth, and SSNs of all users must match what is on file with the Social Security Administration.
We strongly urge all AOs to register no later than September 14, 2009 to ensure that BAOs and EUs have time to register before bidding begins. We recommend that BAOs register no later than October 9, 2009 so that they will be able to assist AOs with approving EU registration. Registration will close on November 4, 2009 at 9:00 p.m. EST – no AOs, BAOs, or EUs can register after registration closes.
To register, go to the Competitive Bidding Implementation Contractor (CBIC) website at www.dmecompetitivebid.com. Please review the IACS Reference Guide for step-by-step instructions on registration. The CBIC web site also has the following useful tools: a registration checklist; Quick Step guides; and frequently asked questions. All suppliers interested in bidding are urged to sign up for E-mail Updates on the home page of the CBIC website.
We would like to remind all suppliers interested in bidding that we will be holding the first in a series of eight Special Open Door Forum (ODF) bidders’ conferences for the Round 1 Rebid of the DMEPOS Competitive Bidding Program on August 19, 2009 from 2:00 to 3:00 pm EDT. At this Special ODF, we will provide an overview of what to expect during the bidder education period and provide suppliers with a step-by-step explanation of the registration process. In addition, we will identify common registration issues from the original Round 1 of the DMEPOS Competitive Bidding Program and discuss refinements to the bidding system. The PowerPoint presentation for the conference, along with information on how to participate, can be found on the CBIC website.
If you have any questions about the registration process, please contact the CBIC Customer Service Center at 1-877-577-5331. For information about the competitive bidding areas and product categories included in the Round 1 Rebid, as well as bidder education materials, please visit the CBIC website at www.dmecompetitivebid.com.
~~~~~~~~~~~~~~~~~~~~
4. Special Open Door Forum on DMEPOS Competitive Bidding: Learn the Rules to Submit a Bid Successfully!
Centers for Medicare & Medicaid Services
Special Open Door Forum:
Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Bidders’ Conference:
Learn the Rules to Submit a Bid Successfully
Wednesday, September 2, 2009
2:00 pm-3:00 pm Eastern Time
Conference Call Only
Please join us for the second in a series of eight Special Open Door Forum (ODF) bidders’ conferences for the Round 1 Rebid of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program. At this Special ODF, we will provide an overview of the competitive bidding areas (CBAs), product categories, and important rules to remember when submitting your bid(s). In addition, we will discuss eligibility requirements such as supplier standards, subcontracting, licensure, bonding, and accreditation. We will also provide an overview of special rules for physicians and treating practitioners, skilled nursing facilities, and hospitals.
Reminder: Registration for user IDs and passwords is open. It’s important for suppliers to register early to avoid delays in accessing the online bidding system when bidding opens.
Background:
On August 3, 2009, the Centers for Medicare & Medicaid Service (CMS) issued the bidding timeline for the Round 1 Rebid of the DMEPOS competitive bidding program and initiated a comprehensive bidder education campaign. CMS’ Competitive Bidding Implementation Contractor (CBIC) is the focal point for bidder education. Please visit the CBIC's dedicated website, www.dmecompetitivebid.com, for important information, including bidding rules, user guides, frequently asked questions, policy fact sheets, checklists, and bidding information charts. The CBIC toll-free help desk, 1‑877‑577‑5331, is open to help bidders with all of their questions and concerns. All suppliers interested in bidding are urged to sign up for e-mail updates on the home page of the CBIC website.
We look forward to your participation.
Special Open Door Participation Instructions:
Dial: 1-800-837-1935 & Reference Conference ID: 23044340
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning Friday, September 11, 2009.
For Open Door Forum schedule updates, E-Mailing list subscriptions, and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .
Thank you for your interest in CMS Open Door Forums.
~~~~~~~~~~~~~~~~~~~~
5. Get Ready for DMEPOS Competitive Bidding!
Four DMEPOS Message Reminders
The Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
Competitive Bidding Program Round 1 Rebid is Coming Soon!!
