A 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. Comment Period Closing on Proposed Rule for Medicare and Medicaid EHR Incentive Program/Meaningful Use



2. The “Temporary Extension Act of 2010” Extends the Zero Percent Medicare Physician Fee Schedule Update and the Therapy Cap Exception Process



3. Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)



4. Unavailability of Internet-Based PECOS Monday, March 29 through Monday, April 5



5. Update on Claims Processing for Ordering/Referring Providers



6. Medicare Ends Contract With Fox Insurance Company Drug Plan



7. Proposed Rule for the Establishment of Certification Programs for Health Information Technology



8. Rescheduled: Fourth National Medicare Fee-For-Service Education Call on HIPAA Version 5010



9. Medicare Contractor Provider Satisfaction Survey (MCPSS)



10. Medicare Fee-For-Service outreach efforts



11. ICD-10-CM National Provider Conference Call Scheduled



12. Pricer Updates



13. New from the Medicare Learning Network



14. Nursing Home Five Star Quality Rating System –March News



15. A new "twist" in the law makes it easier to save on your prescription drug costs.











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1. Comment Period Closing on Proposed Rule for Medicare and Medicaid EHR Incentive Program/Meaningful Use



As part of the HITECH Act in 2009, CMS administers the Electronic Health Record (EHR) incentive programs under Medicare and Medicaid. CMS prepared a proposed rule on the EHR incentive programs for public comment. This proposed rule includes the definition of meaningful use and other requirements for qualifying for incentive payments. The comment period for this proposed rule closes on March 15, 2010. CMS welcomes your comments which may be submitted through http://www.regulations.gov. For additional information on the proposed rule, visit http://www.cms.hhs.gov/Recovery/11_HealthIT.asp on the web. Here you will find fact sheets, presentation materials summarizing the proposed rule, and links to the proposed rule itself.

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2. The “Temporary Extension Act of 2010” Extends the Zero Percent Medicare Physician Fee Schedule Update and the Therapy Cap Exception Process



On March 2, 2010, President Obama signed into law the “Temporary Extension Act of 2010.” Among other things, this law extends through March 31, 2010, the zero percent update to the Medicare Physician Fee Schedule that was in effect for claims with dates of service January 1, 2010, through February 28, 2010. Consequently, effective immediately, claims with dates of service March 1 and later which were being held by Medicare contractors will be released for processing and payment. Please keep in mind that the statutory payment floors still apply and, therefore, clean electronic claims cannot be paid before 14 calendar days after the date they are received by Medicare contractors (29 calendar days for clean paper claims).



The Temporary Extension Act also extends the therapy cap exceptions process through March 31, 2010, retroactive to January 1, 2010. Outpatient therapy service providers may now submit claims with the KX modifier, when an exception is appropriate, for services furnished on or after January 1, 2010 through March 31, 2010.



The therapy caps are determined on a calendar year basis, so all patients began a new cap on January 1, 2010. For physical therapy and speech language pathology services combined, the limit on incurred expenses is $1,860. For occupational therapy services, the limit is $1,860. Deductible and coinsurance amounts applied to therapy services count toward the amount accrued before a cap is reached.



Some therapy providers have been holding claims for services furnished on or after January 1, 2010, for patients who exceeded the cap but qualified for an exception under previous law. These providers may submit those claims to Medicare effective immediately. Therapy providers, who submitted claims which were denied, for services furnished on or after January 1, 2010, for patients who exceeded the cap but whose services now qualify for an exception, should contact their Medicare contractor to request that their claim be adjusted to add the KX modifier and ensure the appropriate exception applies.



A small number of therapy providers continued to submit claims with the KX modifier for services furnished on or after January 1, 2010, even though the exceptions process had expired on December 31, 2009. Medicare contractors held these claims and will now begin to release them for processing. These providers do not need to take any action on the claims that were held.



Providers who charged beneficiaries for services that exceeded caps, which are now payable under the exception process, should refund the beneficiary’s cost, less the appropriate amount of deductible and co-insurance. Affected claims should be either submitted or, if already submitted, the provider should contact their contractor for an adjustment.

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3. Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)



To assist you in protecting, completing and submitting your Medicare enrollment application via Internet-based PECOS, we are providing the following enrollment reminders and tips.



