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. Reminder: Bidding is Now Open for the Round 1 Rebid of the DMEPOS Competitive Bidding Program



2. REMINDER: Accreditation Time Frame for Pharmacies is January 1, 2010



3. Delay in Implementing Phase 2 of CRs 6417 and 6421



4. Physician Quality Reporting Initiative (PQRI) Program Updates



5. Your Latest Health Information Technology Update



6. Medicare Home Health Prospective Payment System Outlier Policy FAQs



7. Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) PC Pricer Updates



8. New from the Medicare Learning Network®



9. Mini-Poster To Help Educate Medicare Beneficiaries About Flu Vaccines



10. Your December Flu Message



11. Extra Help for Medicare Beneficiaries Paying for Prescription Drugs









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1. Reminder: Bidding is Now Open for the Round 1 Rebid of the DMEPOS Competitive Bidding Program



The Centers for Medicare & Medicaid Services (CMS) is currently accepting bids for the Round 1 Rebid of the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program. All bids must be submitted in DBidS, the on-line bidding system, by 9 p.m. prevailing Eastern Time on December 21, 2009; all required hardcopy documents that must be included as part of the bid package must be postmarked by 11:59 p.m. on December 21, 2009.



Here are some important things to remember when submitting your bid:



· You must submit your bid in DBidS using the user ID you received during registration. If you have not already logged into DBidS, we strongly recommend that you do so before December 7, 2009 in order for you to have plenty of time to complete your bid. Please note that you must answer at least 2 and up to 10 authentication questions the first time you log in.

· The Covered Document Review Date (CDRD) for the Round 1 Rebid was November 21, 2009. If you submitted financial documents by the CDRD, we will notify you of any missing financial documents by January 5, 2010, and you will have 10 business days to submit the missing financial documents. Bidders that did not submit any hardcopy financial documents by the CDRD will not be notified of any missing documents. If you did not submit any hardcopy financial documents by the CDRD, you are still required to submit all required hardcopy documents specified in the Request for Bids (RFB) instructions by 11:59 p.m. on December 21, 2009.

· The Round 1 Rebid competitive bidding areas (CBAs), product categories, DBidS information, bidder charts, educational materials, and complete RFB instructions can be found on the CBIC web site, www.dmecompetitivebid.com. You should review this information prior to submitting your bid(s).

If you have any questions about the bidding process, please contact the CBIC Customer Service Center at 1-877-577-5331.

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2. REMINDER: Accreditation Time Frame for Pharmacies is January 1, 2010



Since HR 3663 postponed the accreditation time frame for pharmacies until January 1, 2010, we are reminding pharmacies who have not been accredited to do so by January 1, 2010.



We encourage all pharmacies going through the accreditation process to resolve any outstanding issues on your accreditation report so that the Accrediting Organization can make an accreditation determination in advance of the January 1, 2010 deadline. The DMEPOS Accrediting Organization will notify the National Supplier Clearinghouse (NSC) when your organization is accredited.



Pharmacies who do not plan to remain enrolled in the DMEPOS Medicare Program are strongly encouraged to notify their customers as soon as possible. This will give your customers an opportunity to find another DMEPOS supplier.

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3. 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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4. Physician Quality Reporting Initiative (PQRI) Program Updates



Important Information About Accessing 2007 Re-Run and 2008 Physician Quality Reporting Initiative (PQRI) Feedback Reports

The Centers for Medicare & Medicaid Services (CMS) would like to remind Physician Quality Reporting Initiative (PQRI) participants that there is a “Verify Report Portlet” look-up tool available on the PQRI Portal for Eligible Professionals (EPs) to verify if a 2007 re-run and/or 2008 PQRI feedback report exists for your organization's Tax Identification Number (TIN) or National Provider Identifier (NPI). The TIN or NPI must be the one used by the EP to submit Medicare claims and valid PQRI quality data codes. This tool is available at https://www.qualitynet.org/portal/server.pt on the internet.



