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
Sunday, October 31, 2010
Saturday, October 30, 2010
New College Student Aid Rules
New College Student Aid Rules
http://www.ed.gov/news/press-releases/department-education-establishes-new-student-aid-rules-protect-borrowers-and-tax
http://www.ed.gov/news/press-releases/department-education-establishes-new-student-aid-rules-protect-borrowers-and-tax
Friday, October 29, 2010
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. National Education Call for Non-Contract Suppliers in the DMEPOS Competitive Bidding Program
2. Save-the-Date for National Education Call for Referral Agents for the DMEPOS Competitive Bidding Program
3. Special Open-Door Forum: Update on Medicaid Integrity Provider Audit Program [Wed Nov 3]
4. Skilled Nursing Facility Prospective Payment System Resource Utilization Group-Version 4 (RUG-IV) National Provider Call with Q&A [Tue Nov 9]
5. 2010 Physician Quality Reporting Initiative & Electronic Prescribing Incentive Program National Provider Call with Question & Answer Session [Wed Nov 10]
6. Twelfth National Education Call on Medicare Fee-For-Service (FFS) Implementation of HIPAA Version 5010 and D.0 Transactions: Taking EDI to the Next Level [Wed Nov 17]
7. Registration for ONC Personal Health Records Roundtable Now Open [Fri Dec 3]
8. Updates from the Medicare Learning Network (MLN)
- New DMEPOS Competitive Bidding Program Fact Sheets
- DMEPOS Competitive Bidding Program Nat'l Education Call and MLN Fact Sheet
- Two New Fact Sheets Regarding Walker Exceptions to the DMEPOS Competitive Bidding Program
- “Comprehensive Outpatient Rehabilitation Facility”
- “Rural Health Clinic” Publication Revised
- MLN Matters Article #MM7133: “Counseling to Prevent Tobacco Use”
9. X12 Announces Deadline for Requests for Modifications to the ASC X12 005010 Health Care Implementation Guides
10. EHR Incentive Program: Certified Health IT Product List
11. ONC Reaches Out to Vendor Community to Help Reduce Health Disparities
12. October Flu Shot Reminder
13. National Diabetes Awareness Month and Diabetic Eye Disease Month
14. Clinician Outreach and Communication Activities from the Centers for Disease Control
15. A new "twist" in the law makes it easier to save on your prescription drug costs.
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1. National Education Call for Non-Contract Suppliers in the DMEPOS Competitive Bidding Program
Mon Nov 8, 2-3:30pm EST
The Centers for Medicare & Medicaid Services (CMS) will host a national provider education call on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. The target audience for this call is DMEPOS suppliers that will not be contract suppliers in the program. The target audience includes non-contract suppliers in the DMEPOS Competitive Bidding program.
The presentation for this call will be available on the following website within twenty four hours of the call: http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp.
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 2pm EST on Fri Nov 5 or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the call:
Visit http://www.eventsvc.com/palmettogba/110810.
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation e-mail shortly thereafter. Note: Please save this page, in the event that your server blocks the confirmation e-mails. If you do not receive the confirmation e-mail, please check your spam/junk mail filter as it may have been directed there.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event.
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2. Save-the-Date for National Education Call for Referral Agents for the DMEPOS Competitive Bidding Program
Tue Nov 16, 2-3:30pm EST
Please hold the date for a national provider education call on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, aimed at referral agents for the program. (Referral agents generally include Medicare-enrolled providers, physicians, treating practitioners, discharge planners, social workers, and pharmacists who refer beneficiaries for DMEPOS items and services in a competitive bidding area). The call will take place on Tue Nov 16, from 2pm to 3:30pm EST, and more details (including registration instructions) will be shared in the days to come.
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3. Special Open-Door Forum: Update on Medicaid Integrity Provider Audit Program [Wed Nov 3]
Wed Nov 3, 2-3:30pm EST
Section 1936 of the Social Security Act required CMS to enter into contracts to perform four key Medicaid program integrity activities:
§ Review of provider actions to determine whether fraud, waste, or abuse occurred or may have occurred;
§ Audit provider claims;
§ Identify overpayments;
§ Educate providers and others.
In July 2009, CMS held the first ODF on this topic to discuss the implementation of the MIP Provider Audit Program. CMS staff discussed the MIP audit process, audit timelines, web site information and future meetings. This upcoming special ODF is intended to provide feedback and lessons learned from the initial 18 months of the Medicaid audit program and discuss opportunities for improvement.
Open-Door Forum Instructions:
§ Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45pm EST.
§ Dial 800-837-1935
§ Conference ID 18705250
§ Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
§ An audio recording and transcript of this Special ODF will be posted to the Special ODF website at http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading on or around November 17, 2010 and available for 30 days.
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4. Skilled Nursing Facility Prospective Payment System Resource Utilization Group-Version 4 (RUG-IV) National Provider Call with Q&A [Tue Nov 9]
Tue Nov 9, 2-3:30pm EST
This call is one in a series of calls designed to provide information on key aspects of the RUG-IV SNF PPS case mix system, which was put into place on an interim basis effective October 1, 2010. CMS held three previous calls, which provided details of significant changes related to the RUG-IV payment system.
In June, CMS discussed coding procedures, with emphasis on the appropriate Look-back Period to be used when coding the Minimum Data Set (MDS) 3.0 and how facility staff should separately report individual, concurrent and group therapy for accurate payment, along with changes to the ADL coding requirements and their impact on the assignment of MDS 3.0 records to a RUG-IV group. In August, CMS held a second call, where subject matter experts discussed the transition from RUG-III to RUG-IV. The third call, in September, discussed several SNF PPS policies, including Start of Therapy and End of Therapy Other Medicare Required Assessments and the SNF short stay policy.
For this call, CMS subject matter experts will review some of the significant changes associated with the RUG-IV payment system. Information on the previous calls and future information for this call will be available on the SNF PPS webpage at http://www.cms.gov/SNFPPS/03_RUGIVEdu.asp. Following the formal presentation, callers will have an opportunity to ask questions of CMS subject matter experts.
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 2pm EST on Mon Nov 8, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the call:
Visit http://www.eventsvc.com/palmettogba/110910.
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please 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.
If assistance for hearing impaired services is needed, the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event.
For those who will be unable to attend, a transcript and MP3 audio file of the call will be available at http://www.cms.gov/SNFPPS/03_RUGIVEdu.asp#TopOfPage on the CMS website shortly after the call.
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5. 2010 Physician Quality Reporting Initiative & Electronic Prescribing Incentive Program National Provider Call with Question & Answer Session [Wed Nov 10]
Wed Nov 10, 1:30pm-3pm EST
The PQRI is voluntary quality reporting program that provides an incentive payment to identified individual eligible professionals (EPs), and beginning with the 2010 PQRI, group practices who satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-For-Service (FFS) beneficiaries. The PQRI was first implemented in 2007 as a result of section 101 of the Tax Relief and Health Care Act of 2006 (TRHCA), and further expanded as a result of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), and the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
The eRx Incentive Program is an incentive program for eligible professionals initially implemented in 2009 as a result of section 132(b) of the MIPPA. The eRx Incentive Program promotes the adoption and use of eRx systems by individual eligible professionals and beginning with the 2010 eRx Incentive Program, group practices.
The formal presentation will cover the following:
Overview of the 2011 rule and comments;
2009 PQRI and eRx Incentive Program payment distribution and instructions for understanding these payments;
An overview for the use of the 2009 Feedback Report User Guides for PQRI and the eRx Incentive Program;
Discussion on the changes to the electronic remittance advice for eligible professionals receiving PQRI and eRx incentive payments in 2010; and
Participation in the 2010 eRX Incentive Program.
The lines will be opened to allow participants to ask questions of CMS PQRI and eRx subject matter experts. A PowerPoint slide presentation will be posted to the PQRI webpage (at http://www.cms.gov/PQRI/04_CMSSponsoredCalls.asp) on the CMS website for you to download prior to the call so that you can follow along with the presenter.
