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. Delay in Implementing Phase 2 of CRs 6417 and 6421
2. CMS Processing Pharmacy DME Accreditation Determinations
3. Special Open Door Forum: 2010 Physicians Quality Reporting Initiative (PQRI) and Electronic Prescribing (eRx) Initiative Programs: Group Practice Reporting Option (GPRO)
4. 2011 Physician Quality Reporting Initiative Listening Session
5. DME MAC Contractors Conduct Teleconference to Introduce National Comprehensive Error Rate Testing (CERT) Education Initiative
6. Protecting You and Your Prescriptions Beneficiary Publication
7. Information Regarding the Holding of Claims for Services Paid Under the 2010 Medicare Physician Fee Schedule
8. Updated Information Regarding the Holding of Claims for Services Paid Under the 2010 Medicare Physician Fee Schedule
9. New from the Medicare Learning Network®
10. REVISED: MLN Matters Article #MM6740 - Revisions to Consultation Services Payment Policy
11. January 2010 Average Sales Price (ASP) File Is Now Available
12. Posting of the January 2010 ASP and Not Otherwise Classified (NOC) Pricing Files and Crosswalks
13. Modification to the Healthcare Common Procedure Coding System (HCPCS) Code Set
14. FY 2010 Hospice Wage Index Now Available
15. Security Changes for Home Health OASIS Users
16. Your December Flu Message
17. Extra Help for Medicare Beneficiaries Paying for Prescription Drugs
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1. Delay in Implementing Phase 2 of CRs 6417 and 6421
The Centers for Medicare & Medicaid Services (CMS) will delay, until April 5, 2010, the implementation of Phase 2 of Change Request (CR) 6417 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Claims Processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)) and CR 6421 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Claims Processed by Durable Medical Equipment Medicare Administrative Contractors (DME MACs)). CRs 6417 and 6421 are applicable to Part B claims only.
The delay in implementing Phase 2 of these CRs will give physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers sufficient time to enroll in Medicare or take the action necessary to establish a current enrollment record in Medicare prior to Phase 2 implementation.
Although enrolled in Medicare, many physicians and non-physician practitioners who are eligible to order items or services or refer Medicare beneficiaries to other Medicare providers or suppliers for services do not have current enrollment records in Medicare. A current enrollment record is one that is in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and also contains the physician/non-physician practitioner’s National Provider Identifier (NPI). Under Phase 2 of the above referenced CRs, a physician or non-physician practitioner who orders or refers and who does not have a current enrollment record that contains the NPI will cause the claim submitted by the Part B provider/supplier who furnished the ordered or referred item or service to be rejected.
CMS continues to urge physicians and non-physician practitioners who are enrolled in Medicare but who have not updated their Medicare enrollment record since November 2003 to update their enrollment record now. If these physicians and non-physician practitioners have no changes to their enrollment data, they need to submit an initial enrollment application which will establish a current enrollment record in PECOS.
For physicians and non-physician practitioners who order or refer—
· If you are not enrolled in the Medicare program, or if you enrolled more than 6 years ago and have not submitted any updates or changes to your enrollment information in more than 6 years, you do not have an enrollment record in PECOS. In order to continue to order or refer items or services for Medicare beneficiaries, you will have to submit an initial enrollment application. You may do so either by (1) using Internet-based PECOS (which transmits your enrollment application to the Medicare carrier or A/B MAC via the Internet—be sure to mail the signed and dated Certification Statement to the carrier or A/B MAC immediately after submitting the application), or (2) filling out the appropriate paper Medicare provider enrollment application(s) (CMS-855I and CMS-855R, if appropriate) and mailing the application, along with any required additional supplemental documentation, to the local Medicare carrier or A/B MAC, who will enter your information into PECOS and process your enrollment application. Information on how to enroll in Medicare is found on the Medicare provider/supplier enrollment web site at www.cms.hhs.gov/MedicareProviderSupEnroll.