Summer 2009
Ø CMS announces bidding schedule/schedule of education events
Ø CMS begins bidder education campaign
Ø Bidder registration period to obtain user ID and passwords begins
Fall 2009
Ø Bidding begins
If you are a supplier interested in bidding, prepare now – don’t wait!
Ø UPDATE YOUR NSC FILES: DMEPOS supplier standard # 2 requires ALL suppliers to notify the National Supplier Clearinghouse (NSC) of any change to the information provided on the Medicare enrollment application (CMS-855S) within 30 days of the change. DMEPOS suppliers should use the 3/09 version of the CMS-855S and should review and update:
• The list of products and services found in section 2.D;
• The Authorized Official(s) information in sections 6A and 15; and
• The correspondence address in section 2A2 of the CMS-855S.
This is especially important for suppliers who will be involved in the Medicare DMEPOS Competitive Bidding Program. These suppliers must ensure the information listed on their supplier files is accurate to enable participation in this program. Information and instructions on how to submit a change of information may be found on the NSC Web site (http://www.palmettogba.com/nsc) and by following this path: Supplier Enrollment/Change of Information/Change of Information Guide.
Ø GET LICENSED: Suppliers submitting a bid for a product category in a competitive bidding area (CBA) must meet all DMEPOS state licensure requirements and other applicable state licensure requirements, if any, for that product category for every state in that CBA. Prior to submitting a bid for a CBA and product category, the supplier must have a copy of the applicable state licenses on file with the NSC. As part of the bid evaluation we will verify with the NSC that the supplier has on file a copy of all applicable required state license(s).
Ø GET ACCREDITED: CMS would like to remind DMEPOS suppliers that time is running out to obtain accreditation by the September 30, 2009 deadline or risk having their Medicare Part B billing privileges revoked on October 1, 2009. Accreditation takes an average of 6 months to complete. DMEPOS suppliers should contact a CMS deemed accreditation organization to obtain information about the accreditation process and the application process. Suppliers must be accredited for a product category in order to submit a bid for that product category. CMS cannot contract with suppliers that are not accredited by a CMS-approved accreditation organization.
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/01_Overview.asp .
Ø GET BONDED: CMS would like to remind DMEPOS suppliers that certain suppliers will need to obtain and submit a surety bond by the October 2, 2009 deadline or risk having their Medicare Part B billing privileges revoked. Suppliers subject to the bonding requirement must be bonded in order to bid in the DMEPOS competitive bidding program. A list of sureties from which a bond can be secured is found at the Department of the Treasury’s “List of Certified (Surety Bond) Companies;” the web site is located at:
www.fms.treas.gov/c570/c570_a-z.html.
Visit the CMS website at http://www.cms.hhs.gov/DMEPOSCompetitiveBid/ for the latest information on the DMEPOS competitive bidding program.
# # # # #
DMEPOS Supplier Accreditation and Surety Bond Requirement Deadlines Coming In October
Suppliers May Choose to Voluntarily Terminate Enrollment If They Do Not Plan To Comply
Medicare suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), unless exempt, must be accredited and obtain a surety bond by October 1, 2009 and October 2, 2009, respectively.
If you have made the decision not to obtain accreditation or a surety bond when required, you may want to voluntarily terminate your enrollment in the Medicare program before the implementation dates above. You can voluntary terminate your enrollment with the Medicare program by completing the sections associated with voluntary termination on page 4 of the Medicare enrollment application (CMS-855S). Once complete, you should sign, date and send the completed application to the National Supplier Clearinghouse (NSC). By voluntarily terminating your Medicare enrollment, you will preserve your right to re-enroll in Medicare once you meet the requirements to participate in the Medicare program.
If you do not comply with the accreditation and surety bond requirements and do not submit a voluntary termination, your Medicare billing privileges will be revoked. A revocation will bar you from re-enrolling in Medicare for at least one year after the date of revocation.
Suppliers who do not plan to stay enrolled in Medicare are strongly encouraged to notify their beneficiaries as soon as possible so the beneficiary can find another supplier.