Protect Your Privacy: Physicians and non-physician practitioners need to take steps to ensure that their Medicare enrollment information does not get into the hands of people who can use that information to commit fraud. (See the document titled, “Medicare Physicians and Non-Physician Practitioners - Protecting Your Privacy, Protecting Your Medicare Enrollment Record.” This document can be found at: http://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/MedPhysPrivacy.pdf.)



Organizations Must Be Enrolled Before Individuals: Before a physician or non-physician practitioner can reassign their benefits to a medical group or clinic other than the one they solely own, the medical group or clinic must have an approved enrollment record in PECOS.



Initial Enrollment Application for an Individual: Physicians and non-physician practitioners who have not enrolled or updated their Medicare enrollment since November 2003 will need to complete an initial enrollment application. PECOS does not contain information for physicians and non-physician practitioners enrolled before November 2003 who have not updated their enrollment record since that time.



Using Internet-based PECOS: We suggest you use Internet-based PECOS because it is faster and more efficient than the paper enrollment application process. Before you begin to use Internet-based PECOS, you should:



· Be sure that you have the National Provider Identifier (NPI) that was assigned to you as an individual and, if you solely own an organization provider, the NPI assigned that was assigned to your organization.



· Review the document titled, “Internet-based PECOS -- Getting Started Guide for Physicians and Non-Physician Practitioners.” This document can be found at:

http://www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/GettingStarted.pdf



Internet-based PECOS Limitations: While Internet-based PECOS supports most Medicare enrollment application actions, there are some limitations. A physician or non-physician practitioner cannot use Internet-based PECOS to:



· Change his/her name or Social Security Number,



· Reassign benefits to another supplier if that supplier does not have an approved enrollment record in PECOS,



· Change in non-physician practitioner specialty type, or



· Change an existing business structure. For example:



o A sole owner of an enrolled Professional Association, Professional Corporation, or

LLC cannot change the business structure to a sole proprietorship; or



o An enrolled sole proprietorship cannot be changed to a solely-owned Professional Association, Professional Corporation, or LLC.



Finalizing Submission and Responding to Development Request: After submitting an enrollment application via Internet-based PECOS, you:



· Must print, sign and date (blue ink recommend) the Certification Statement(s) and mail the Certification Statement(s) and supporting documentation to the appropriate Medicare contractor. The Medicare contractor will not begin to process your enrollment application until it receives a signed and dated Certification Statement.



· May be asked to make corrections or submitted additional documents by the Medicare contractor. In order for your application to be processed, you must submit this information.



Reporting Responsibilities: Physicians and non-physician practitioners enrolled in the Medicare program have reporting responsibilities. See the download section found at www.cms.hhs.gov/MedicareProviderSupEnroll for information about your reporting responsibilities.



More Information: For more information about Internet-based PECOS, including contact information for the External User Services (EUS) Help Desk, go to www.cms.hhs.gov/MedicareProviderSupEnroll and select the “Internet-based PECOS” tab on the left side of screen.



EUS Help Desk provides assistance physicians and non-physician practitioners if they encounter an application navigation or systems problem with Internet-based PECOS. A navigation problem occurs when a practitioner is unable to determine how to use Internet-based PECOS.



Physicians and non-physician practitioners who have problems with their User Ids or password should contact the NPI Enumerator at 1-800-465-3203.

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4. Unavailability of Internet-Based PECOS Monday, March 29 through Monday, April 5



Due to scheduled maintenance, Internet-based Provider Enrollment, Chain and Ownership System (PECOS) will be unavailable from Monday, March 29, 2010 through Monday, April 5, 2010. Internet-based PECOS allows physicians, non-physician practitioners, providers, and other suppliers (except suppliers of durable medical equipment, prosthetics, orthotics, and supplies [DMEPOS]) to enroll or make a change to their existing Medicare enrollment information over the Internet.



If you would like to enroll or make a change to your existing Medicare enrollment record, you can do either of the following:



· Use Internet-based PECOS prior to March 29, 2010 or after April 5, 2010.