· If you are already enrolled in Medicare, make sure you have a current enrollment record. You can find out if you have an enrollment record in PECOS by calling your designated carrier or A/B MAC or by going on-line, using Internet-based PECOS, to view your enrollment record. We will be posting information to the Medicare provider/supplier enrollment web site that will guide you through this process. Information about Internet-based PECOS and a link to Internet-based PECOS can be found on the Medicare provider/supplier enrollment web site. Before using Internet-based PECOS, we recommend that you read the information that is posted there and that is available in the downloadable documents section.
· If you are a dentist or a physician with a specialty such as a pediatrics who is eligible to order or refer items or services for Medicare beneficiaries but have not enrolled in Medicare because the services you provide are not covered by Medicare or you treat few Medicare beneficiaries, you need to enroll in Medicare in order to continue to order or refer items or services for Medicare beneficiaries.
· If you are a physician who is employed by the Department of Veterans Affairs, the Public Health Service, or the Department of Defense Tricare program but have not enrolled in Medicare because you would not be paid by Medicare for your services, you need to enroll in Medicare in order to continue to order or refer items or services for Medicare beneficiaries.
If you are a resident who has a medical license but have not enrolled in Medicare because you would not be paid by Medicare for your services, you do not need to enroll in Medicare in order to continue to order or refer items or services for Medicare beneficiaries. The teaching physician—not the resident—should be identified in claims as the ordering/referring provider when a resident orders or refers items or services for Medicare beneficiaries.
CMS actions to mitigate the number of informational messages:
Since many Part B providers and suppliers are receiving a high volume of informational messages in their Remittances, CMS is taking the following actions to reduce the number of informational messages being generated:
1. Prior to the implementation of Phase 2, CMS will systematically add the NPIs to the PECOS enrollment records of all physicians and non-physician practitioners whose enrollment records are in PECOS but do not contain their NPIs. Because the NPI is one of the matching criteria used in implementing the two new edits on the Ordering/Referring Provider, it is essential that the NPI be in the PECOS enrollment record. Because the data file used to implement the two edits contains only the eligible physicians and non-physician practitioners who are in PECOS with NPIs in their enrollment records, this action will add many more physicians and non-physician practitioners to that data file.
2. Prior to the implementation of Phase 2, CMS will make publicly available on the Internet the names and NPIs of the Medicare physicians and non-physician practitioners who are eligible to order or refer in the Medicare program. The name displayed will be that of the physician or non-physician practitioner as it appears in his or her PECOS enrollment record. This will allow Part B providers and suppliers who furnish and bill for items or services based on orders or referrals to determine if the Ordering/Referring Provider being identified in their claims will pass the two new edits prior to submitting the claims to Medicare.
3. Prior to the implementation of Phase 2, CMS will issue instructions to carriers and A/B MACs that will assist them in processing enrollment applications from physicians who are employed by the Department of Veterans Affairs, the Public Health Service, and the Department of Defense Tricare program. The instructions will also state that the teaching physician should be reported as the Ordering/Referring Physician in situations where a resident orders or refers items or services for Medicare beneficiaries. The instructions will also note that dentists and pediatricians, who sometimes order or refer items or services for Medicare beneficiaries, may be enrolling in Medicare in order to continue to order and refer.
4. CMS will be preparing a Special Edition Medicare Learning Network (MLN) Matters Article on the implementation of these two new edits. This MLN Matters Article will expand upon the information currently available in MLN Matters Articles MM 6417 and MM 6421.
Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser.
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2. CMS Processing Pharmacy DME Accreditation Determinations
CMS will continue to process accreditation determinations for pharmacies after January 1, 2010. The revocation process for those who do not meet the accreditation requirement will be prioritized based on any potential beneficiary access issues as well as the Agency’s workload. Pharmacies should proceed with their accreditation activities and the accrediting organization will notify the National Supplier Clearinghouse of any newly processed accreditations.
CMS encourages pharmacies to complete their accreditation applications as soon as possible and will notify pharmacies that furnish DME items of any changes in the accreditation requirements.