If a report is available for your organization’s TIN or NPI there are two ways to access 2007 re-run and/or 2008 PQRI feedback reports:



1) An individual EP can simply call their respective Carrier or A/B MAC provider contact center to request confidential 2007 PQRI re-run and/or 2008 PQRI feedback reports that will contain information based on their individual NPI. If an EP is part of a group practice, each EP in the group practice must individually call their respective Carrier or A/B MAC provider contact center to request a feedback report based on the individual NPI. To obtain a list of Provider Contact Centers, visit http://www.cms.hhs.gov/MLNProducts/Downloads/CallCenterTollNumDirectory.zip on the CMS website. In addition to PQRI information, these reports will provide individual EPs with information on their Medicare Part B Physician Fee Schedule allowed charges for the 2007 or 2008 PQRI reporting period, upon which an incentive payment is based.



Additional information about this alternative feedback report request process can be found by accessing special edition Medicare Learning Network (MLN) article (SE0922) “Alternative Process for Individual Eligible Professionals to Access Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Feedback Reports.” Visit http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0922.pdf on the CMS website.



or

2) EPs can logon to the secure PQRI Portal on QualityNet at http://www.qualitynet.org/portal/server.pt to access their feedback report(s) based their TIN, or for a group. Access to the PQRI Portal requires registration in the Individuals Authorized Access to CMS Computer Services (IACS) system to obtain a userID and password.

Important Information on Updating IACS User Accounts and Passwords



CMS would like to remind users that the CMS Security policy requires IACS passwords to be changed every 60 days. An IACS user who has not changed his or her password in over 60 days will be prompted to do so at the next login attempt.



An IACS user who has not changed his or her password in over 120 days will first be prompted to answer the security questions established at registration. After successfully answering security questions, the user will then be prompted for a password change.



Updating IACS user accounts and passwords is essential to maintaining this access and functionality.



Resources

The IACS account management page is at https://applications.cms.hhs.gov/category.html?name=acctmngmt. Click on “My Profile” to login, change your password, or use the “Forgot Password?” option.

If you are having difficulty with IACS registration or disabled accounts, follow the self-service instructions below on how to recover your IACS userId and/or password and/or change your IACS password.

Instructions for Retrieving Your IACS UserID

1. Go to the CMS Applications portal at https://applications.cms.hhs.gov

2. Enter the portal; select the Account Management tab, and then the “Forgot Your User ID?” link in the Account Management section. Follow the online instructions.

3. You will receive an email at the email address on record.



Instructions for Retrieving Your IACS Password

1. Go to the CMS Applications portal at https://applications.cms.hhs.gov/warning.html

2. Enter the portal; select the Account Management tab, and then “My Profile” link in the Account Management section.

3. Enter your UserID

4. Click on “Forgot Your Password?” button on the login page and follow the online instructions.

5. You will receive a onetime password in an email at the email address on record.



Instructions to Login and Change Your IACS Password:

1. Go to the CMS Applications portal at https://applications.cms.hhs.gov

2. Enter the portal; select the Account Management tab

3. Select the My Profile link

4. Login using your UserID and onetime temporary Password.

5. The system will prompt you to change your password.

6. Enter your new password in both the New Password and Confirm New Password fields and then select the Change Password button.

7. The system will take you back to the My Profile screen.

8. Log out.



Once you have successfully changed your password you may login and access your PQRI feedback report(s) on the PQRI portal at https://www.qualitynet.org/portal/server.pt on the internet. If you are still having difficulty with IACS registration or disabled accounts, please contact the External Users Services (EUS) Help Desk

at 1-866-484-8049, TTY/TDD at 1-866-523-4759 (Monday – Friday 7:00 a.m.-7:00 p.m. EST) or via e-mail at EUSSupport@cgi.com.



The IACS home page for the Provider/Supplier user Community, which includes PQRI, is at http://www.cms.hhs.gov/IACS/04_Provider_Community.asp#TopOfPage on the CMS website. Provider Community users should direct questions or concerns to the External User Services (EUS) Help Desk at 1-866-484-8049, TTY/TDD at 1-866-523-4759 (Monday - Friday 7:00 a.m.-7:00 p.m. EST) or via email at EUSSupport@cgi.com.



The PQRI Portal is available at https://www.qualitynet.org/portal/server.pt on the internet. Although the “Forgot Password” link on the PQRI Portal sends users to the IACS website, IACS and the PQRI Portal are two separate websites.