For more information about Internet-based PECOS, see the appropriate “Getting Started” guide available in the Downloads section at http://www.cms.hhs.gov/MedicareProviderSupEnroll/04_InternetbasedPECOS.asp#TopOfPage. There is a “Getting Started” guide for physicians and non-physician practitioners and one for provider and supplier organizations.



· Complete and submit the paper Medicare provider enrollment applications(s) (CMS-855) along with any required supporting documentation and mail the application(s) to the appropriate Medicare carrier, fiscal intermediary, or A/B MAC. The CMS-855 forms are downloadable from the CMS forms page: www.cms.hhs.gov/cmsforms.



If you need assistance or have questions, contact the Medicare fee-for-service contractor serving your State.

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5. Update on Claims Processing for Ordering/Referring Providers



The Centers for Medicare & Medicaid Services (CMS) will delay until January 3, 2011, 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)).



This delay 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 contains the 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.

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6. Medicare Ends Contract With Fox Insurance Company Drug Plan



Important Notice Regarding Medicare Prescription Drug Plan



FOR IMMEDIATE RELEASE Contact: CMS Office of Media Affairs

March 9, 2010 (202) 690-6145



MEDICARE ENDS CONTRACT WITH FOX INSURANCE COMPANY DRUG PLAN

Members Will Be Provided Access to Drugs While Transitioning to New Plans



The Centers for Medicare & Medicaid Services (CMS) today terminated its contract with Fox Insurance Company. After an onsite review of the plan and its services, CMS determined that the plan’s significant deficiencies – not meeting Medicare’s requirements to provide enrollees with prescription drugs according to recognized standards of care – jeopardized the health and safety of Fox enrollees. CMS found that Fox committed a series of violations, including improperly denying its enrollees coverage of critical HIV, cancer, and seizure medications. The termination of the contract is effective immediately.



The immediate termination will not impact or delay access to drugs for the more than 123,000 Medicare beneficiaries currently enrolled in Fox plans. Beginning tomorrow, all enrollees will obtain their drugs through LI-NET, a program run by Medicare and administered by Humana, to ensure that beneficiaries receive their Medicare prescription drugs. Fox enrollees will be able to choose a new Medicare prescription drug plan through May 1, 2010. Current enrollees who do not choose a plan will be enrolled into a new plan by Medicare.



“The immediate termination of Fox as a Medicare prescription drug plan demonstrates our commitment to protecting the health of some of their most vulnerable enrollees from getting necessary drugs, in some cases life-sustaining medicines. CMS’s immediate action was essential to protect members’ health and safety – an integral part of our contract with all Medicare beneficiaries,” said Jonathan Blum, acting director of CMS’ Center for Drug and Health Plan Choices. “Fox enrollees also need to know that they are not losing their drug coverage and will continue to have access to needed medicines. We will be sending letters explaining the steps we are taking to ensure they continue to get their medicines. They can also call 1-800-MEDICARE or their local state health insurance assistance programs if they have questions.”



CMS issued an enrollment and marketing sanction to Fox on Feb. 26, 2010, because the organization was not following Medicare’s rules for providing prescription drug coverage to its enrollees. After an onsite audit, which ran between March 2 and March 4, CMS found Fox’s problems persisted and it continued to subject its enrollees to obstacles in getting needed and, in many cases, life–sustaining medicines. CMS also found that many of the obstacles were in place to limit access to high-cost drugs, which could have led to enrollees’ clinical needs not being met. In many cases, Fox enrollees were required to have unnecessary and invasive medical procedures before they were able to obtain drugs. Fox was unable to satisfactorily address these compliance concerns and furnish medicines to its Medicare enrollees.





Among the audit findings CMS found include:

· Failing to provide access to Medicare prescription drugs benefits by imposing unapproved prior authorization and step therapy criteria that made it more difficult for beneficiaries to get drugs that are protected by law.

· Not meeting the plan’s appeals deadlines,

· Not complying with Medicare regulations requiring enrollees to be transitioned to new drugs at the beginning of the new plan year.

· Failing to notify enrollees about prior authorization and step therapy determinations as required by Medicare.



According to CMS auditors, Fox was unable to satisfactorily address compliance concerns cited in the enrollment and marketing sanction and meet contractual obligations to provide medicines to Medicare beneficiaries enrolled in their plans.