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3. Special Open Door Forum: 2010 Physicians Quality Reporting Initiative (PQRI) and Electronic Prescribing (eRx) Initiative Programs: Group Practice Reporting Option (GPRO)
Thursday, January 14, 2010 3:30-5:00 pm ET
Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will host a Special Open Door Forum on the 2010 PQRI and eRx Incentive programs. This Special Open Door Forum will focus on a new reporting option, available for the 2010 PQRI and eRx Incentive Program, known as the Group Practice Reporting Option (GPRO). Group practices that are interested in participating in the GPRO for PQRI and/or the eRx Incentive Program must submit a self-nomination letter to CMS by no later than January 31, 2010. Once a group practice (Tax Identification Number or TIN) is selected to participate in the GPRO for PQRI or eRx, this is the only method of PQRI or eRx reporting available to the group and all individual eligible professionals (National Provider Identifier or NPI) who bill Medicare under the group’s TIN for 2010.
During this call, CMS will:
· Provide information on the eligibility requirements for participating in the 2010 PQRI GPRO and/or the 2010 eRx Incentive Program GPRO;
· Provide instructions for self-nominating to participate in the 2010 PQRI GPRO and/or 2010 eRx Incentive Program GPRO;
· Provide an overview of the data submission process for PQRI and the eRx Incentive Program;
· Describe the measures for the 2010 PQRI GPRO;
· Discuss the criteria for satisfactory reporting of PQRI quality measures under GPRO; and
· Discuss the criteria for successful reporting of the eRx measure under GPRO.
Following the presentation, the telephone lines will be opened to allow participants to ask questions of the CMS subject matter experts as well as of individuals who have experience with the data submission process that will be used for quality reporting under the PQRI GPRO.
The 2010 GPRO for the PQRI and eRx Incentive Programs was finalized in the 2010 Physician Fee Schedule final rule with comment period. The final regulation was published in the Federal Register on November 25, 2009. To view the entire 2010 PFS final rule with comment period, go to the CMS PQRI website http://www.cms.hhs.gov/PQRI and click on the “Statute/Regulations/Program Instructions” section page. PQRI GPRO information is also available by clicking on the “Group Practice Reporting Option” section page of the CMS PQRI website. eRx Incentive GPRO information is available by clicking on the “Group Practice Reporting Option” section page of the CMS eRx Incentive Program website located at http://www.cms.hhs.gov/erxincentive .
We look forward to your participation.
Special Open Door Forum Participation Instructions:
Dial: 1-800-837-1935 Conference ID 45243499
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 A Relay Communications Assistant will help.
An audio recording and transcript 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 on or around January 27, 2010.
For automatic emails of 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.
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4. 2011 Physician Quality Reporting Initiative Listening Session
The Centers for Medicare & Medicaid Services (CMS) is hosting a Listening Session on the 2011 Physician Quality Reporting Initiative (PQRI). The purpose of this listening session is to discuss and solicit feedback on the individual quality measures and measures groups being considered for possible inclusion in the proposed set of quality measures for use in the 2011 PQRI program and key components of the design of the PQRI program, such as possible reporting mechanisms, reporting periods, criteria for satisfactory reporting, the group practice reporting option, and public reporting of 2011 PQRI data.
Measure developers, eligible professionals, professional associations and other interested parties are invited to participate either onsite at CMS’ headquarters in Baltimore, MD., or via teleconference. The listening session will include several speakers as well as interactive question and answer sessions. The meeting is open to the public, but attendance is limited to space and teleconference lines available.
A summary of the measures and measures groups and other background materials for the listening session will be posted on the PQRI section at www.cms.hhs.gov/PQRI on the CMS website in the coming weeks.
The listening session will be held on February 2, 2010 from 10 a.m. to 4:30 p.m. (EST) in the main auditorium of the Central Building of the Centers for Medicare & Medicaid Services, located at 7500 Security Boulevard, Baltimore, MD 21244–1850.
Anyone interested in attending the meeting or participating by teleconference must register by completing the online registration at http://www.usqualitymeasures.org on the internet. Registration for this event opens on Monday, December 21. In order to participate in the meeting, registration must be completed no later than 5 pm EST on January 22, 2010.
For more information, please see the Federal Register meeting notice posted at http://edocket.access.gpo.gov/2009/pdf/E9-30122.pdf on the Internet.