For additional information regarding DMEPOS accreditation or the provisions associated with a surety bond, go to http://www.cms.hhs.gov/MedicareProviderSupEnroll. Frequently Asked Questions (FAQs) on the surety bond requirement can be found on the NSC’s FAQ page at http://www.palmettogba.com/nsc.
# # # # #
Take Action Now to Prepare for the Medicare Durable Medical Equipment, Prosthetics, Orthotics,
and Supplies (DMEPOS) Competitive Bidding Program!
A Special Edition MLN Matters education article identifying steps suppliers should take in preparation for the DMEPOS Competitive Bidding Program to ensure successful bidder registration is available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0915.pdf.
# # # # #
Also recently released--MM6571 - Program Instructions Designating the Competitive Bidding Areas and Product Categories Included in the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program Round One Rebid in calendar year (CY) 2009. This article identifies the nine metropolitan statistical areas (MSAs) as well as product categories in which the DMEPOS competitive bidding round one re-bid will occur in CY 2009 under section 1847 of the Social Security Act. You can view this article at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6571.pdf .
~~~~~~~~~~~~~~~~~~~~
6. 5010: Taking EDI to the Next Level - Third National Medicare Fee-For-Service (FFS) Education Call on HIPAA Version 5010
Conference call details:
Date: September 9, 2009
Conference Title: Third National Medicare FFS Education Call on HIPAA Version 5010
Time: 2:00 p.m. – 3:30 p.m. ET
The Centers for Medicare & Medicaid Services (CMS) will present the third in a series of National Education Conference Calls focused on Medicare’s Fee-for-Service (FFS) implementation of HIPAA Version 5010. The presentation will cover Medicare FFS error handling transactions (TA1, 999, and 277CA), planned use of each transaction and applicable rules and exceptions for the Medicare FFS program. The presentation is geared to billing software programmers or developers that reside within provider organizations. A Question & Answer (Q&A) session will follow the presentation that will give participants an opportunity to ask questions of CMS’ subject matter experts.
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation.
Registration will close at 2:00 p.m. ET on September 8, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
To register for the call participants need to go to:
http://www2.eventsvc.com/palmettogba/090909
Fill in all required data.
Verify your time zone is displayed correctly the drop down box.
Click "Register".
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
A few days prior to the call (not before September 6th), check the Educational Resources page on CMS’ 5010 web page at http://www.cms.hhs.gov/Versions5010andD0/40_Educational_Resources.asp to obtain a copy of the presentation that will be used during the call.
Learn more about 5010, visit CMS’ dedicated page at http://www.cms.hhs.gov/Versions5010andD0/ on the web.
~~~~~~~~~~~~~~~~~~~~
7. CMS Seeks Public Comments on Cardiac Outcomes Measures -- Comments Accepted through August 25, 2009
Comments Accepted through August 25, 2009
The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale New Haven Health Services Corporation/Center for Outcomes Research and Evaluation (YNHHSC/CORE) to develop two cardiac outcomes measures based on registry data and designed for potential use in public reporting and pay for reporting of hospital quality.
This email serves as a call for public comment on the two measures currently in development.
In partnership with the American College of Cardiology (ACC), YNHHSC/CORE is developing the following measures:
Complications following Implantable Cardioverter-Defibrillator (ICD) implantation. This measure uses data from the ACC National Cardiovascular Disease Registry (NCDR) ICD Registry for risk adjustment and Medicare Part A inpatient and outpatient administrative claims data to assess complications.
Readmission following Percutaneous Coronary Intervention (PCI). This measure uses data from the ACC National Cardiovascular Disease Registry (NCDR) CathPCI Registry for risk adjustment and Medicare Part A inpatient and outpatient administrative claims data to assess readmissions.
CMS is requesting stakeholder review and public comment of these measures still under development. All measure comments are welcome, but we are particularly interested in the following areas:
Outcome definitions and time period of assessment
Risk adjustment strategy
Technical Expert Panel (TEP) feedback (report available in the download section)
Comments on the measures must be received by August 25, 2009, 5:00 pm ET and may be general or specific to either measure.