“We take our oversight role of Medicare prescription drug plans seriously,” said Blum. “We review and take action on all complaints received about Medicare health and drug plans and will take appropriate and immediate actions wherever necessary.”



CMS encourages Medicare prescription drug plan enrollees having concerns with access to drug coverage to contact 1-800-MEDICARE (1-800-633-4227) or the state health insurance assistance program (SHIP) to help get them resolved. Medicare enrollees, their families and their caregivers can contact a SHIP near them by visiting: http://www.medicare.gov/Contacts/staticpages/ships.aspx



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NOTE: States in which the Fox plan was available were: Arkansas, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Louisiana, Maryland, Missouri, North Carolina, New Jersey, New York, Nevada, Ohio, Pennsylvania, South Carolina, Texas and West Virginia.

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7. Proposed Rule for the Establishment of Certification Programs for Health Information Technology


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

March 2, 2010

Today the Secretary of the Department of Health and Human Services (HHS) released a notice of proposed rulemaking (NPRM) outlining the proposed approach for establishing a certification program to test and certify electronic health records (EHRs). The HITECH Act mandates the development of a certification program which will give purchasers and users of EHR technology assurances that the technology and products have the necessary functionality and security to help meet meaningful use criteria. While we are making significant strides toward modernizing our health care system, these efforts will only succeed if providers and patients are confident that their health information systems are safe and functional.

The proposed rule incorporates two phases of development for the certification program to ensure that eligible professionals and eligible hospitals are able to adopt and implement Certified EHR Technology in time to qualify for meaningful use incentive payments. The rulemaking process will take time, so this phased approach provides a bridge to detailed guidelines to support an ongoing program of testing and certification of health IT.

The first proposed program creates a temporary certification process under which the National Coordinator would authorize organizations to assume many of the responsibilities that will eventually be fulfilled under the permanent certification program. For the permanent certification program, the rule proposes transitioning much of the responsibility for testing and certification to organizations in the private sector.

Publication of the proposed rule on the Establishment of Certification Programs for Health Information Technology is an important first step in bringing structure and cohesion to the evaluation of EHRs, EHR modules, and potentially other types of health IT. The programs will help support end users of certified products, and ultimately serve the interests of each patient by ensuring that their information is securely managed and available where and when it is needed.

Your input is essential to bringing this important process to fruition. We encourage your participation in the open public comment period.

Additional information on both of these programs and how you can comment can be found through the HHS news release issued today and at the http://HealthIT.HHS.Gov website.

The vision of the HITECH Act is unfolding rapidly, and all of us at ONC look forward to continuing to work with you to achieve the meaningful use of EHRs.

Sincerely,

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

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8. Rescheduled: Fourth National Medicare Fee-For-Service Education Call on HIPAA Version 5010



5010: Taking EDI to the Next Level



Rescheduled: Fourth National Medicare Fee-For-Service (FFS) Education Call on HIPAA Version 5010



The Centers for Medicare & Medicaid Services (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: March 24, 2010



Conference Title: HIPAA Version 5010 Fourth National Provider Call



Discussion topics:

· General overview of 5010

· Additional changes to Medicare Fee For Service (FFS)

· Timelines and deadlines

· What you need to do to prepare

· CMS’s approach for new error handling transactions: 999 and 277CA

· Hot Topics:

1. Billing provider address change - P.O. Boxes no longer permitted

2. Discussions on handling Transaction Errata



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 March 23, 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://www.eventsvc.com/palmettogba/032410



2. Fill in all required data.



3. Verify your time zone is displayed correctly the drop down box.



4. 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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9. Medicare Contractor Provider Satisfaction Survey (MCPSS)



The Centers for Medicare & Medicaid Services (CMS) is conducting the fifth national administration of the Medicare Contractor Provider Satisfaction Survey (MCPSS). This survey is designed to collect quantifiable data on providers' satisfaction with the performance of the Medicare fee-for-service (FFS) contractors that process and pay their Medicare claims. CMS conducts the MCPSS on an annual basis and uses the results for Medicare contractor oversight and process improvement initiatives.