Educational products are available on the PQRI-dedicated webpage (http://www.cms.hhs.gov/PQRI) in the Educational Resources section and on the eRx-dedicated webpage (http://www.cms.hhs.gov/ERxIncentive) on the CMS website. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
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 1:30pm EST on Tue Nov 9 or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the call:
Visit http://www.eventsvc.com/palmettogba/111010.
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please 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.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event. For those of who will be unable to attend, a transcript and MP3 file of the call will be available at least one week after the call at http://www.cms.hhs.gov/PQRI on the CMS website.
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6. Twelfth National Education Call on Medicare Fee-For-Service (FFS) Implementation of HIPAA Version 5010 and D.0 Transactions: Taking EDI to the Next Level [Wed Nov 17]
Wed Nov 17, 2pm-3:30pm EST
The Centers for Medicare & Medicaid Services (CMS) will host its twelfth national education call regarding Medicare FFS’s implementation of HIPAA Version 5010 and D.0 transaction standards on Wed Nov 17, focusing on the Coordination of Benefits (COB). Subject matter experts will review Medicare FFS specific changes, including those arising from the adoption of the HIPAA 5010 Errata, as well as general information to help the audience prepare for the transition; the presentation will be followed by a Q&A session. Target Audience includes vendors, clearinghouses, and providers who will need to make Medicare FFS specific changes in compliance with HIPAA version 5010 requirements. The presentation will be available on the CMS website at http://www.cms.gov/Versions5010andD0/V50/list.asp.
Agenda:
§ General Overview
§ Medicare Specific COB Changes
§ Timelines and Deadlines
§ What you need to do to prepare
§ Q & A
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 November 16, 2010, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the call:
Visit http://www.eventsvc.com/palmettogba/111710.
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation e-mail shortly thereafter. Note: Please save this page, in the event that your server blocks the confirmation e-mails. If you do not receive the confirmation e-mail, please check your spam/junk mail filter as it may have been directed there.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event.
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7. Registration for ONC Personal Health Records Roundtable Now Open [Fri Dec 3]
Fri Dec 3, 8:30am-4:30pm
Online registration is now open for the roundtable on “Personal Health Records – Understanding the Evolving Landscape.” This free day-long public roundtable, hosted by the Office of the National Coordinator for Health Information Technology (ONC), will be held on Fri Dec 3 at the FTC Conference Center in Washington DC (601 New Jersey Avenue NW, Washington, DC 20001).
Register to attend in person or via webcast by visiting http://healthit.hhs.gov/PHRroundtable. The webcast will be hosted at http://healthit.hhs.gov/blog/phr-roundtable.
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8. Updates from the Medicare Learning Network (MLN)
New DMEPOS Competitive Bidding Program Fact Sheets
New from the Medicare Learning Network!
The following new fact sheets related to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program are now available in downloadable format from the Medicare Learning Network®.
§ DMEPOS Competitive Bidding Program Traveling Beneficiary Fact Sheet,
§ DMEPOS Competitive Bidding Program Physicians and Other Treating Practitioners Who Are Enrolled Medicare DMEPOS Suppliers Fact Sheet, and
§ DMEPOS Competitive Bidding Program Hospitals That Are Not Contract Suppliers Fact Sheet
On January 1, 2011, when the DMEPOS Competitive Bidding Program goes into effect in nine competitive bidding areas (CBAs), beneficiaries with Original Medicare who obtain competitively bid items in CBAs must obtain those items from a contract supplier in order for Medicare to pay, unless an exception applies.
To learn more, view the fact sheets at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp on the CMS website and click on the appropriate links in the “Downloads” section.
For more information about the DMEPOS Competitive Bidding Program, including a list of the first nine CBAs and items included in the program, visit http://www.cms.gov/DMEPOSCompetitiveBid on the CMS website.
# # # # # #
DMEPOS Competitive Bidding Program Nat'l Education Call and MLN Fact Sheet
National Education Call for Non-Contract Suppliers in the DMEPOS Competitive Bidding Program
Mon Nov 8, 2-3:30pm EST
Conference Call Only
Please hold the date for a national provider education call on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. The target audience for this call is DMEPOS suppliers that will not be contract suppliers in the program. The call will take place on Mon Nov 8, from 2pm to 3:30pm EST, and more details (including registration instructions) will be shared in the days to come.
From the Medicare Learning Network: “The DMEPOS Competitive Bidding Program Traveling Beneficiary Fact Sheet”
The Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Traveling Beneficiary Fact Sheet is now available, free of charge, from the Medicare Learning Network®.
Once the DMEPOS competitive bidding program becomes effective on January 1, 2011, beneficiaries with Original Medicare who obtain competitively bid items in competitive bidding areas (CBAs) must obtain these items from a contract supplier for Medicare to pay, unless an exception applies. This includes beneficiaries who do not live in a CBA but who obtain competitively bid items while traveling to a CBA. This fact sheet contains helpful information on competitive bidding program rules that apply when a beneficiary travels.
To learn more, please visit the DMEPOS Competitive Bidding Educational Resources page at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp on the CMS website, then select the link entitled “DMEPOS Competitive Bidding Program Traveling Beneficiary Fact Sheet” in the “Downloads” section.
# # # # # #
Two New Fact Sheets Regarding Walker Exceptions to the DMEPOS Competitive Bidding Program
The Medicare Learning Network® has released two fact sheets related to exceptions for walkers under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. They are the “DMEPOS Competitive Bidding Program Hospitals That Are Not Contract Suppliers Fact Sheet” and the “DMEPOS Competitive Bidding Program Physicians and Other Treating Practitioners Who Are Enrolled Medicare DMEPOS Suppliers Fact Sheet.”
Under the DMEPOS Competitive Bidding Program, beneficiaries with Original Medicare who obtain competitive bidding items in designated competitive bidding areas (CBAs) are required to obtain these items from a contract supplier, unless an exception applies. For the first phase of competitive bidding, which is effective January 1, 2011, one of these exceptions allows hospitals to furnish competitively bid walkers in a CBA to their own patients, without submitting a bid and being selected as a contract supplier. Similarly, another of these exceptions allows physicians and other treating practitioners who are enrolled Medicare DMEPOS suppliers to furnish competitively bid walkers in a CBA to their own patients without submitting a bid and being selected as a contract supplier.
To learn more and download these fact sheets, please visit the DMEPOS Competitive Bidding Educational Resources page at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp on the CMS website, then select the appropriate link in the “Downloads” section.
# # # # # #
“Comprehensive Outpatient Rehabilitation Facility”
A new Medicare Learning Network® publication titled “Comprehensive Outpatient Rehabilitation Facility” is now available in downloadable format at http://www.cms.gov/MLNProducts/downloads/Comprehensive_Outpatient_Rehabilitation_Facility_Fact_Sheet_ICN904085.pdf. This fact sheet provides information about basic, core and optional Comprehensive Outpatient Rehabilitation Facility (CORF) services; place of treatment requirements; rehabilitation plan of care requirements; and CORF payments.
# # # # # #
“Rural Health Clinic” Publication Revised
A revised Medicare Learning Network® publication titled “Rural Health Clinic” is now available in downloadable format at http://www.cms.gov/MLNProducts/downloads/RuralHlthClinfctsht.pdf. This fact sheet provides information about Rural Health Clinic (RHC) services, Medicare certification as a RHC, RHC visits, RHC payments, cost reports, and annual reconciliation.
# # # # # #
MLN Matters Article #MM7133: “Counseling to Prevent Tobacco Use”
The Medicare Learning Network® (MLN) has released MLN Matters Article #MM7133 to inform providers that the Centers for Medicare & Medicaid Services (CMS) will cover counseling services to prevent tobacco use for outpatient and hospitalized beneficiaries. Effective for claims with dates of service on and after August 25, 2010, CMS will cover tobacco cessation counseling for outpatient and hospitalized Medicare beneficiaries [1] who use tobacco, regardless of whether they have signs or symptoms of tobacco-related disease, [2] who are competent and alert at the time that counseling is provide, and [3] whose counseling is furnished by a qualified physician or other Medicare-recognized practitioner. This article is based on Change Request (CR) #7133 and is available at http://www.cms.gov/MLNMattersArticles/downloads/MM7133.pdf.
