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. CMS Education Calls for Individual Practitioners and Hospitals on the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs



2. Affordable Care Act Saving Money for Medicare and Taxpayers



3. CMS Finalizes Policy and Payment Rate Changes for Inpatient Stays in Acute Care, Long-Term Care, and Certain Excluded Hospitals in FY 2011



4. SAVE THE DATE! ICD-10 Implementation in a 5010 Environment Follow-Up National Provider Call



5. Electronic Health Record (EHR) Incentive Programs: NEW: Tip Sheets for Medicaid Eligible Professionals and Hospitals



6. CMS Announces EHR Matching Funds Awards for Six States (CT, DE, IN, NH, RI, WV and District of Columbia)



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











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1. CMS Education Calls for Individual Practitioners and Hospitals on the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs



Education Calls for Providers on the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs











The Centers for Medicare & Medicaid Services (CMS) will hold a series of national provider calls next week addressing the specifics of the Medicare and Medicaid EHR Incentive Programs. The call on Tuesday, August 10 is for individual practitioners. The call Wednesday , August, 11, is for hospitals. The call Thursday, August 12, is a Question and Answer session for both hospitals and individual practitioners. Be sure to register for the right program(s) for you. Registration instructions for these calls can be found at:



http://www.cms.gov/EHRIncentivePrograms/05_Spotlight_and_Upcoming_Events.asp on the CMS website.







Medicare & Medicaid EHR Incentive Program Specifics for Eligible Professionals:

A session just for individual practitioners on the specifics about the Medicare & Medicaid EHR incentive program

Tuesday, August 10, 2010

2:00-3:30 pm EST





Medicare & Medicaid EHR Incentive Program Specifics for Hospitals:

A session just for hospitals on the specifics about the Medicare & Medicaid EHR incentive program

Wednesday, August 11, 2010

2:00-3:30 pm EST





Medicare & Medicaid EHR Incentive Program Question and Answer Session:

Have questions? Join this session to have an opportunity to ask a question and hear answers by our panel of experts on the Medicare and Medicaid EHR incentive programs. For both Eligible Professionals and Hospitals



Thursday, August 12, 2010

2:00-3:30 pm EST







The CMS’ web section on the Medicare & Medicaid EHR Incentive Programs at: http://www.cms.gov/EHRIncentivePrograms/ contains helpful information about these programs, including tip sheets for hospitals and eligible professionals. These tip sheets may be found by selecting the Hospital or Eligible Professional tabs on the left and scrolling to “Downloads.”

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2. Affordable Care Act Saving Money for Medicare and Taxpayers



MEDICARE NEWS



FOR IMMEDIATE RELEASE CONTACT: CMS Media Affairs

(202) 690-6145



AFFORDABLE CARE ACT SAVING MONEY FOR MEDICARE AND TAXPAYERS

New CMS Report Shows Savings of Nearly $8 Billion by 2012



Medicare will see savings of nearly $8 billion by the end of 2012 with the implementation of the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) reported.



In a new study examining the impact of the new law and actions taken to achieve its goals, available at www.cms.gov, CMS reports that savings to Medicare will rise to more than $575 billion over the next decade. These reforms include new provisions that will improve the quality of care, develop and promote new models of care delivery, appropriately price services, modernize the health system, and fight waste, fraud, and abuse. The Affordable Care Act is projected to more than double the life of the Medicare Trust Fund, extending its life from 2017 to 2029.



Without enactment of the Affordable Care Act, the nation’s already excessive health care spending would have reached unsustainable levels within the next few decades. The Congressional Budget Office projected in 2009 that national health care spending would be 31 percent of the Gross Domestic Product (GDP) by 2035 and 46 percent of GDP by 2080. The Medicare Trustees projected in 2009 that the Hospital Insurance (HI) Trust Fund, which pays for Medicare services, would be insolvent in eight years, by 2017.



To read the entire CMS Press Release issued August 2, click here: https://www.cms.gov/apps/media/press_releases.asp



The report is now available under “CMS Highlights” at www.cms.gov.

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3. CMS Finalizes Policy and Payment Rate Changes for Inpatient Stays in Acute Care, Long-Term Care, and Certain Excluded Hospitals in FY 2011



The Centers for Medicare & Medicaid Services (CMS) today issued a final rule establishing fiscal year (FY) 2011 policies and payment rates for inpatient services furnished to people with Medicare by acute care hospitals, long-term care hospitals (LTCHs), and certain excluded hospitals. Due to the timing of the passage of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively, the “Affordable Care Act”), CMS issued a FY 2011 IPPS/LTCH proposed rule, as well as a supplemental proposed rule that addressed certain changes made by the Affordable Care Act. The final rule responds to comments received by CMS on both the proposed rule and the supplemental proposed rule, which appeared in the May 4 and June 2 issues of the Federal Register, respectively.



CMS is similarly updating LTCH rates by 2.5 percent for inflation, but reducing the inflation update by 0.5 percentage point as required by the Affordable Care Act.



To read the entire CMS Press Release issued today (7/30) click here: http://www.cms.gov/apps/media/press_releases.asp



CMS Issued three Fact Sheets (7/30) with additional details at: http://www.cms.gov/apps/media/fact_sheets.asp



The final rule was placed on display at the Federal Register today, and can be found under Special Filings at: http://www.ofr.gov/OFRUpload/OFRData/2010-19092_PI.pdf or rwww.ofr.gov/inspection.aspx#special



The comment period for this interim final rule closes on Sept. 28, 2010.



