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. Physician and non-physician practitioners who order or refer must be enrolled in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and must be of the types/specialties that are eligible to order/refer services for Medicare beneficiaries Effective April 5, 2010.
2. Medicare's DMEPOS Competitive Bidding Program
3. Free Educational Products and Free Shipping from the Medicare Learning Network!
4. New from the Medicare Learning Network
5. MLN Matters Special Edition Article Now Available on the Medicare DMEPOS Competitive Bidding Program
6. CANCELLED: CR No. 6375-- Place of Service (POS) and Date of Service (DOS) Instructions for the Interpretation (Professional Component) and Technical Component of Diagnostic Tests
7. Special Open Door Forum: Medicare Provider & Supplier Enrollment
8. Technical Expert Panel (TEP) for the Development of New Quality Measures for the End-Stage Renal Disease (ESRD) Population
9. Agenda Now Available for Program Advisory and Oversight Committee (PAOC) Meeting on Competitive Acquisition for DMEPOS
10. Your Latest 5010 Updates
11. Pricer Updates
12. January Minimum Data Set (MDS) 3.0 Information Update
13. February is American Heart Month!
14. Your February Flu Message
15. A new "twist" in the law makes it easier to save on your prescription drug costs.
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1. Physician and non-physician practitioners who order or refer must be enrolled in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and must be of the types/specialties that are eligible to order/refer services for Medicare beneficiaries Effective April 5, 2010.
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. Medicare's DMEPOS Competitive Bidding Program
Medicare’s Competitive Bidding Program for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) is designed to ensure beneficiaries with Original Medicare continue to receive quality medical equipment and related services from accredited suppliers, while reducing out-of-pocket expenses for Medicare beneficiaries and saving the Medicare program money.
Medicare’s current fee schedule rates for DMEPOS items are overpriced and based on outdated, inflated supplier charges from over 20 years ago. Competitive bidding among suppliers will establish new, lower Medicare payment amounts for DMEPOS items.
The DMEPOS Competitive Bidding Program:
· starts January 1, 2011 in nine areas of the country and will be phased into other areas in future years;
· applies to Medicare beneficiaries who live in (or travel to) these areas and who buy or rent certain items of durable medical equipment and supplies;
· includes items such as oxygen equipment and supplies, certain power wheelchairs, walkers, mail order diabetic supplies and hospital beds; and
· selects enough qualified, accredited contract suppliers to meet Medicare beneficiaries’ needs for competitively bid items and services.
The nine initial competitive bidding areas are:
· Charlotte-Gastonia-Concord (North Carolina and South Carolina)
· Cincinnati-Middletown (Ohio, Kentucky and Indiana)
· Cleveland-Elyria-Mentor (Ohio)
· Dallas-Fort Worth-Arlington (Texas)
· Kansas City (Missouri and Kansas)
· Miami-Fort Lauderdale-Pompano Beach (Florida)
· Orlando (Florida)
· Pittsburgh (Pennsylvania)
· Riverside-San Bernardino-Ontario (California)
In order to help you stay fully and accurately informed about Medicare’s DMEPOS Competitive Bidding Program, CMS has prepared the first in a series of “program preview” documents, which can be found at http://www.cms.hhs.gov/Partnerships/03_DMEPOS_Toolkit.asp#TopOfPage. We encourage you to share this information with your local affiliates throughout the country, particularly in the nine initial competitive bidding areas. Please note that “program preview” documents are not intended for distribution to Medicare beneficiaries. We’ll be forwarding materials for you to share with beneficiaries later this year when DMEPOS users may need to take action.
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3. Free Educational Products and Free Shipping from the Medicare Learning Network!
The high quality Medicare Learning Network products you depend on are always free! Did you know that shipment to your office or home is also free?
Go to the MLN Product Ordering page for a listing of products available in hard copy, and then add the products to your shopping cart. Your order will be processed for delivery and shipped right to your door!
Need multiple copies? When you checkout, just increase the quantity and follow the system prompts. Make sure to include your e-mail address in case we need to contact you to process your order.
Visit the MLN Products page and scroll down to MLN Ordering Page to start learning today.
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4. New from the Medicare Learning Network
The National Provider Identifier (NPI): What You Need to Know Booklet is Now Available for Download! The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of a standard, unique health identifier for each health care provider. The NPI Final Rule, published on January 23, 2004, established the NPI as this standard. Covered entities under HIPAA are required by regulation to use NPIs to identify health care providers in HIPAA standard transactions. This booklet contains information previously available in NPI fact sheet and tip sheets.
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The revised Outpatient Maintenance Dialysis - End-Stage Renal Disease Fact Sheet (January 2010), which provides information about the bundled End-Stage Renal Disease (ESRD) Prospective Payment System for Medicare outpatient ESRD facilities that will replace the current basic case-mix adjusted composite payment system beginning January 1, 2011, the basic case-mix adjusted composite payment rate system, and separately billable items and services, is available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/ESRDpaymtfctsht2010.pdf .