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9. X12 Announces Deadline for Requests for Modifications to the ASC X12 005010 Health Care Implementation Guides
On Wed Oct 20, 2010, the Accredited Standards Committee X12 (ASC X12) announced that February 4, 2011 is the deadline to submit revision requests related to the ASC X12 005010 Type 3 Technical Reports (TR3), also known as Implementation Guides.
Requests for revisions to the ASC X12 Technical Reports mandated under HIPAA may be submitted via the Designated Standard Maintenance Organizations (DSMO) website at http://www.hipaa-dsmo.org. Requests for revisions to other ASC X12 Technical Reports may be submitted via http://www.x12.org/TR3ChangeRequest. To be considered for inclusion in the 006020 implementation guides, requests must include all of the detailed information requested on the on-line submission forms. Change requests submitted after the deadline will be considered for inclusion in a future version.
The ASC X12 Insurance Subcommittee (ASC X12N) has implemented a new process for managing change requests, beginning with this ASC X12 006020 maintenance cycle. The new process shortens the timeline for revisions to ASC X12 TR3s by as much as 15 months, to approximately 21 months. For additional information, please visit http://www.x12.org/dsmo/help or contact info@disa.org.
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10. EHR Incentive Program: Certified Health IT Product List
Providers must use certified Electronic Health Record (EHR) technology in order to earn incentives under the Medicare and Medicaid EHR Incentive Programs. How can you be sure which EHR technology has been certified?
The Office of the National Coordinator for Health Information Technology (ONC) has published the Certified Health IT Product List (CHPL), a comprehensive listing of Complete EHRs and EHR Modules that have been tested and certified under the Temporary Certification Program. Each Complete EHR and EHR Module included in the CHPL has been tested and certified by an ONC-Authorized Testing and Certification Body (ATCB), and reported to ONC by an ONC-ATCB, with reports validated by ONC. Only those EHR technologies appearing on the ONC-CHPL may be granted the reporting number that will be accepted by CMS for purposes of attestation under the EHR Incentive Programs.
The listing will be updated as additional products are certified by ONC-ATCBs and reported to ONC for validation. For more information about this product listing, please visit http://healthit.hhs.gov/CHPL. For more information on the Medicare and Medicaid EHR Incentive Programs, visit http://www.cms.gov/EHRIncentivePrograms.
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11. ONC Reaches Out to Vendor Community to Help Reduce Health Disparities
The Office of the National Coordinator for Health Information Technology (ONC) and the Office of Minority Health (OMH) believe that electronic health records (EHRs) can help improve health care for low-income and minority communities who remain disproportionately affected by chronic illnesses. However, EHR adoption rates among providers who serve these communities remain low.
In an effort to prevent health disparities caused by a “digital divide,” Dr David Blumenthal, National Coordinator for Health Information Technology, and Dr Garth Graham, Director of the OMH, are encouraging vendors to work together to help providers serving low-income and minority communities adopt EHRs. Read more in Dr Blumenthal’s new letter to the vendor community.
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12. October Flu Shot Reminder
Vaccination is the Best Protection Against the Flu. This year, the Centers for Disease Control and Prevention (CDC) is encouraging everyone 6 months of age and older to get vaccinated against the seasonal flu. The risks for complications, hospitalizations and deaths from the flu are higher among individuals aged 65 years and older. Medicare pays for the seasonal flu vaccine and its administration for seniors and others with Medicare with no co-pay or deductible. And remember, vaccination is particularly important for health care workers, who may spread the flu to high risk patients. Don’t forget to immunize yourself and your staff. Protect your patients. Protect your family. Protect yourself. Get Your Flu Vaccine - Not the Flu.
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 influenza vaccine and its administration, as well as related educational resources for health care professionals and their staff, please visit http://www.cms.gov/AdultImmunizations.
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13. National Diabetes Awareness Month and Diabetic Eye Disease Month
November is National Diabetes Awareness Month and Diabetic Eye Disease Month. Diabetes can lead to severe complications such as heart disease, stroke, and kidney failure. It is also a significant risk factor for developing glaucoma.
The Centers for Medicare & Medicaid Services (CMS) asks the provider community to keep their patients with Medicare healthy by encouraging eligible patients to take advantage of Medicare-covered diabetes-related services. Medicare provides coverage of several diabetes-related preventive services for eligible beneficiaries, including:
§ Diabetes Screening Tests,
§ Diabetes Self-Management Training,
§ Medical Nutrition Therapy,
§ Diabetes-Related Supplies, and
§ Glaucoma Screening.
What Can You Do? As a health care professional who provides care to patients with Medicare, you can help protect the health of your patients by encouraging them to take advantage of Medicare-covered preventive services, including diabetes-related services, that are appropriate for them.
For More Information – CMS has developed several educational products related to Medicare-covered diabetes-related services. They are all available, free of charge, from the Medicare Learning Network®:
The MLN Preventive Services Educational Products Web Page – provides descriptions and ordering information for Medicare Learning Network® (MLN) educational products for health care professionals related to Medicare-covered preventive services. Visit http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp.
The Diabetes-Related Services brochure – provides information on coverage for Medicare-covered diabetes-related services. This product is available in hardcopy or as a downloadable PDF. Visit http://www.cms.gov/MLNProducts/downloads/DiabetesSvcs.pdf.
The Glaucoma Screening brochure – provides information on coverage for Medicare-covered glaucoma screening. This product is available in hardcopy or as a downloadable PDF. Visit http://www.cms.gov/MLNProducts/downloads/glaucoma.pdf.
The Guide to Medicare Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals – provides coverage and coding information on Medicare-covered preventive services and screenings. Available as a downloadable PDF only. Visit http://www.cms.hhs.gov/MLNProducts/downloads/mps_guide_web-061305.pdf.
Quick Reference Information: Medicare Preventive Services – this chart provides coverage and coding information on Medicare-covered preventive services. Visit http://www.cms.hhs.gov/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf.
The Medicare Preventive Services Series: Part 2 Web-Based-Training (WBT) course – this WBT includes lessons on coverage, coding, and billing for Medicare-covered preventive services, including diabetes-related services. To access the course, please visit the MLN home page at http://www.cms.gov/mlngeninfo. Scroll down to “Related Links Inside CMS” and click on “Web Based Training (WBT) Modules.”
The Medicare Preventive Services Series: Part e Web-Based-Training (WBT) course – this WBT includes lessons on coverage, coding, and billing for Medicare-covered preventive services, including glaucoma screening. To access the course, please visit the MLN home page at http://www.cms.gov/mlngeninfo. Scroll down to “Related Links Inside CMS” and click on “Web Based Training (WBT) Modules.”
Please visit the Medicare Learning Network for more information on these and other Medicare fee-for-service educational products. For more information on National Diabetes Awareness Month, please visit the American Diabetes Association’s official page at http://www.diabetes.org/in-my-community/programs/american-diabetes-month. For additional information on National Diabetes Awareness Month, please visit the National Diabetes Education Program (NDEP) website at http://ndep.nih.gov/whats-new/posting.aspx?id=23. For more information on diabetic eye disease, please visit the Prevent Blindness America website at http://www.preventblindness.org. For more information to share with your patients about diabetes, please visit the NDEP website at http://www.ndep.nih.gov.
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14. Clinician Outreach and Communication Activities from the Centers for Disease Control
Upcoming COCA Conference Call: Neglected Infections of Poverty in the United States
Tue Nov 2, 2-3pm EST
Neglected infections of poverty are a group of parasitic, bacterial, and viral infections that disproportionately affect impoverished groups in the United States, and lead to illness in a significant number of individuals in vulnerable populations. These infections are often not well studied or tracked; thereby impacting diagnosis, treatment, and prevention. During this call, a CDC subject matter expert will describe the epidemiology, diagnosis, and treatment of 3 neglected infections of poverty: Chagas Disease, Toxocariasis, and Trichomoniasis. For more information on this call visit http://emergency.cdc.gov/coca/callinfo.asp.