In January, CMS notified approximately 30,000 Medicare FFS providers and suppliers that they had been randomly selected to participate in the 2010 MCPSS study. As representatives of the more than 1.5 million providers nationwide who serve Medicare beneficiaries across the country, these providers and suppliers have an opportunity to give CMS valuable feedback on their satisfaction, attitudes, perceptions, and opinions about the services provided by their respective contractor.



If you have been notified that you were selected to participate in this study and have not yet done so, CMS is listening and wants to hear from you. Please take a few minutes to go online and complete your survey via a secure online Internet survey tool. Responding online is a convenient, easy, and quick way to provide CMS with your feedback. Survey questionnaires can also be submitted by mail, secure fax, and over the telephone. The survey takes approximately 20 minutes to complete.



CMS has contracted with SciMetrika, a public health consulting firm, to administer this important survey and report statistical data to CMS. If you received notification that you were selected to participate in the MCPSS study and you no longer have your online survey tool access information or need help accessing the survey tool, please call the MCPSS Provider Helpline at 1-800-835-7012 or send an email to MCPSS@scimetrika.com



Please Note: Only providers and suppliers notified that they have been randomly selected to take part in the 2010 MCPSS may participate in this study. A new random sample of providers and suppliers is selected annually to participate in the MCPSS study.



For more information about the MCPSS, please visit the CMS MCPSS website at http://www.cms.hhs.gov/mcpss, or read the CMS MLN Matters Special Edition article at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE1005.pdf featuring the survey.



CMS urges you to please take a few moments to complete your survey today.

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10. Medicare Fee-For-Service outreach efforts



The Centers for Medicare & Medicaid Services (CMS) continues to break new ground to enhance our Medicare Fee-For-Service outreach efforts. CMS is now using the following social media outlets to get information out to our audience as fast as possible.



· LinkedIn: Join the CMS group at www.LinkedIn.com/in/CMSGov



· YouTube: Log on to the official CMS YouTube channel at www.YouTube.com/CMSHHSGov to view several videos currently available and more to come in the upcoming months.



· Twitter: Follow CMS’ two accounts, twitter.com@CMSGov and twitter.com@IKNGov, to get the latest updates on information you need know about CMS (including Medicare Learning Network updates) and Insure Kids Now.



Log on to see the latest!

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11. ICD-10-CM National Provider Conference Call Scheduled



The Basic Introduction to ICD-10-CM National Provider Conference Call will be conducted on Tuesday, March 23, 2010 from 1:00 p.m. – 2:30 p.m. Eastern Daylight Time.



This conference call will provide an overview of ICD-10-CM/PCS requirements and a basic introduction to ICD-10-CM. The following topics will be discussed:

· Requirement to report ICD-10-CM/PCS codes for services provided on or after October 1, 2013.

· ICD-9-CM codes will not be accepted after October 1, 2013 (there will not be a grace period).

· Benefits of ICD-10-CM.

· Key similarities and differences between ICD-9-CM and ICD-10-CM.

· General structure and characteristics of ICD-10-CM.

· New features in ICD-10-CM.

· Setting the record straight about common ICD-10-CM myths and misperceptions.

· Impact of ICD-10-CM on medical record documentation.



Registration information and discussion materials for this conference call can be accessed at

http://www.cms.hhs.gov/ICD10/07_CMS_Sponsored_Calls.asp .

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12. Pricer Updates



Fiscal Year (FY) 2010 Inpatient Prospective Payment System (PPS) Personal Computer (PC) Pricer Updated



The Fiscal Year (FY) 2010 Inpatient PPS PC Pricer has been updated for FY 2010 claims with recent provider data from January 2010 and a correction of the Pricer version. You can go to the Inpatient PPS PC Pricer page, http://www.cms.hhs.gov/PCPricer/03_inpatient.asp, and download the latest version of the FY 2010 PC Pricer.



Fiscal Year (FY) 2009 Inpatient Prospective Payment System (PPS) Personal Computer (PC) Pricer Updated



The Fiscal Year (FY) 2009 Inpatient PPS PC Pricer has been updated on the web for FY 2009 claims with corrected provider data from January 2010. If you use the FY 2009 Inpatient PPS PC Pricer, go to http://www.cms.hhs.gov/PCPricer/03_inpatient.asp, and download the latest version of the PC Pricer.