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The Medicare Physician Fee Schedule Fact Sheet (February 2010) has been revised to include information about the two month zero percent (0%) update to the 2010 Medicare Physician Fee Schedule (MPFS) effective only for dates of service January 1, 2010 through February 28, 2010. This fact sheet, which also provides information about MPFS payment rates and the MPFS payment rates formula, is available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/MedcrePhysFeeSchedfctsht.pdf .
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5. MLN Matters Special Edition Article Now Available on the Medicare DMEPOS Competitive Bidding Program
The MLN Matters Special Edition Article #SE1007 – Medicare’s DMEPOS Competitive Bidding Program - A Better Way for Medicare to Pay for Medical Equipment – has just been released and is available at
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE1007.pdf . This article is informational for physicians, providers, and suppliers submitting claims to the Medicare Program and provides an overview of and the rationale for Medicare’s Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) being implemented by the Centers for Medicare & Medicaid Services (CMS).
Read it now to find out more!
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6. CANCELLED: CR No. 6375-- Place of Service (POS) and Date of Service (DOS) Instructions for the Interpretation (Professional Component) and Technical Component of Diagnostic Tests
This is to alert you that Change Request (CR) 6375, dated December 11, 2009 and titled, “Place of Service (POS) and Date of Service (DOS) Instructions for the Interpretation (Professional Component) and Technical Component of Diagnostic Tests,” is rescinded and will be replaced with another CR in the future pending further policy clarification on date of service and place of service reporting for the interpretation of diagnostic tests. The revised CR will address the full spectrum of clinical scenarios. The accompanying MLN Matters articles, MM6375, is also rescinded. Another MLN Matters article will be issued when the new CR is released.
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7. Special Open Door Forum: Medicare Provider & Supplier Enrollment
Centers for Medicare & Medicaid Services
Special Open Door Forum:
Medicare Provider & Supplier Enrollment
February 17, 2010
2:00 PM – 3:30 PM ET
Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss Medicare provider enrollment issues. During this call, CMS staff will discuss:
• Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for physicians, non-physician practitioners and provider and supplier organizations
• Provider and supplier reporting responsibilities
• Medicare ordering and referring Issues
• Revalidation efforts
Afterwards, there will be an opportunity for the public to ask questions.
We look forward to your participation.
Open Door Forum Instructions:
**Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.**
Dial: 1-800-837-1935
Reference Conference ID 52537484
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html. A Relay Communications Assistant will help.
An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading on or around Monday March 1, 2010 and available for 30 days.
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.
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8. Technical Expert Panel (TEP) for the Development of New Quality Measures for the End-Stage Renal Disease (ESRD) Population
CMS is convening a Technical Expert Panel (TEP) for the development of new quality measures for the ESRD population on March 10-11, 2010. Nominations for this TEP are now being accepted through February 17 at our Call for Technical Expert Panel website (http://www.cms.hhs.gov/apps/QMIS/CallforTEP.asp); self-nominations are also welcome. This TEP will be unique in that we will be convening Six Clinical TEPs of approximately 6-8 individuals each that will evaluate evidence for the development of new measures based on the following topic areas:
• Anemia Management (Target value for Serum Ferritin, Target value for Transferrin Saturation);
• Mineral Metabolism (Target value for Calcium, Target value for Phosphorus)
• Vascular Access Infection Rate (Catheter Infection Rate)
• Pediatric Adequacy (Hemodialysis [HD], Peritoneal Dialysis [PD])
• Pediatric Anemia (Anemia Management)
• Fluid Weight Management
In order to develop the strongest quality measures we are seeking experts with the following qualifications: Topic Knowledge; Expertise including, but not limited to: ESRD, Anemia Management, Mineral Metabolism, Vascular Access Infection Rate, Pediatric Adequacy, Pediatric Anemia and Fluid Weight Management; Performance Measurement; Quality Improvement; Consumer Perspective; Purchaser Perspective; Health Care Disparities.
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9. Agenda Now Available for Program Advisory and Oversight Committee (PAOC) Meeting on Competitive Acquisition for DMEPOS
PROGRAM ADVISORY and OVERSIGHT COMMITTEE (PAOC) MEETING DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS, and SUPPLIES (DMEPOS) COMPETITIVE BIDDING PROGRAM
February 23, 2010
8:00 A.M. - 4:30 P.M. (Eastern Standard Time)
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, Maryland 21244
The Centers for Medicare & Medicaid Services (CMS) will be hosting a meeting with the Program Advisory and Oversight Committee (PAOC) on February 23, 2010 to discuss the Round 1 Rebid and upcoming Rounds of the Medicare DMEPOS Competitive Bidding Program. The agenda for the meeting is now available on the CMS website at: http://www.cms.hhs.gov/DMEPOSCompetitiveBid/downloads/PAOC_Agenda_022310.pdf
CMS expects to begin registration for the meeting early next week and will send a listserv notification when registration opens. For more information about the DMEPOS competitive bidding program, including information about the PAOC, please visit: www.cms.hhs.gov/DMEPOSCompetitiveBid/.