Additional information about PQRI can be found at http://www.cms.hhs.gov/PQRI on the CMS website. For more information on the 2007 re-run and 2008 PQRI feedback reports or incentive payments, see the "PQRI and eRx Quick-Reference Support Guide for Eligible Professionals" at http://www.cms.hhs.gov/PQRI/Downloads/PQRI-eRxEPQuickRefGuideDiagram_100209.pdf on the CMS website.



Users who still have questions or need assistance should contact the QualityNet Help Desk at 1-866-288-8912 (Monday-Friday 7:00 a.m.-7:00 p.m. CST) or qnetsupport@sdps.org.

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5. Your Latest Health Information Technology Update



Beacon Communities: Shining a Light on the Real Impacts of Health IT

December 2, 2009

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology

Today the administration announced the availability of $235 million in funds to support the Beacon Community Program. The Beacon Community Program (BCP) will help to accelerate and demonstrate the ability of health IT to transform local health care systems, and to improve the lives of Americans and the performance of the health care providers who serve them. The Program will take communities at the cutting edge of electronic health record (EHR) adoption and health information exchange and push them to a new level of health care quality and efficiency. The resulting experience will inform efforts throughout the United States to support the meaningful use of EHRs, the primary goal of the Federal Government’s new health IT initiative.

$220M of the funds will support 15 communities, which are expected to have rates of EHR adoption that are significantly higher than published national estimates. These communities are best positioned to lead the way in accomplishing meaningful use of EHRs and to provide valuable lessons to other localities on the preferred approaches to elevating the performance of local health systems using health IT. An additional $15 million will subsequently support technical assistance to the communities and an independent evaluation of the program.

As part of the $220 million in cooperative agreements that will support the 15 chosen communities, recipients will be asked to define, track, and report on progress toward concrete, measurable health and efficiency goals that are related to EHR adoption and meaningful use. These might include reductions in blood pressure among hypertensives, reduced blood sugar levels among diabetics, lower smoking levels, or reductions in health care disparities among populations. The resulting data will provide information for mid-course corrections and will also help independent evaluations judge the success of the program.

In order to make maximum use of existing federal resources, Beacon Communities also will be expected wherever possible to tap into other existing federal programs that are working to promote health information exchange at the community level. Close coordination with the Regional Extension Center Program, State Health Information Exchange Program, and the national Health Information Technology Research Center (HITRC), will ensure that lessons learned are shared for the benefit of all. Beacon Communities are expected to maximize their efforts by leveraging other existing federal programs and resources that are working to promote health information exchange at the community level, including the Department of Defense and the Department of Veterans Affairs development of a Virtual Lifetime Electronic Health Record (VLER) for all active duty, Guard and Reserve, retired military personnel, and eligible separated Veterans.

I’ve spoken often of my own experience with electronic health records in medical practice, and my resulting conviction that access to electronic health information at the point of care made me a better doctor, and helped my patients. I’ve highlighted examples of health systems, large and small, urban and rural, that have experienced major improvements in care and reduced costs resulting from the use of EHR systems and health IT. And I’ve shared the opinions of experts who conclude that the entry of the medical profession into the digital age is much needed, and long overdue. The Beacon Community Program will enable us to test the capacity of health IT to accomplish this shared vision at an accelerated pace. We hope these communities will truly prove beacons that the rest of our health system can use to guide our collective efforts to use information to improve the health and health care of Americans.


Sincerely,

David Blumenthal, M.D., M.P.P.
National Coordinator for Health Information Technology
U.S. Department of Health & Human Services


The Office of the National Coordinator for Health Information Technology (ONC) encourages you to share this information as we work together to enhance the quality, safety and value of care and the health of all Americans through the use of electronic health records and health information technology.

For more information and to receive regular updates from the Office of the National Coordinator for Health Information Technology, please subscribe to our Health IT News list

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6. Medicare Home Health Prospective Payment System Outlier Policy FAQs



The Centers for Medicare and Medicaid Services (CMS) has provided guidance (clarifying information) regarding the new CY 2010 outlier policy under the Home Health Prospective Payment System (HH PPS), which was promulgated in the Medicare Home Health Prospective Payment System Rate Update for CY 2010 Final Rule (CMS-1560-F). The guidance can be found in the Questions and Answers available in the first spotlight on the CMS web page at http://www.cms.hhs.gov/center/hha.asp.