For more information, please see: www.cms.gov/AcuteInpatientPPS/01_overview.asp



Note: More information about the proposed rule, including the documentation and coding adjustment and the RHQDAPU changes and HACs discussion, will be included in Fact Sheets to be posted on our Web page at: www.cms.gov/apps/media/fact_sheets.asp

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4. SAVE THE DATE! ICD-10 Implementation in a 5010 Environment Follow-Up National Provider Call



The Centers for Medicare & Medicaid Services (CMS) will host a follow-up national provider conference call on "ICD-10 Implementation in a 5010 Environment". This toll-free teleconference will focus on ICD-10 implementation issues, including proposals to partially freeze code updates, and implementation updates for versions 5010 and D.0, including implemented readiness review, how 5010 updates impact ICD-10 implementation, and advice for providers in moving toward 5010 implementation. Subject matter experts will review basic information on both ICD-10 and 5010 and explain how they are interrelated. A question and answer session will follow the presentations.

When: Monday, September 13, 2010

Time: 12:00 p.m. – 1:30 p.m. ET

Target Audience: Medical coders, physician office staff, provider billing staff, health records staff, vendors, educators, system maintainers and all Medicare fee-for-service (FFS) providers

Agenda:

ICD-10

ICD-10 implementation for services provided on and after October 1, 2013
Differences between ICD-10 and ICD-9-CM codes
ICD-10-CM basic information for all users
Tools for converting codes – General Equivalence Mappings (GEMs)
Proposal to freeze ICD-9-CM and ICD-10 code updates except for new technologies and diseases
HIPAA Version 5010

Compliance dates and timelines (No contingencies)
5010 before and after ICD-10 Implementation
Readiness review for implementing HIPAA version 5010 and D.0
What you need to be doing to prepare
Medicare fee-for-service activities update
Other issues and considerations
Registration information for this informative national provider conference call will be announced soon. For information about the awarding of continuing education credits for this call, visit http://www.cms.gov/ICD10/02c_CMS_Sponsored_Calls.asp#TopOfPage

Additional information about ICD-10/5010 can be found at http://www.cms.hhs.gov/ICD10 on the CMS website.

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5. Electronic Health Record (EHR) Incentive Programs: NEW: Tip Sheets for Medicaid Eligible Professionals and Hospitals



Now available on the CMS EHR Incentive Programs website



Get up-to-date and accurate information about the Medicare and Medicaid EHR incentive programs from CMS at http://www.cms.gov/EHRIncentiveprograms/. Visit the website to get specifics about the program and download our new tip sheets.



Tip Sheet : Medicaid Electronic Health Record Incentive Payments for Eligible Professionals

This tip sheet describes which types of individual practitioners can participate in the Medicaid EHR incentive program. It provides information about Medicaid patient volume requirements and incentive payments.



Now available on the CMS EHR Incentive Programs website http://www.cms.gov/EHRIncentivePrograms. Select the Medicaid Eligible Professional tab on the left, and then scroll to “Downloads.”



Tip Sheet: Medicaid Hospital Incentive Payment Calculations

Learn which hospitals are eligible for Medicaid incentive payments. This sheet provides user friendly information about the factors which impact incentive payment amounts and contains sample payment calculations.



Now available on the CMS EHR Incentive Programs website http://www.cms.gov/EHRIncentivePrograms. Select the Hospitals tab on the left, and then scroll to “Downloads.”

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6. CMS Announces EHR Matching Funds Awards for Six States (CT, DE, IN, NH, RI, WV and District of Columbia)



Six States (CT, DE, IN, NH, RI, WV) and District of Columbia to Receive Federal Matching Funds for Electronic Health Record Incentives Program



In another key step to further states’ role in developing a robust U.S. health information technology (HIT) infrastructure, the Centers for Medicare & Medicaid Services (CMS) announced 8/2 that the Medicaid programs of Connecticut, Delaware, Indiana, New Hampshire, Rhode Island, West Virginia, and the District of Columbia will receive federal matching funds for state planning activities necessary to implement the electronic health record (EHR) incentive program established by the American Recovery and Reinvestment Act of 2009 (Recovery Act). The matching funds to the six states and DC total $5.75 million.



EHRs will improve the quality of health care for the citizens of the six states and DC and make their care more efficient. EHRs make it easier for the many providers who may be treating a Medicaid patient to coordinate care. Additionally, EHRs make it easier for patients to access the information they need to make decisions about their health care.



The releases highlight awards (totaling $5.75 million) of 90 percent federal matching funds for planning activities for the Recovery Act’s Medicare and Medicaid Electronic Health Record Incentives Program.



This group of releases is part of a rolling announcement we began in November 2009. To date, including these new announcements, we will have awarded a total of $73.32 million to 45 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.



Connecticut: $695,000

Delaware: $247,000

District of Columbia: $817,000

Indiana: $2.31 million

New Hampshire: $335,000

Rhode Island: $401,000

West Virginia: $945,000



Subtotal: $5.75 million



Total awards to date: $73.32 million



Additional information on implementation of the Medicaid-related provisions of the Recovery Act’s EHR incentive payment program may be found at: http://www.cms.hhs.gov/Recovery/11_HealthIT.asp#TopOfPage



The CMS press releases issued 8/2 are available at: https://www.cms.gov/apps/media/press_releases.asp

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7. 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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