§ Call Number: 888-790-6180 / Passcode 1281914
Upcoming COCA Conference Call: Practical Tools for Radiation Emergency Preparedness
Tue Nov 9, 2-3pm EST
Healthcare providers play an important role in any radiation emergency. Clinicians of all specialties will be responsible for providing care and information to patients in multiple settings from hospitals to community reception centers (CRCs). It is important for clinicians to develop plans and response capacity for radiation emergencies using practical tools for radiation emergency preparedness. Join subject matter experts as they describe the process flow and stations in a Community Reception Center; identify the unique psychological effects of radiation disasters; and define skills and techniques used when performing psychological first aid in radiation disasters.
This COCA call will utilize a webinar format. We are going to use an interactive webinar for this call to deliver content, as an alternative to using the traditional audio and PowerPoint option. This new webinar format will utilize several new features such as automated presentation transition, live and recorded video, and optional call registration. You may still access the audio portion of the call by using the provided call number. For additional information visit: http://emergency.cdc.gov/coca/callinfo.asp.
§ Register for this webinar at http://events.constantcontact.com/register/event?llr=pf7m85dab&oeidk=a07e33aaoq677b7b5e4
§ Call-in Number: 800-619-8497 / Passcode 3381626
Courses and On-Demand Trainings: CDC Public Health Grand Rounds: Malaria
Thu Nov 18, 1-2pm EST
The Public Health Grand Rounds is a monthly series created to further strengthen CDC’s common scientific culture and foster discussion and debate on major public health issues. This session of the Public Health Grand Rounds will focus on key issues related to Malaria. Watch live and archived broadcasts at www.cdc.gov/about/grand-rounds.
Upcoming Conference: Modeling for Public Health Action: From Epidemiology to Operations
Thu Dec 9 – Fri Dec 10, 2010 // Location: Atlanta, GA
This conference promotes the exchange of information and ideas about modeling uses to shape public health action. The conference will address effective and practical modeling applications to public health and provide high-quality sessions, training and networking opportunities. It is intended for public health practitioners and policy makers in state and local health departments; scientists and modelers working at CDC and its federal partners in public health; academic researchers, non-government organizations, and international practitioners, modelers and policy makers. For more information, visit http://www.phmodeling2010conference.com/index.html.
H1N1 & Seasonal Influenza Resources: Seasonal Flu: International Situation Update
This report is a summary of key influenza-related updates created from regional World Health Organization (WHO) reports, country reports, CDC field staff updates, and other sources. Updates are listed by region and focus on data collected during epidemiologic weeks 37 through 40 (September 12 – October 9, 2010). Visit http://www.cdc.gov/flu/international/activity.htm.
H1N1 & Seasonal Influenza Resources: Seasonal Influenza Vaccine Coverage
Current available coverage data and past trends available at http://www.cdc.gov/flu/professionals/vaccination/vaccinecoverage.htm.
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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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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. National Education Call for Non-Contract Suppliers in the DMEPOS Competitive Bidding Program
2. Save-the-Date for National Education Call for Referral Agents for the DMEPOS Competitive Bidding Program
3. Special Open-Door Forum: Update on Medicaid Integrity Provider Audit Program [Wed Nov 3]
4. Skilled Nursing Facility Prospective Payment System Resource Utilization Group-Version 4 (RUG-IV) National Provider Call with Q&A [Tue Nov 9]
5. 2010 Physician Quality Reporting Initiative & Electronic Prescribing Incentive Program National Provider Call with Question & Answer Session [Wed Nov 10]
6. Twelfth National Education Call on Medicare Fee-For-Service (FFS) Implementation of HIPAA Version 5010 and D.0 Transactions: Taking EDI to the Next Level [Wed Nov 17]
7. Registration for ONC Personal Health Records Roundtable Now Open [Fri Dec 3]
8. Updates from the Medicare Learning Network (MLN)
- New DMEPOS Competitive Bidding Program Fact Sheets
- DMEPOS Competitive Bidding Program Nat'l Education Call and MLN Fact Sheet
- Two New Fact Sheets Regarding Walker Exceptions to the DMEPOS Competitive Bidding Program
- “Comprehensive Outpatient Rehabilitation Facility”
- “Rural Health Clinic” Publication Revised
- MLN Matters Article #MM7133: “Counseling to Prevent Tobacco Use”
9. X12 Announces Deadline for Requests for Modifications to the ASC X12 005010 Health Care Implementation Guides
10. EHR Incentive Program: Certified Health IT Product List
11. ONC Reaches Out to Vendor Community to Help Reduce Health Disparities
12. October Flu Shot Reminder
13. National Diabetes Awareness Month and Diabetic Eye Disease Month
14. Clinician Outreach and Communication Activities from the Centers for Disease Control
15. A new "twist" in the law makes it easier to save on your prescription drug costs.
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1. National Education Call for Non-Contract Suppliers in the DMEPOS Competitive Bidding Program
Mon Nov 8, 2-3:30pm EST
The Centers for Medicare & Medicaid Services (CMS) will host a national provider education call on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. The target audience for this call is DMEPOS suppliers that will not be contract suppliers in the program. The target audience includes non-contract suppliers in the DMEPOS Competitive Bidding program.
The presentation for this call will be available on the following website within twenty four hours of the call: http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp.
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 2pm EST on Fri Nov 5 or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the call:
Visit http://www.eventsvc.com/palmettogba/110810.
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation e-mail shortly thereafter. Note: Please save this page, in the event that your server blocks the confirmation e-mails. If you do not receive the confirmation e-mail, please check your spam/junk mail filter as it may have been directed there.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event.
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2. Save-the-Date for National Education Call for Referral Agents for the DMEPOS Competitive Bidding Program
Tue Nov 16, 2-3:30pm EST
Please hold the date for a national provider education call on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, aimed at referral agents for the program. (Referral agents generally include Medicare-enrolled providers, physicians, treating practitioners, discharge planners, social workers, and pharmacists who refer beneficiaries for DMEPOS items and services in a competitive bidding area). The call will take place on Tue Nov 16, from 2pm to 3:30pm EST, and more details (including registration instructions) will be shared in the days to come.
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3. Special Open-Door Forum: Update on Medicaid Integrity Provider Audit Program [Wed Nov 3]
Wed Nov 3, 2-3:30pm EST
Section 1936 of the Social Security Act required CMS to enter into contracts to perform four key Medicaid program integrity activities:
§ Review of provider actions to determine whether fraud, waste, or abuse occurred or may have occurred;
§ Audit provider claims;
§ Identify overpayments;
§ Educate providers and others.
In July 2009, CMS held the first ODF on this topic to discuss the implementation of the MIP Provider Audit Program. CMS staff discussed the MIP audit process, audit timelines, web site information and future meetings. This upcoming special ODF is intended to provide feedback and lessons learned from the initial 18 months of the Medicaid audit program and discuss opportunities for improvement.
Open-Door Forum Instructions:
§ Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45pm EST.
§ Dial 800-837-1935
§ Conference ID 18705250
§ Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
§ An audio recording and transcript of this Special ODF will be posted to the Special ODF website at http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading on or around November 17, 2010 and available for 30 days.
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4. Skilled Nursing Facility Prospective Payment System Resource Utilization Group-Version 4 (RUG-IV) National Provider Call with Q&A [Tue Nov 9]
Tue Nov 9, 2-3:30pm EST
This call is one in a series of calls designed to provide information on key aspects of the RUG-IV SNF PPS case mix system, which was put into place on an interim basis effective October 1, 2010. CMS held three previous calls, which provided details of significant changes related to the RUG-IV payment system.
In June, CMS discussed coding procedures, with emphasis on the appropriate Look-back Period to be used when coding the Minimum Data Set (MDS) 3.0 and how facility staff should separately report individual, concurrent and group therapy for accurate payment, along with changes to the ADL coding requirements and their impact on the assignment of MDS 3.0 records to a RUG-IV group. In August, CMS held a second call, where subject matter experts discussed the transition from RUG-III to RUG-IV. The third call, in September, discussed several SNF PPS policies, including Start of Therapy and End of Therapy Other Medicare Required Assessments and the SNF short stay policy.