Please use the following link to access the CMS public comment system: https://www.cms.hhs.gov/apps/QMIS/publicComment.asp.
A summary of all the comments received will be posted in the Downloads area below within four weeks after the public comment period closes.
Thank you for your support and participation.
Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser.
~~~~~~~~~~~~~~~~~~~~
8. REMINDER: Second National Medicare Fee-For-Service (FFS) Education Call on HIPAA Version 5010
5010: Taking EDI to the Next Level
Second National Medicare Fee-For-Service (FFS) Education Call on HIPAA Version 5010
Conference call details:
Date: August 26, 2009
Conference Title: Version 5010: Medicare FFS Error Handling Transactions
Time: 2:00 p.m. – 3:30 p.m. ET
The Centers for Medicare & Medicaid Services (CMS) presents the second in a series of national provider training calls on Medicare's Fee-For-Service (FFS) implementation of HIPAA Version 5010. The target audiences for this call are clearinghouses and billing software vendors. The topic for this call is error handling transactions (TA1, 999, and 277CA). The discussion will cover CMS’ planned use of each transaction, including rules and exceptions, for the Medicare FFS program. There will be a Q&A session following the presentation where you will have a chance to ask questions from CMS subject matter experts.
In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation.
Registration will close at 2:00 p.m. ET on August 25, 2009, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.
1. To register for the call participants need to go to:
http://www2.eventsvc.com/palmettogba/082609
2. Fill in all required data.
3. Verify your time zone is displayed correctly the drop down box.
4. Click "Register".
5. You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
6. A few days prior to the call (not before August 24th), check the Educational Resources page on CMS’ 5010 web page at http://www.cms.hhs.gov/Versions5010andD0/40_Educational_Resources.asp to obtain a copy of the presentation that will be used during the call.
Learn more about 5010, visit CMS’ dedicated page at http://www.cms.hhs.gov/Versions5010andD0/
~~~~~~~~~~~~~~~~~~~~
9. Medicare Demonstrations Show Paying For Quality Health Care Pays Off
Demonstrations being conducted by the Centers for Medicare & Medicaid Services (CMS) continue to provide strong evidence that offering financial incentives for improving or delivering high quality care increases quality and can reduce the growth in Medicare expenditures.
CMS recently announced new results from three of these demonstrations, one for large physician practices, one for small and solo physician practices, and one for hospitals. CMS is also announcing the start of three additional value based purchasing demonstrations. “We continue to be encouraged by the progress of our ongoing programs that test value based-purchasing across a variety of health care services,” said Charlene Frizzera, Acting Administrator of CMS; “Building on those efforts, we are pleased to announce the start of our Nursing Home Value-Based Purchasing Demonstration and two gainsharing demonstrations.”
The CMS value-based purchasing (VBP) initiative is designed to tie Medicare payments to performance on quality and efficiency and is part of CMS’ effort to transform Medicare from a passive payer to an active purchaser of higher quality, more efficient health care. New demonstration programs include the Nursing Home Value-Based Purchasing Demonstration, the Medicare Hospital Gainsharing Demonstration, and the Physician Hospital Collaboration Demonstration. These demonstrations will allow physicians to share in the savings generated by the adoption of structural and procedural changes made to improve the quality of inpatient hospital care.
For additional information on value based purchasing demonstrations, visit the demonstrations webpage at http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/list.asp. To read the entire CMS press release please click here: http://www.cms.hhs.gov/apps/media/press_releases.asp
~~~~~~~~~~~~~~~~~~~~
10. Nursing Home Five-Star Quality Rating System – August News
1. The Five-Star provider preview reports will be available beginning August 18, 2009. 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. Providers can write to BetterCare@cms.hhs.gov for questions and concerns about the August data. The helpline will reopen in October 2009.