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10. Your Latest 5010 Updates
5010: Taking EDI to the Next Level
New from the Medicare Learning Network (MLN): The Centers for Medicare & Medicaid Services (CMS) has released two new HIPAA Version 5010 fact sheets, as well as two companion checklists, to assist providers in transitioning to 5010.
Version 5010 is the new version of the X12 standards for HIPAA transactions; version D.0 is the new version of the National Council for Prescription Drug Program (NCPDP) standards for pharmacy and supplier transactions; and version 3.0 is a new NCPDP standard for Medicaid pharmacy subrogation.
The implementation of HIPAA Version 5010 presents substantial changes in the content of the data that providers submit with their claims, as well as the data available to them in response to their electronic inquiries for eligibility or claims status. These new educational materials inform providers of these changes and how they need to plan for their implementation. This information is designed for Medicare Fee-For-Service providers; however, it may be of interest to all health care providers. Go to the CMS 5010 website at http://www.cms.hhs.gov/Versions5010andD0 and click on “Educational Resources” to view these new educational products.
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Reminder: Fourth National Medicare Fee-For-Service (FFS) Education Call on HIPAA Version 5010
CMS will be hosting its fourth national provider call regarding the implementation of HIPAA Version 5010. There will be a brief presentation given by CMS followed by a Q&A session with CMS subject matter experts. Please note that this call is geared towards vendors, clearinghouses, and providers who are performing their own development of 5010.
Conference call details:
Date: February 11, 2010
Conference Title: HIPAA Version 5010 National Provider Call: CMS’ approach for new error handling transactions: 999 and 277CA
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 February 10, 2010, 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/02112010
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.
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Reminder: CMS’ Dedicated Website for Information & Education on Versions 5010, D.0 and 3.0 Now Available!
CMS has launched its website for agency-wide information and education on Versions 5010, D.0 and 3.0. On this website, you can view background information on the new standards, regulatory information, the latest outreach messages from CMS, educational resources, resources specific to D.0 and 3.0, as well as implementation information for the Medicare Fee-For-Service systems. CMS adds new and updated information as it becomes available so bookmark the site today!
http://www.cms.hhs.gov/Versions5010andD0
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11. Pricer Updates
Skilled Nursing Facilities Prospective Payment System (SNF PPS) Personal Computer (PC) Pricer Files Updated for Fiscal Year (FY) 2009 and FY 2010
Due to receiving updated quarterly provider data, the FY 2009 SNF PPS PC Pricer and the FY 2010 SNF PPS PC Pricer have been updated at: http://www.cms.hhs.gov/PCPricer/04_SNF.asp, under the Downloads section. The FY 2009 SNF PPS PC Pricer and the FY 2010 SNF PPS PC Pricer have been updated with the most recent provider data from January 2010. If you use the FY 2010 SNF PPS PC Pricer or the FY 2009 SNF PPS PC Pricer, please go to the page above and download the latest version of the PC Pricers.
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Calendar Year (CY) 2009 Home Health Prospective Payment System (HH PPS) Personal Computer (PC) Pricer Updated -- Posted 1/29/10
The CY 2009 Home Health PPS (HH PPS) PC Pricer has been updated (posted 1/29/10) with the January 2010 provider specific data. This PC Pricer is 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 of the PC Pricer with the latest provider data.
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Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) Personal Computer (PC) Pricers Updated
The Inpatient Psychiatric Facility (IPF) PPS PC Pricers have been updated with the latest January 2010 provider data for Rate Year (RY) 2010 and RY 2009. The versions for RY 2009 and RY 2010 have been made available on the CMS website. If you use the IPF PPS PC Pricer for RY 2009 or RY 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 02/04/2010.
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12. January Minimum Data Set (MDS) 3.0 Information Update
• RAI Manual: Chapters 2 and 4 along with Appendix C have been published on the MDS 3.0 homepage (www.cms.hhs.gov/NursingHomeQualityInits/25_NHQIMDS30.asp).
• MDS 3.0 Item Subsets V1.00.1 January 2010: Includes a file called MDS3.0_Item_Changes_v1.00.1.pdf that lists the changes that have made since the previously-posted version to each of the individual item subsets. The previously-posted MDS 3.0 Item Matrix has been moved to Appendix F of the RAI manual. A more detailed version of the item matrix that is intended for software developers is available as part of the MDS 3.0 data submission specifications.