For this call, CMS subject matter experts will review some of the significant changes associated with the RUG-IV payment system. Information on the previous calls and future information for this call will be available on the SNF PPS webpage at http://www.cms.gov/SNFPPS/03_RUGIVEdu.asp. Following the formal presentation, callers will have an opportunity to ask questions of CMS subject matter experts.
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 2pm EST on Mon Nov 8, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the call:
Visit http://www.eventsvc.com/palmettogba/110910.
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please 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.
If assistance for hearing impaired services is needed, the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event.
For those who will be unable to attend, a transcript and MP3 audio file of the call will be available at http://www.cms.gov/SNFPPS/03_RUGIVEdu.asp#TopOfPage on the CMS website shortly after the call.
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5. 2010 Physician Quality Reporting Initiative & Electronic Prescribing Incentive Program National Provider Call with Question & Answer Session [Wed Nov 10]
Wed Nov 10, 1:30pm-3pm EST
The PQRI is voluntary quality reporting program that provides an incentive payment to identified individual eligible professionals (EPs), and beginning with the 2010 PQRI, group practices who satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-For-Service (FFS) beneficiaries. The PQRI was first implemented in 2007 as a result of section 101 of the Tax Relief and Health Care Act of 2006 (TRHCA), and further expanded as a result of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), and the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
The eRx Incentive Program is an incentive program for eligible professionals initially implemented in 2009 as a result of section 132(b) of the MIPPA. The eRx Incentive Program promotes the adoption and use of eRx systems by individual eligible professionals and beginning with the 2010 eRx Incentive Program, group practices.
The formal presentation will cover the following:
Overview of the 2011 rule and comments;
2009 PQRI and eRx Incentive Program payment distribution and instructions for understanding these payments;
An overview for the use of the 2009 Feedback Report User Guides for PQRI and the eRx Incentive Program;
Discussion on the changes to the electronic remittance advice for eligible professionals receiving PQRI and eRx incentive payments in 2010; and
Participation in the 2010 eRX Incentive Program.
The lines will be opened to allow participants to ask questions of CMS PQRI and eRx subject matter experts. A PowerPoint slide presentation will be posted to the PQRI webpage (at http://www.cms.gov/PQRI/04_CMSSponsoredCalls.asp) on the CMS website for you to download prior to the call so that you can follow along with the presenter.
Educational products are available on the PQRI-dedicated webpage (http://www.cms.hhs.gov/PQRI) in the Educational Resources section and on the eRx-dedicated webpage (http://www.cms.hhs.gov/ERxIncentive) on the CMS website. Feel free to download the resources prior to the call so that you may ask questions of the CMS presenters.
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 1:30pm EST on Tue Nov 9 or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the call:
Visit http://www.eventsvc.com/palmettogba/111010.
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Note: Please 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.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event. For those of who will be unable to attend, a transcript and MP3 file of the call will be available at least one week after the call at http://www.cms.hhs.gov/PQRI on the CMS website.
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6. Twelfth National Education Call on Medicare Fee-For-Service (FFS) Implementation of HIPAA Version 5010 and D.0 Transactions: Taking EDI to the Next Level [Wed Nov 17]
Wed Nov 17, 2pm-3:30pm EST
The Centers for Medicare & Medicaid Services (CMS) will host its twelfth national education call regarding Medicare FFS’s implementation of HIPAA Version 5010 and D.0 transaction standards on Wed Nov 17, focusing on the Coordination of Benefits (COB). Subject matter experts will review Medicare FFS specific changes, including those arising from the adoption of the HIPAA 5010 Errata, as well as general information to help the audience prepare for the transition; the presentation will be followed by a Q&A session. Target Audience includes vendors, clearinghouses, and providers who will need to make Medicare FFS specific changes in compliance with HIPAA version 5010 requirements. The presentation will be available on the CMS website at http://www.cms.gov/Versions5010andD0/V50/list.asp.
Agenda:
§ General Overview
§ Medicare Specific COB Changes
§ Timelines and Deadlines
§ What you need to do to prepare
§ Q & A
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 November 16, 2010, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the call:
Visit http://www.eventsvc.com/palmettogba/111710.
Fill in all required data.
Verify that your time zone is displayed correctly in the drop down box.
Click “Register.”
You will be taken to the “Thank you for registering” page and will receive a confirmation e-mail shortly thereafter. Note: Please save this page, in the event that your server blocks the confirmation e-mails. If you do not receive the confirmation e-mail, please check your spam/junk mail filter as it may have been directed there.
If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event.
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7. Registration for ONC Personal Health Records Roundtable Now Open [Fri Dec 3]
Fri Dec 3, 8:30am-4:30pm
Online registration is now open for the roundtable on “Personal Health Records – Understanding the Evolving Landscape.” This free day-long public roundtable, hosted by the Office of the National Coordinator for Health Information Technology (ONC), will be held on Fri Dec 3 at the FTC Conference Center in Washington DC (601 New Jersey Avenue NW, Washington, DC 20001).
Register to attend in person or via webcast by visiting http://healthit.hhs.gov/PHRroundtable. The webcast will be hosted at http://healthit.hhs.gov/blog/phr-roundtable.
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8. Updates from the Medicare Learning Network (MLN)
New DMEPOS Competitive Bidding Program Fact Sheets
New from the Medicare Learning Network!
The following new fact sheets related to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program are now available in downloadable format from the Medicare Learning Network®.
§ DMEPOS Competitive Bidding Program Traveling Beneficiary Fact Sheet,
§ DMEPOS Competitive Bidding Program Physicians and Other Treating Practitioners Who Are Enrolled Medicare DMEPOS Suppliers Fact Sheet, and
§ DMEPOS Competitive Bidding Program Hospitals That Are Not Contract Suppliers Fact Sheet
On January 1, 2011, when the DMEPOS Competitive Bidding Program goes into effect in nine competitive bidding areas (CBAs), beneficiaries with Original Medicare who obtain competitively bid items in CBAs must obtain those items from a contract supplier in order for Medicare to pay, unless an exception applies.
To learn more, view the fact sheets at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp on the CMS website and click on the appropriate links in the “Downloads” section.
For more information about the DMEPOS Competitive Bidding Program, including a list of the first nine CBAs and items included in the program, visit http://www.cms.gov/DMEPOSCompetitiveBid on the CMS website.
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DMEPOS Competitive Bidding Program Nat'l Education Call and MLN Fact Sheet
National Education Call for Non-Contract Suppliers in the DMEPOS Competitive Bidding Program
Mon Nov 8, 2-3:30pm EST
Conference Call Only
Please hold the date for a national provider education call on the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. The target audience for this call is DMEPOS suppliers that will not be contract suppliers in the program. The call will take place on Mon Nov 8, from 2pm to 3:30pm EST, and more details (including registration instructions) will be shared in the days to come.
From the Medicare Learning Network: “The DMEPOS Competitive Bidding Program Traveling Beneficiary Fact Sheet”
The Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Traveling Beneficiary Fact Sheet is now available, free of charge, from the Medicare Learning Network®.
Once the DMEPOS competitive bidding program becomes effective on January 1, 2011, beneficiaries with Original Medicare who obtain competitively bid items in competitive bidding areas (CBAs) must obtain these items from a contract supplier for Medicare to pay, unless an exception applies. This includes beneficiaries who do not live in a CBA but who obtain competitively bid items while traveling to a CBA. This fact sheet contains helpful information on competitive bidding program rules that apply when a beneficiary travels.
To learn more, please visit the DMEPOS Competitive Bidding Educational Resources page at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp on the CMS website, then select the link entitled “DMEPOS Competitive Bidding Program Traveling Beneficiary Fact Sheet” in the “Downloads” section.