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5. DME MAC Contractors Conduct Teleconference to Introduce National Comprehensive Error Rate Testing (CERT) Education Initiative
DME MAC Contractors Introduce National Comprehensive Error Rate Testing (CERT) Education Initiative In Special “Ask-The-Contractor Teleconference” January 13, 2010.
The Department of Health and Human Services and the Centers for Medicare & Medicaid Services recently revised and improved its calculations of Medicare fee-for-service error rates in 2009. Strengthening this process has resulted in increased audits and requests for additional documentation to support payment of supplier claims.
In a unique approach to reducing common CERT error rates, DME MAC Jurisdictions A, B, C, and D have collaborated to form the DME MAC CERT Education Task Force. The Task Force has identified common national errors and has developed consistent educational messages which will be used by all four DME MAC jurisdictions in support of reducing errors. Learn how participation in new CERT education initiatives will help reduce errors and improve your responses to documentation requests.
Shana Olshan, Division Director for the Division of Contractor Provider Communications for CMS will introduce the new education initiative. Members of the DME MAC CERT Education Task Force will share important details on CERT education during the special Ask-the-Contractor teleconference Wednesday, January 13, 2009 at 2 p.m. ET/ 1 p.m. CST.
Conference call details:
Date: January 13, 2010
Conference Title: DME MAC CERT Education Task Force National Call
Time: 2:00 p.m. – 3:30 p.m. ET
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 January 12, 2010, 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://www.eventsvc.com/palmettogba/011310
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.
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6. Protecting You and Your Prescriptions Beneficiary Publication
MEDICARE NEWS
Immediate Release
Protecting You and Your Prescriptions Beneficiary Publication
Medicare wants prescriptions filled only with drugs that are properly listed with the
Food and Drug Administration(FDA)
Today the Centers for Medicare & Medicaid Services (CMS) issued a Fact Sheet for Medicare Part D enrollees to help ensure that beneficiaries receive safe and legally marketed prescription drugs. Effective January 1, 2010, CMS will no longer reimburse Part D sponsors for prescription drugs that are not listed with the FDA. This policy is part of a safety initiative to ensure that Medicare Part D enrollees receive prescription drugs that are properly registered with the FDA.
The notice is a beneficiary tip sheet that explains that Part D prescriptions will be filled only with drugs that are properly listed with the Food and Drug Administration (FDA). Most Part D enrollees should experience no difficulty with filling their prescriptions under this policy as only a small number of the affected products were prescribed to Medicare Part D enrollees in 2009. However, to answer questions, CMS is issuing the attached Fact Sheet. This Fact Sheet provides beneficiaries and people who work with beneficiaries with information about filling their prescriptions with FDA listed products. In addition, to minimize beneficiary disruption, CMS has conducted extensive outreach to inform pharmacies, Part D sponsors, wholesalers, and manufacturers of this new policy.
This Beneficiary Fact Sheet pub. ID 11453 can be found here: http://www.medicare.gov/Publications/Pubs/pdf/11453.pdf
Or click on www.medicare.gov
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7. Information Regarding the Holding of Claims for Services Paid Under the 2010 Medicare Physician Fee Schedule
To the extent possible and in consideration of possible legislative changes, the Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare physician fee schedule, beginning January 1, 2010. In this regard, CMS has instructed its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule (MPFS) for the first 10 business days of January (January 1 through January 15) for 2010 dates of service. This should have minimum impact on provider cash flow because, under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 days for paper claims) after the date of receipt. Meanwhile, all claims for services delivered on or before December 31, 2009, will be processed and paid under normal procedures.
After 10 business days, contractors will begin releasing held claims into processing under the fee schedule which implements current law. This, of course, could result in claims being processed with the negative 21.2 percent update. If a new law is enacted which changes the negative update effective January 1, CMS will correctly process claims under the new law and, if necessary, CMS is prepared to automatically reprocess most of those claims which have already been processed at the lower rate.
Under the Medicare statute, Medicare payments to physicians and other affected providers are based upon the lesser of the actual charge or the MPFS amount. Providers who submit charges that are greater than the negative 2010 MPFS will automatically have their claims reprocessed. Physicians who submit charges that are equal to or less than the 2010 MPFS amount will need to request an adjustment. Submitted charges on claims cannot be altered without a request from the physician/provider.