3. Nursing Home Compare will update with August Five-Star data on Thursday, August 27, 2009.
4. Please visit http://www.cms.hhs.gov/CertificationandComplianc/13_FSQRS.asp for the latest Five-Star Quality Rating system information.
~~~~~~~~~~~~~~~~~~~~
11. Pricer Updates for Home Health PPS and Inpatient Psychiatric Facility PPS
Calendar Year (CY) 2009 Home Health PPS (HH PPS) Personal Computer (PC) Pricer Update
The CY 2009 Home Health PPS (HH PPS) PC Pricer needed to revert back to the previous release level. However, the provider data distributed with the HH PPS PC Pricer has been updated as of August 2009. This is available on the web page, http://www.cms.hhs.gov/PCPricer/05_HH.asp, under the Downloads section. If you use the HH PPS PC Pricer, please go to the page above and download the latest version (which is the previous version) of the PC Pricer.
Rate Year (RY) 2010 Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) Personal Computer (PC) Pricers Release -- 08/20/2009
The Inpatient Psychiatric Facility (IPF) PPS PC Pricers for RY 2010 has been made available on the CMS website. If you use the IPF PPS PC Pricer for 2010, please go to the page, http://www.cms.hhs.gov/PCPricer/09_inppsy.asp, under the Downloads section, and download the latest versions of the IPF PPS PC Pricers, posted 08/20/2009.
~~~~~~~~~~~~~~~~~~~~
12. New from the Medicare Learning Network
The following ICD-10-CM/PCS publications are now available from the Centers for Medicare & Medicaid Services Medicare Learning Network:
· ICD-10-CM/PCS Myths & Facts (June 2009), which presents correct information in response to some myths regarding the ICD-10-Clinical Modification/Procedure Coding System, is now available in print format. To place your order, visit http://www.cms.hhs.gov/MLNGenInfo/ , scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”
ICD-10-CM-PCS Bookmark (revised August 2009), which provides information about the ICD-10-Clinical Modification/Procedure Coding System including the benefits of adopting the coding system, recommended steps to be taken in order to plan and prepare for implementation of the coding system, and where additional information about the coding system can be found, is now available in downloadable format at http://www.cms.hhs.gov/MLNProducts/downloads/ICD-10ClinModBookmrk.pdf .
# # # # # #
The Smoking and Tobacco-Use Cessation Counseling Services brochure, which provides information about the smoking and tobacco-use cessation counseling benefit covered under Medicare, and the Bone Mass Measurements brochure, which provides information about the bone mass measurement benefit covered under Medicare, have been newly revised and updated! They are now available on the Medicare Learning Network in a downloadable, printable format at the following addresses:
http://www.cms.hhs.gov/MLNProducts/downloads/smoking.pdf
http://www.cms.hhs.gov/MLNProducts/downloads/bone_mass.pdf
Printed hardcopy versions will be available at a later date. For more products related to Medicare-covered preventive services, please visit our preventive services educational products website at: http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp
# # # # # #
The revised Skilled Nursing Facility Prospective Payment System Fact Sheet (August 2009), which provides the elements of the Skilled Nursing Facility Prospective Payment System, is now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/snfprospaymtfctsht.pdf .
~~~~~~~~~~~~~~~~~~~~
13. 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.
~~~~~~~~~~~~~~~~~~~~
Lucretia James
Division for Medicare Health Plans Operations
Centers for Medicare & Medicaid Services
Region VIII
1600 Broadway, Suite 700
Denver, CO 80202
(303) 844-1568
lucretia.james@cms.hhs.gov
Professor Emeritus -- Dr. Tom Seymour from West Fargo, North Dakota -- Professor, Minot State University, MSU Faculty Regents Award (2015) -- PAST Peer Reviewer (Higher Learning Commission - Chicago); - Author and Presenter Board of Directors, SRT Communications, Inc and Minot City Alderman - Ward 5 (2010-June, 2016) PAST - Editor-in-Chief (North Dakota State Senator (2002-2010) 2017-Cass County Electric Cooperative- Board of Directors
No comments:
Post a Comment