• Information about the upcoming MDS 3.0 training in March and April has also been added to the MDS 3.0 Training Conference Information web page (www.cms.hhs.gov/NursingHomeQualityInits/40_NHQIMDS30TrainingConferenceInformation.asp). All details regarding the training and registration process is contained within this webpage. Individuals will not be able to get any additional information by contacting CMS staff or submitting questions to MDS30Comments@cms.hhs.gov.
A listserv note will be sent out when additional information becomes available. Any questions about the MDS 3.0 RAI manual can be directed to mds30comments@cms.hhs.gov. Any technical questions pertaining to software development should be directed to Michael.Stoltz@cms.hhs.gov. Responses to questions will be provided during regularly scheduled CMS public teleconferences.
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13. February is American Heart Month!
Heart disease is the leading cause of death in the United States for both men and women.[1] Medicare provides coverage for cardiovascular screening blood tests, ultrasound screening for abdominal aortic aneurysms (AAA), and smoking and tobacco-use cessation counseling for qualified beneficiaries.
What Can You Do?
As a health care professional who provides care to seniors and others with Medicare, you can help protect the health of your Medicare patients by educating them about their risk factors and reminding them of the importance of Medicare-covered preventive services that are appropriate for them, including services related to cardiovascular health.
For More Information
CMS has developed several educational products related to Medicare-covered preventive services:
o The Guide to Medicare Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals ~ this newly revised comprehensive resource provides coverage and coding information on the array of preventive services and screenings that Medicare covers, including cardiovascular screening blood tests, AAA screenings, and smoking and tobacco-use cessation counseling. http://www.cms.hhs.gov/MLNProducts/downloads/mps_guide_web-061305.pdf
o The MLN Preventive Services Educational Products Web Page ~ provides descriptions and ordering information for Medicare Learning Network (MLN) preventive services educational products and resources for health care professionals and their staff. http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp
o Quick Reference Information: Medicare Preventive Services ~ this double-sided chart provides coverage and coding information on Medicare-covered preventive services, including smoking and tobacco-use cessation counseling, and AAA and cardiovascular screenings. http://www.cms.hhs.gov/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf
o Expanded Benefits brochure ~ this brochure provides information on coverage for Medicare-covered cardiovascular blood test and AAA screenings. http://www.cms.hhs.gov/MLNProducts/downloads/expanded_benefits.pdf
o Smoking and Tobacco-Use Cessation Counseling brochure ~ this brochure provides information on coverage for Medicare-covered smoking and tobacco-use cessation counseling. http://www.cms.hhs.gov/MLNProducts/downloads/smoking.pdf
Please visit the Medicare Learning Network for more information on these and other Medicare fee-for-service educational products.
For more information on American Heart Month, please visit the American Heart Month website at: http://www.americanheart.org/presenter.jhtml?identifier=4441
Thank you for helping CMS improve the health of patients with Medicare by joining in the effort to educate beneficiaries about the importance of taking advantage of preventive services covered by Medicare.
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14. Your February Flu Message
There’s still time to get the seasonal flu shot! Although influenza activity has declined recently, it still may continue for several months. The Centers for Disease Control continues to recommend that patients and health care providers and caregivers be vaccinated against seasonal influenza[1].
CMS encourages health care providers to use each office visit as an opportunity to talk with Medicare your patients about the importance of getting a seasonal flu shot. And remember, it is also important to immunize yourself and your staff.
Remember – Seasonal influenza vaccinations and their administration are covered Part B benefits. Note that influenza and pneumococcal vaccines are NOT Part D covered drugs.
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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[1] Seasonal Influenza (Flu). [online]. Atlanta, GA: The Centers for Disease Control and Prevention, January 19, 2010 [cited 21 January 2010]. Available from the World Wide Web: (http://www.cdc.gov/flu)
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15. A new "twist" in the law makes it easier to save on your prescription drug costs.
http://www.ssa.gov/prescriptionhelp/
Under a new law, more Medicare beneficiaries could qualify for Extra Help with their Medicare prescription drug plan costs because some things no longer count as income and resources. The Extra Help is estimated to be worth an average of $3,900 per year. To qualify for the Extra Help, a person must be on Medicare, have limited income and resources, and reside in one of the 50 states or the District of Columbia.
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[1] Heart Disease, Heart Disease Facts. [online]. Atlanta, GA: The Centers for Disease Control and Prevention, December 21, 2009 [cited 21 January 2010]. Available from the World Wide Web: (http://www.cdc.gov/heartdisease/facts.htm)
[1] Seasonal Influenza (Flu). [online]. Atlanta, GA: The Centers for Disease Control and Prevention, January 19, 2010 [cited 21 January 2010]. Available from the World Wide Web: (http://www.cdc.gov/flu)
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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