To the extent possible, providers may hold claims in-house until it becomes clearer as to whether new legislation will be enacted or until cash flow becomes problematic. This will reduce the need for providers to reconcile two payments (i.e., the initial claim and the reprocessed claim), and it will simplify provider billings of beneficiary coinsurance and payment calculations for payers which are secondary to Medicare.
CMS has extended the 2010 Annual Participation Enrollment Program end date from January 31, 2010, to March 17, 2010– therefore, the enrollment period now runs from November 13, 2009, through March 17, 2010.
The effective date for any Participation status change during the extension, however, remains January 1, 2010, and will be in force for the entire year.
Contractors will accept and process any Participation elections or withdrawals, made during the extended enrollment period that are received or post-marked on or before March 17, 2010.
In addition, be on the alert for more information about other legislative provisions which may affect you.”
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8. Updated Information Regarding the Holding of Claims for Services Paid Under the 2010 Medicare Physician Fee Schedule
This is a clarification to the listserv message that was issued on December 21, 2009. The President has signed the Department of Defense Appropriations Act of 2010 which provides for a zero percent (0%) update to the 2010 Medicare Physician Fee Schedule for a two month period, January 1, 2010 through February 28, 2010.
The Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare physician fee schedule, beginning January 1, 2010. In this regard, CMS has instructed its contractors to hold claims for services paid under the Medicare Physician Fee Schedule (MPFS) for up to the first 10 business days of January (January 1 through January 15) for 2010 dates of service. This should have minimum impact on provider cash flow because, by law, clean electronic claims are not paid any sooner than 14 calendar days (29 days for paper claims) after the date of receipt. Meanwhile, all claims for services delivered on or before December 31, 2009, will be processed and paid under normal procedures.
The holding of claims allows Medicare contractors time to receive the new, updated payment files and perform necessary testing before paying claims at the new rates. CMS has instructed contractors to begin processing claims at the new rates no later than January 19, 2010. Please note that most contractors are closed on the January 18 Martin Luther King Day holiday. Therefore, even absent a new update, most claims likely would not have been paid any sooner than January 19, 2010, given the aforementioned statutory 14-day payment floor.
CMS has extended the 2010 Annual Participation Enrollment Program end date from January 31, 2010, to March 17, 2010– therefore, the enrollment period now runs from November 13, 2009, through March 17, 2010.
The effective date for any Participation status change during the extension, however, remains January 1, 2010, and will be in force for the entire year.
Contractors will accept and process any Participation elections or withdrawals, made during the extended enrollment period that are received or post-marked on or before March 17, 2010.
In addition, be on the alert for more information about other legislative provisions which may affect you.
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9. New from the Medicare Learning Network®
Revised--Special Edition MLN Matters Article #SE0929 - 2010 Annual Participation Enrollment Program Extension
This article was revised on December 22, 2009, to show that the 2010 Annual Participation Enrollment Program has been extended through March 17, 2010. Due to recent revisions that were made to the 2010 Medicare Physician Fee Schedule (MPFS), CMS has extended the 2010 Annual Participation Enrollment Program end date from December 31, 2009, to March 17, 2010 – therefore, the enrollment period now runs from November 13, 2009, through March 17, 2010. The effective date for any Participation status change during the extension, however, remains January 1, 2010; and will be in force for the entire year. For more information, please view the article located at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0929.pdf on the CMS website.
New--Special Edition MLN Matters Article #SE0931 - Expiration of Various Payment Provisions Under the Medicare Program
This special edition article is being issued by CMS to notify affected providers that a number of Medicare payment provisions, such as the Therapy Cap Exceptions Process and Allowing Independent Laboratories to Bill for the Technical Component of Physician Pathology Services Furnished to Hospital Patients, will no longer be in effect when the provisions sunset as of December 31, 2009. For more information, please view the article located at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0931.pdf on the CMS website.
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10. REVISED: MLN Matters Article #MM6740 - Revisions to Consultation Services Payment Policy
Note: This article was revised on December 17, 2009, to correct the "initial hospital day codes" referenced on the top of page 4 (in bold). Those codes should be 99221-99223. The error listed them as 99231-99233. All other information remains the same.