Fiscal Year (FY) 2009 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) Personal Computer (PC) Pricer Updated



The FY 2009 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) PC Pricers have been updated with corrected January 2010 PSF data and is ready for download from the Centers for Medicare & Medicaid Services (CMS) web page at http://www.cms.hhs.gov/PCPricer/06_IRF.asp. If you use the IRF PPS PC Pricers, please go to the page above and download the latest FY 2009 version of the Pricer, posted 03/05/10, in the Downloads section.

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13. New from the Medicare Learning Network



The revised Ambulance Fee Schedule Fact Sheet (January 2010), which provides general information about the Ambulance Fee Schedule including how payment rates are set for ground and air ambulance services, is now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/AmbulanceFeeSched_508.pdf



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A new fact sheet entitled The Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program - A Better Way for Medicare to Pay for Medical Equipment (February 2010), is now available in downloadable format on the DMEPOS Competitive Bidding website. This fact sheet gives providers and suppliers an overview of the DMEPOS Competitive Bidding program as well as useful information regarding the benefits and inherit qualities of the program. The fact sheet may be downloaded by clicking on the following web address: http://www.cms.hhs.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp#TopOfPage http://www.cms.hhs.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp#TopOfPage>



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The Medicare Preventive Services Quick Reference Information Charts have been updated and are now available in downloadable format. This includes the following charts:



Quick Reference Information: Medicare Preventive Services: This two-sided reference chart provides health care providers with coverage, coding, and payment information on the many preventive services covered by Medicare.



Quick Reference Information: Medicare Immunization Billing: This two-sided reference chart provides coverage, coding and payment information on seasonal influenza, pneumococcal, and Hepatitis B vaccinations covered by Medicare.



Quick Reference Information: The ABCs of Providing the Initial Preventive Physical Examination (IPPE): This two-sided reference chart provides a checklist of the elements of an IPPE, as well as coding information and frequently asked questions.



To view the revised charts, please visit the "Preventive Services Educational Products" page at: http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp and select the "Educational Products" link in the "Downloads" section.



Hard copies of all three charts will be available at a later date.



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The NEW Health Professional Shortage Area (HPSA) Fact Sheet (March 2010) is now available in downloadable format from the Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/HPSAfctsht.pdf on the CMS website. This fact sheet provides general requirements and an overview of the Health Professional Shortage Area (HPSA) payment system.



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The CMS Website Wheel has been revised and can now be ordered through the Medicare Learning Network. The CMs Website Wheel is an informational resource that provides a variety of CMS Medicare related websites. To place an order, go to www.cms.hhs.gov/MLNProducts , scroll to the downloads section of the page and select MLN Product Ordering Page, then select the CMS Website Wheel.



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The Medicare Physician Fee Schedule Fact Sheet (March 2010) has been revised to include information about the two month zero percent (0%) update to the 2010 Medicare Physician Fee Schedule (MPFS) effective for dates of service January 1, 2010 through March 31, 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 Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/MedcrePhysFeeSchedfctsht.pdf .



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The revised Clinical Laboratory Fee Schedule Fact Sheet (January 2010), which provides general information about the Clinical Laboratory Fee Schedule, coverage of clinical laboratory services, and how payment rates are set, is now available in downloadable format from the Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/clinical_lab_fee_schedule_fact_sheet.pdf . If you are unable to open the fact sheet, please copy and paste the url into your Internet browser.

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14. Nursing Home Five Star Quality Rating System –March News



1. The Five-Star provider preview reports will be available beginning Monday, March 15, 2010. Providers can access the report from the Minimum Data Set (MDS) State Welcome pages available at the State servers for submission of Minimum Data Set data.

Provider Preview access information:

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

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

· Once in the CASPER Reporting system,

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

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

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

2. BetterCare@cms.hhs.gov is available to address any Five Star rating questions and concerns.

3. Nursing Home Compare will update with March’s Five Star data on Thursday, March 25, 2010.

4. Please visit http://www.cms.hhs.gov/CertificationandComplianc/13_FSQRS.asp for the latest Five-Star Quality Rating system information.

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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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