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Two New Fact Sheets Regarding Walker Exceptions to the DMEPOS Competitive Bidding Program
The Medicare Learning Network® has released two fact sheets related to exceptions for walkers under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. They are the “DMEPOS Competitive Bidding Program Hospitals That Are Not Contract Suppliers Fact Sheet” and the “DMEPOS Competitive Bidding Program Physicians and Other Treating Practitioners Who Are Enrolled Medicare DMEPOS Suppliers Fact Sheet.”
Under the DMEPOS Competitive Bidding Program, beneficiaries with Original Medicare who obtain competitive bidding items in designated competitive bidding areas (CBAs) are required to obtain these items from a contract supplier, unless an exception applies. For the first phase of competitive bidding, which is effective January 1, 2011, one of these exceptions allows hospitals to furnish competitively bid walkers in a CBA to their own patients, without submitting a bid and being selected as a contract supplier. Similarly, another of these exceptions allows physicians and other treating practitioners who are enrolled Medicare DMEPOS suppliers to furnish competitively bid walkers in a CBA to their own patients without submitting a bid and being selected as a contract supplier.
To learn more and download these fact sheets, please visit the DMEPOS Competitive Bidding Educational Resources page at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp on the CMS website, then select the appropriate link in the “Downloads” section.
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“Comprehensive Outpatient Rehabilitation Facility”
A new Medicare Learning Network® publication titled “Comprehensive Outpatient Rehabilitation Facility” is now available in downloadable format at http://www.cms.gov/MLNProducts/downloads/Comprehensive_Outpatient_Rehabilitation_Facility_Fact_Sheet_ICN904085.pdf. This fact sheet provides information about basic, core and optional Comprehensive Outpatient Rehabilitation Facility (CORF) services; place of treatment requirements; rehabilitation plan of care requirements; and CORF payments.
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“Rural Health Clinic” Publication Revised
A revised Medicare Learning Network® publication titled “Rural Health Clinic” is now available in downloadable format at http://www.cms.gov/MLNProducts/downloads/RuralHlthClinfctsht.pdf. This fact sheet provides information about Rural Health Clinic (RHC) services, Medicare certification as a RHC, RHC visits, RHC payments, cost reports, and annual reconciliation.
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MLN Matters Article #MM7133: “Counseling to Prevent Tobacco Use”
The Medicare Learning Network® (MLN) has released MLN Matters Article #MM7133 to inform providers that the Centers for Medicare & Medicaid Services (CMS) will cover counseling services to prevent tobacco use for outpatient and hospitalized beneficiaries. Effective for claims with dates of service on and after August 25, 2010, CMS will cover tobacco cessation counseling for outpatient and hospitalized Medicare beneficiaries [1] who use tobacco, regardless of whether they have signs or symptoms of tobacco-related disease, [2] who are competent and alert at the time that counseling is provide, and [3] whose counseling is furnished by a qualified physician or other Medicare-recognized practitioner. This article is based on Change Request (CR) #7133 and is available at http://www.cms.gov/MLNMattersArticles/downloads/MM7133.pdf.
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9. X12 Announces Deadline for Requests for Modifications to the ASC X12 005010 Health Care Implementation Guides
On Wed Oct 20, 2010, the Accredited Standards Committee X12 (ASC X12) announced that February 4, 2011 is the deadline to submit revision requests related to the ASC X12 005010 Type 3 Technical Reports (TR3), also known as Implementation Guides.
Requests for revisions to the ASC X12 Technical Reports mandated under HIPAA may be submitted via the Designated Standard Maintenance Organizations (DSMO) website at http://www.hipaa-dsmo.org. Requests for revisions to other ASC X12 Technical Reports may be submitted via http://www.x12.org/TR3ChangeRequest. To be considered for inclusion in the 006020 implementation guides, requests must include all of the detailed information requested on the on-line submission forms. Change requests submitted after the deadline will be considered for inclusion in a future version.
The ASC X12 Insurance Subcommittee (ASC X12N) has implemented a new process for managing change requests, beginning with this ASC X12 006020 maintenance cycle. The new process shortens the timeline for revisions to ASC X12 TR3s by as much as 15 months, to approximately 21 months. For additional information, please visit http://www.x12.org/dsmo/help or contact info@disa.org.
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10. EHR Incentive Program: Certified Health IT Product List
Providers must use certified Electronic Health Record (EHR) technology in order to earn incentives under the Medicare and Medicaid EHR Incentive Programs. How can you be sure which EHR technology has been certified?
The Office of the National Coordinator for Health Information Technology (ONC) has published the Certified Health IT Product List (CHPL), a comprehensive listing of Complete EHRs and EHR Modules that have been tested and certified under the Temporary Certification Program. Each Complete EHR and EHR Module included in the CHPL has been tested and certified by an ONC-Authorized Testing and Certification Body (ATCB), and reported to ONC by an ONC-ATCB, with reports validated by ONC. Only those EHR technologies appearing on the ONC-CHPL may be granted the reporting number that will be accepted by CMS for purposes of attestation under the EHR Incentive Programs.
The listing will be updated as additional products are certified by ONC-ATCBs and reported to ONC for validation. For more information about this product listing, please visit http://healthit.hhs.gov/CHPL. For more information on the Medicare and Medicaid EHR Incentive Programs, visit http://www.cms.gov/EHRIncentivePrograms.
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11. ONC Reaches Out to Vendor Community to Help Reduce Health Disparities
The Office of the National Coordinator for Health Information Technology (ONC) and the Office of Minority Health (OMH) believe that electronic health records (EHRs) can help improve health care for low-income and minority communities who remain disproportionately affected by chronic illnesses. However, EHR adoption rates among providers who serve these communities remain low.
In an effort to prevent health disparities caused by a “digital divide,” Dr David Blumenthal, National Coordinator for Health Information Technology, and Dr Garth Graham, Director of the OMH, are encouraging vendors to work together to help providers serving low-income and minority communities adopt EHRs. Read more in Dr Blumenthal’s new letter to the vendor community.
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12. October Flu Shot Reminder
Vaccination is the Best Protection Against the Flu. This year, the Centers for Disease Control and Prevention (CDC) is encouraging everyone 6 months of age and older to get vaccinated against the seasonal flu. The risks for complications, hospitalizations and deaths from the flu are higher among individuals aged 65 years and older. Medicare pays for the seasonal flu vaccine and its administration for seniors and others with Medicare with no co-pay or deductible. And remember, vaccination is particularly important for health care workers, who may spread the flu to high risk patients. Don’t forget to immunize yourself and your staff. Protect your patients. Protect your family. Protect yourself. Get Your Flu Vaccine - Not the Flu.
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 influenza vaccine and its administration, as well as related educational resources for health care professionals and their staff, please visit http://www.cms.gov/AdultImmunizations.
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13. National Diabetes Awareness Month and Diabetic Eye Disease Month
November is National Diabetes Awareness Month and Diabetic Eye Disease Month. Diabetes can lead to severe complications such as heart disease, stroke, and kidney failure. It is also a significant risk factor for developing glaucoma.
The Centers for Medicare & Medicaid Services (CMS) asks the provider community to keep their patients with Medicare healthy by encouraging eligible patients to take advantage of Medicare-covered diabetes-related services. Medicare provides coverage of several diabetes-related preventive services for eligible beneficiaries, including:
§ Diabetes Screening Tests,
§ Diabetes Self-Management Training,
§ Medical Nutrition Therapy,
§ Diabetes-Related Supplies, and
§ Glaucoma Screening.
What Can You Do? As a health care professional who provides care to patients with Medicare, you can help protect the health of your patients by encouraging them to take advantage of Medicare-covered preventive services, including diabetes-related services, that are appropriate for them.
For More Information – CMS has developed several educational products related to Medicare-covered diabetes-related services. They are all available, free of charge, from the Medicare Learning Network®:
The MLN Preventive Services Educational Products Web Page – provides descriptions and ordering information for Medicare Learning Network® (MLN) educational products for health care professionals related to Medicare-covered preventive services. Visit http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp.
The Diabetes-Related Services brochure – provides information on coverage for Medicare-covered diabetes-related services. This product is available in hardcopy or as a downloadable PDF. Visit http://www.cms.gov/MLNProducts/downloads/DiabetesSvcs.pdf.