This article pertains to Change Request (CR) 6740, which alerts physicians and non-physician practitioners that effective January 1, 2010, the Current Procedural Terminology (CPT) consultation codes (ranges 99241-99245 and 99251-99255) are no longer recognized for Medicare Part B payment. Effective for services furnished on or after January 1, 2010, physicians and non-physician practitioners should code a patient evaluation and management visit with E/M codes that represent where the visit occurs and that identify the complexity of the visit performed. For more information, please view the article located at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6740.pdf on the CMS website.
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11. January 2010 Average Sales Price (ASP) File Is Now Available
The Centers for Medicare and Medicaid Services (CMS) has posted the revised January 2010 ASP pricing file and crosswalk. All are available for download at: http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a19_2010aspfiles.asp
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12. Posting of the January 2010 ASP and Not Otherwise Classified (NOC) Pricing Files and Crosswalks
The Centers for Medicare & Medicaid Services (CMS) has posted the January 2010 ASP and Not Otherwise Classified (NOC) pricing files and crosswalks. The ASP pricing files for October 2009 and January 2009 have also been updated. All are available for download at: http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/ (see left menu for year-specific links).
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13. Modification to the Healthcare Common Procedure Coding System (HCPCS) Code Set
The Centers for Medicare & Medicaid Services (CMS) has released a modification to the Healthcare Common Procedure Coding System (HCPCS) code set. CMS has revised the definition for HCPCS code L8680 to “IMPLANTABLE NEUROSTIMULATOR ELECTRODE, EACH”. In making this change, the CY 2010 definition for L8680 reverts to the definition reflected in the CY 2009 HCPCS code set. This change has been posted to the 2010 HCPCS Corrections document located on the HCPCS web page at http://www.cms.hhs.gov/HCPCSReleaseCodeSets/ANHCPCS/list.asp.
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14. FY 2010 Hospice Wage Index Now Available
The FY 2010 Hospice Wage Index is now available in Excel and text (508 compliant) file formats on the Hospice Center web page on the Centers for Medicare & Medicaid Services website at (http://www.cms.hhs.gov/center/hospice.asp).
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15. Security Changes for Home Health OASIS Users
The Centers for Medicare & Medicaid Services (CMS) would like to notify providers that at the end of February 2010, CMS will change the way Home Health Agencies (HHA) users’ login to submit assessment files and access agency reporting. The changes will be rolled out to transition login IDs away from shared agency login IDs, used by multiple people, to individual user IDs.
Beginning in February 2010 and wrapping up in August 2010, small groups of states will transition to individual user IDs about every two weeks.
Information regarding the roll out schedule, as well as, detailed instructions will be available in the upcoming months.
As the information is available it will be posted on your state’s OASIS State Welcome Page and the QIES Technical Support Office at http://www.qtso.com on the Internet.
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16. Your December Flu Message
Flu Season is Here!
Annual outbreaks of the seasonal flu usually occur from late fall to early spring. Typically, 5 to 20 percent of Americans get the seasonal flu, resulting in approximately 36,000 flu-related deaths.[1]
If you have Medicare patients who haven’t yet received their flu shot, you can help them reduce their risk of contracting the seasonal flu by recommending an annual seasonal influenza vaccination. Medicare provides coverage of the seasonal flu vaccine and its administration. And don’t forget to immunize yourself and your staff. Protect yourself, your staff, your patients, and your family and friends.
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 seasonal 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. You will find a variety of resources that explain Medicare coverage and claims submission policies related to the seasonal influenza vaccine.
For information on Medicare policies related to H1N1 influenza, please go to http://www.cms.hhs.gov/H1N1 on the CMS website.
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17. Extra Help for Medicare 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. This can mean big savings on prescription drug costs.
· Encourage people with Medicare to file for Extra Help online: https://secure.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/staticpages/ships.aspx or by calling 1-800-MEDICARE.
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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
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[1] Flu.gov. 2009. About the Flu [online]. Washington DC: The U.S. Department of Health and Human Services, 2009 [cited 30 November 2009]. Available from the World Wide Web:
(http://www.flu.gov/individualfamily/about/index.htm )
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
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