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7. Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) PC Pricer Updates



The FY 2010 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) PC Pricer is ready for download from the Centers for Medicare & Medicaid Services (CMS) web page at http://www.cms.hhs.gov/PCPricer/06_IRF.asp. CMS has also updated the October 2009 Provider Specific data for the FY 2009 IRF PPS PC Pricer and the FY 2009 Pricer is now available for download. If you use the IRF PPS PC Pricers, please go to the page above and download the latest versions of the Pricer, posted 11/20/2009, in the Downloads section.

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8. New from the Medicare Learning Network®



Do you ever wonder about how to utilize search tools in selected areas of the CMS website? The searchable Medicare Coverage Database (MCD) contains all Medicare National Coverage Determinations (NCDs), National Coverage Analyses (NCAs), Local Coverage Determinations (LCDs), and local policy articles. The Medicare Learning Network (MLN) has produced a “How To” booklet (2.5MB), that provides an explanation of the MCD, as well as how to use the Search, Indexes, Reports and Downloads features. The How to Use the Medicare Coverage Database booklet (November 2009) can be located at http://www.cms.hhs.gov/MLNProducts/MPUB/list.asp on the MLN Publications page. Use search key words how to, to locate this publication quickly. Understanding the search tool is the best way to find the information you are looking for!



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The newly redesigned MLN Products Catalog is now available and can be viewed at www.cms.hhs.gov/MLNGENINFO . The MLN Products Catalog is an interactive downloadable document that lists all Medicare Learning Network products by media format. The catalog has been revised to provide new customer-friendly links that are embedded within the document as well as both subject and provider type indexes. All product titles and the word "download" when selected, will link you to the online version of the product. The word "hard copy" when selected, will automatically link you to the MLN Product Ordering page. To access the catalog, click on the link MLN Product Catalog.



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The revised Hospice Payment System Fact Sheet (November 2009) is now available in downloadable format. This fact sheet provides general information about the Medicare hospice benefit including coverage of hospice services, certification requirements, election periods, how payment rates are set, patient coinsurance payments, caps on hospice payments, and additional reporting required on hospice claims. The fact sheet can be accessed at http://www.cms.hhs.gov/MLNProducts/downloads/hospice_pay_sys_fs.pdf .

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9. Mini-Poster To Help Educate Medicare Beneficiaries About Flu Vaccines



CMS would appreciate your help communicating with the public, especially seniors and vulnerable populations, that Medicare and Medicaid cover both the seasonal and H1N1 flu vaccines. Seniors are encouraged to get their seasonal flu vaccine as soon as possible. The vaccine that protects against the 2009 H1N1 influenza virus (sometimes called swine flu) is a separate vaccine and is available now. The first available doses of this vaccine should be given to those at highest risk of infection and complications such as children, pregnant women, health care workers and younger adults with certain medical conditions. There is some evidence that people 65 and older are less likely than younger people to be infected with the 2009 H1N1 influenza virus.



Please share this bilingual mini-poster http://www.cms.hhs.gov/AdultImmunizations/Downloads/FluPoster2009.pdf with your colleagues and encourage them to post it in places where Medicare patients will see and understand the need for their seasonal flu shot and that they can get the H1N1 vaccine once the high risk groups are vaccinated.


We encourage Medicare practitioners to refer patients to www.flu.gov if they need more information about the seasonal and H1N1 flu vaccines. Information for practitioners, mass immunizers and others who want to bill Medicare for the flu vaccines can be obtained at www.cms.hhs.gov/adultimmunizations. The Immunizers Q & A Guide in the download section also includes a list of regional CMS contacts on page 55 that would be helpful if you want to organize a large scale immunization clinic for seniors.



CMS would also very much appreciate any feedback you can give us as to the use of this poster (e.g., did your colleagues post it in their offices, was it posted in senior centers, etc.). As always, thank you for your help in getting this important message to our Medicare beneficiaries.

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10. 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.



[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 )

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11. 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 )