The Glaucoma Screening brochure – provides information on coverage for Medicare-covered glaucoma screening. This product is available in hardcopy or as a downloadable PDF. Visit http://www.cms.gov/MLNProducts/downloads/glaucoma.pdf.
The Guide to Medicare Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals – provides coverage and coding information on Medicare-covered preventive services and screenings. Available as a downloadable PDF only. Visit http://www.cms.hhs.gov/MLNProducts/downloads/mps_guide_web-061305.pdf.
Quick Reference Information: Medicare Preventive Services – this chart provides coverage and coding information on Medicare-covered preventive services. Visit http://www.cms.hhs.gov/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf.
The Medicare Preventive Services Series: Part 2 Web-Based-Training (WBT) course – this WBT includes lessons on coverage, coding, and billing for Medicare-covered preventive services, including diabetes-related services. To access the course, please visit the MLN home page at http://www.cms.gov/mlngeninfo. Scroll down to “Related Links Inside CMS” and click on “Web Based Training (WBT) Modules.”
The Medicare Preventive Services Series: Part e Web-Based-Training (WBT) course – this WBT includes lessons on coverage, coding, and billing for Medicare-covered preventive services, including glaucoma screening. To access the course, please visit the MLN home page at http://www.cms.gov/mlngeninfo. Scroll down to “Related Links Inside CMS” and click on “Web Based Training (WBT) Modules.”
Please visit the Medicare Learning Network for more information on these and other Medicare fee-for-service educational products. For more information on National Diabetes Awareness Month, please visit the American Diabetes Association’s official page at http://www.diabetes.org/in-my-community/programs/american-diabetes-month. For additional information on National Diabetes Awareness Month, please visit the National Diabetes Education Program (NDEP) website at http://ndep.nih.gov/whats-new/posting.aspx?id=23. For more information on diabetic eye disease, please visit the Prevent Blindness America website at http://www.preventblindness.org. For more information to share with your patients about diabetes, please visit the NDEP website at http://www.ndep.nih.gov.
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14. Clinician Outreach and Communication Activities from the Centers for Disease Control
Upcoming COCA Conference Call: Neglected Infections of Poverty in the United States
Tue Nov 2, 2-3pm EST
Neglected infections of poverty are a group of parasitic, bacterial, and viral infections that disproportionately affect impoverished groups in the United States, and lead to illness in a significant number of individuals in vulnerable populations. These infections are often not well studied or tracked; thereby impacting diagnosis, treatment, and prevention. During this call, a CDC subject matter expert will describe the epidemiology, diagnosis, and treatment of 3 neglected infections of poverty: Chagas Disease, Toxocariasis, and Trichomoniasis. For more information on this call visit http://emergency.cdc.gov/coca/callinfo.asp.
§ Call Number: 888-790-6180 / Passcode 1281914
Upcoming COCA Conference Call: Practical Tools for Radiation Emergency Preparedness
Tue Nov 9, 2-3pm EST
Healthcare providers play an important role in any radiation emergency. Clinicians of all specialties will be responsible for providing care and information to patients in multiple settings from hospitals to community reception centers (CRCs). It is important for clinicians to develop plans and response capacity for radiation emergencies using practical tools for radiation emergency preparedness. Join subject matter experts as they describe the process flow and stations in a Community Reception Center; identify the unique psychological effects of radiation disasters; and define skills and techniques used when performing psychological first aid in radiation disasters.
This COCA call will utilize a webinar format. We are going to use an interactive webinar for this call to deliver content, as an alternative to using the traditional audio and PowerPoint option. This new webinar format will utilize several new features such as automated presentation transition, live and recorded video, and optional call registration. You may still access the audio portion of the call by using the provided call number. For additional information visit: http://emergency.cdc.gov/coca/callinfo.asp.
§ Register for this webinar at http://events.constantcontact.com/register/event?llr=pf7m85dab&oeidk=a07e33aaoq677b7b5e4
§ Call-in Number: 800-619-8497 / Passcode 3381626
Courses and On-Demand Trainings: CDC Public Health Grand Rounds: Malaria
Thu Nov 18, 1-2pm EST
The Public Health Grand Rounds is a monthly series created to further strengthen CDC’s common scientific culture and foster discussion and debate on major public health issues. This session of the Public Health Grand Rounds will focus on key issues related to Malaria. Watch live and archived broadcasts at www.cdc.gov/about/grand-rounds.
Upcoming Conference: Modeling for Public Health Action: From Epidemiology to Operations
Thu Dec 9 – Fri Dec 10, 2010 // Location: Atlanta, GA
This conference promotes the exchange of information and ideas about modeling uses to shape public health action. The conference will address effective and practical modeling applications to public health and provide high-quality sessions, training and networking opportunities. It is intended for public health practitioners and policy makers in state and local health departments; scientists and modelers working at CDC and its federal partners in public health; academic researchers, non-government organizations, and international practitioners, modelers and policy makers. For more information, visit http://www.phmodeling2010conference.com/index.html.
H1N1 & Seasonal Influenza Resources: Seasonal Flu: International Situation Update
This report is a summary of key influenza-related updates created from regional World Health Organization (WHO) reports, country reports, CDC field staff updates, and other sources. Updates are listed by region and focus on data collected during epidemiologic weeks 37 through 40 (September 12 – October 9, 2010). Visit http://www.cdc.gov/flu/international/activity.htm.
H1N1 & Seasonal Influenza Resources: Seasonal Influenza Vaccine Coverage
Current available coverage data and past trends available at http://www.cdc.gov/flu/professionals/vaccination/vaccinecoverage.htm.
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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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Minot State University Athletics
Minot State University Athletics
http://www.msubeavers.com/index.aspx
http://www.msubeavers.com/index.aspx
Thursday, October 28, 2010
Voting Locations in Minot, North Dakota
Voting Locations in Minot, ND
http://www.co.ward.nd.us/election/cityprecinctlist.shtml
http://www.co.ward.nd.us/election/cityprecinctlist.shtml
Wednesday, October 27, 2010
North Dakota Road Reports
North Dakota Road Conditions
http://www.dot.nd.gov/roadreport/roadreport/roadreportinfo.asp
http://www.dot.nd.gov/roadreport/roadreport/roadreportinfo.asp
Tuesday, October 26, 2010
North Dakota Campaign Funding Reports
http://web.apps.state.nd.us/sec/emspublic/gp/cfdisclosurerptsearchbyrpt.htm?year=2010&result=All&filerType=CAN&search.x=99&lastName=&reportType=G&type=byRpt&search.x=32&search.y=13
Monday, October 25, 2010
Sunday, October 24, 2010
Saturday, October 23, 2010
Friday, October 22, 2010
Lisa Feldner head of North Dakota Information Technology
Lisa Feldner Head of North Dakota ITD
http://www.nd.gov/itd/
http://www.nd.gov/itd/
Thursday, October 21, 2010
Wednesday, October 20, 2010
Tom Seymour in Minot Daily News -- 5th Ward Alderman Seat
http://www.minotdailynews.com/page/content.detail/id/543992.html?nav=5010
Northern Sun Intercollegiate Conference
Northern Sun Intercollegiate Conference
http://www.northernsun.org/
http://www.northernsun.org/
Tuesday, October 19, 2010
Sharon Reynold's Servers are on Web site
Sharon Reynold's Servers are on Web site
http://www.minot.com/tom/
http://www.minot.com/tom/
Monday, October 18, 2010
Tom Seymour on November 2 Ballot in Minot, North Dakota
Tom Seymour on Nov 2 Ballot
https://vip.sos.nd.gov/pdfs/ballots/51011.pdf
https://vip.sos.nd.gov/pdfs/ballots/51011.pdf
Sunday, October 17, 2010
Phi Beta Lambda
Phi Beta Lambda
http://www.fbla-pbl.org/web/page/585/sectionid/585/pagelevel/2/pbl.asp
http://www.fbla-pbl.org/web/page/585/sectionid/585/pagelevel/2/pbl.asp
Saturday, October 16, 2010
Friday, October 15, 2010
Thursday, October 14, 2010
Wednesday, October 13, 2010
Dr. Doris Slaaten gifts Minot State University
Dr. Doris Slaaten gifts Minot State University
http://www.minotdailynews.com/
http://www.minotdailynews.com/
Tuesday, October 12, 2010
Doris Slaaten has been active in SCORE
Doris Slaaten is active in SCORE...
http://www.score.org/women/site.html
http://www.score.org/women/site.html
Monday, October 11, 2010
Various Web sites to Review
Various Web sites to Review....
http://www.minot.com/tom/educational-sites-pg1.html
http://www.minot.com/tom/educational-sites-pg1.html
Sunday, October 10, 2010
Internationa Association for Computer Information Systems Meeting Videos
IACIS Convention Videos
http://www.youtube.com/results?search_query=IACIS&aq=f
http://www.youtube.com/results?search_query=IACIS&aq=f
Saturday, October 9, 2010
Wednesday, October 6, 2010
Internationa Association of Computer Information Systems
International Association for Computer Information Systems
http://www.iacis.org/
http://www.iacis.org/
Tuesday, October 5, 2010
A North Dakota Example November 2 BALLOT
A North Dakota Nov 2 Ballot
https://vip.sos.nd.gov/pdfs/ballots/51011.pdf
https://vip.sos.nd.gov/pdfs/ballots/51011.pdf
Publications for Your Review
Publications for Your Review
http://www.inderscience.com/mapper.php?id=19
http://www.inderscience.com/mapper.php?id=19
Monday, October 4, 2010
How To Review University Athletic Programs
Copy and Paste Link into Your Browser
http://www.insidehighered.com/news/2010/10/04/austen
http://www.insidehighered.com/news/2010/10/04/austen
North Dakota Legislative Employee Benefits Committee Meeting in Bismarck
North Dakota Legislative Employee Benefits Committee
http://www.legis.nd.gov/assembly/61-2009/interim-info/notices/eb102610notice.pdf
http://www.legis.nd.gov/assembly/61-2009/interim-info/notices/eb102610notice.pdf
Sunday, October 3, 2010
North Dakota Legislative Education Committee Meeting in Bismarck
North Dakota Legislative Education Committee Meeting
http://www.legis.nd.gov/assembly/61-2009/interim-info/agenda/ed101210agenda.pdf
http://www.legis.nd.gov/assembly/61-2009/interim-info/agenda/ed101210agenda.pdf
North Dakota Legislative Financial Facts Brochure
North Dakota Legislative Financial Facts Brochure
http://www.legis.nd.gov/fiscal/pdf/2010ndfinancefacts.pdf
http://www.legis.nd.gov/fiscal/pdf/2010ndfinancefacts.pdf
North Dakota Health and Human Services Committee Meeting
ND Legislative Human Services Committee
http://www.legis.nd.gov/assembly/61-2009/interim-info/agenda/hh100710agenda.pdf
http://www.legis.nd.gov/assembly/61-2009/interim-info/agenda/hh100710agenda.pdf
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. Message from CMS: Electronic Health Record (EHR) Incentive Program Information
2. Thirty-Three Electronic Health Record (EHR) Products Certified
3. Two Final Awardees for the Regional Extension Center (REC) Program
4. Personal Health Records — Understanding the Evolving Landscape (December 3)
5. 2009 Electronic Prescribing (eRx) Incentive Program Update
6. Special Open-Door Forum: Medicare Provider & Supplier Enrollment – Pharmacy Focused (Wed Oct 13)
7. Updates from the Medicare Learning Network
8. Medicare Self-Referral Disclosure Protocol
9. October Flu Shot Reminder
10. Clinician Outreach and Communication Activities (COCA) from the Centers for Disease Control
11. A new "twist" in the law makes it easier to save on your prescription drug costs.
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1. Message from CMS: Electronic Health Record (EHR) Incentive Program Information
Incentive payments totaling as much as $27 billion may be made under the Medicare & Medicaid Electronic Health Record (EHR) Incentive Programs beginning in 2011. Are you eligible for an incentive? How much can an eligible professional earn? What are the key dates for these programs?
Learn more on the Centers for Medicare & Medicaid Services EHR Incentive Programs website!
Tip Sheets for Eligible Professionals:
· UPDATED: Medicare EHR Incentive Programs, PQRI, and E-Prescribing Comparison
Learn what opportunities are available to Medicare Eligible Professionals to receive incentive payments for participating in important Medicare initiatives. This fact sheet provides information on eligibility, timeframes, and maximum payments for each program.
· UPDATED: Flow Chart – Determine Eligibility for Medicare and Medicaid EHR Incentive Programs
Unsure if you are eligible to participate in the Medicare or Medicaid EHR Incentive Programs? Use this handy flow chart to find out!
· Medicare EHR Incentive Payments for Eligible Professionals
Which types of individual practitioners can participate in the Medicare EHR Incentive Program? This easy tip sheet provides information about incentive payment amounts and describes how payments are calculated for fee for service (FFS) and Medicare Advantage providers. It also describes payment adjustments beginning in 2015 for Eligible Professionals who are not meaningful users of certified EHR technology.
For the 3 tip sheets above, go to http://www.cms.gov/EHRIncentivePrograms. Select the “Medicare Eligible Professional” tab on the left, and then scroll to “Downloads.”
· NEW: Medicaid EHR Incentive Payments for Eligible Professionals
Which types of individual practitioners can participate in the Medicaid EHR Incentive Program? Learn about Medicaid patient volume requirements, payment amounts, and the timeframes for the Medicaid EHR Incentive Program.
Go to http://www.cms.gov/EHRIncentivePrograms. Select the “Medicaid Eligible Professional” tab on the left, and then scroll to “Downloads.”
Important Dates:
· NEW: EHR Incentive Program Timeline
Find it at http://www.cms.gov/EHRIncentivePrograms in the “Downloads” section of the “Overview” tab.
Electronic Health Record Incentives – Get the Facts from CMS.
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2. Thirty-Three Electronic Health Record (EHR) Products Certified
The Certification Commission for Health Information Technology (CCHIT®) announced today that it has tested and certified 33 Electronic Health Record (EHR) products under the Commission’s ONC-ATCB program, which certifies that the EHRs are capable of meeting the 2011/2012 criteria supporting Stage 1 meaningful use as approved by the Secretary of Health and Human Services (HHS). Certification is required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA). The certifications include 19 Complete EHRs, which meet all of the 2011/2012 criteria for either eligible provider or hospital technology, and 14 EHR Modules, which meet one or more – but not all – of the criteria.
More news….. http://www.cchit.org/media/news/2010/10/commission-announces-first-onc-atcb-20112012-certifications
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3. Two Final Awardees for the Regional Extension Center (REC) Program
The Office of the National Coordinator for Health Information Technology (ONC) announced today the selection of two final awardees for the Regional Extension Center (REC) program:
CalOptima Foundation, covering Orange County, California ($4,662,426)
Massachusetts eHealth Collaborative, covering the state of New Hampshire ($5,105,495)
ONC also announced expanded coverage areas for two existing RECs in Florida:
Community Health Centers Alliances will cover additional areas in Glades and Hendry counties
Health Choice Network of Florida will cover additional areas in Indian River, Palm Beach, St. Lucie, Martin and Okeechobee counties
These additional awards complete a nationwide system of RECs that will help providers move from paper-based medical records to electronic health records (EHRs).
For more information about the awards and a complete listing of RECs, visit http://www.HealthIT.hhs.gov/programs/REC/.
Learn more about the Medicare and Medicaid EHR Incentive Programs at www.cms.gov/EHRincentiveprograms
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4. Personal Health Records — Understanding the Evolving Landscape (December 3)
On Friday, December 3, the Office of National Coordinator for Health Information Technology (ONC) will host a free day-long public roundtable on "Personal Health Records — Understanding the Evolving Landscape." The roundtable is designed to inform ONC’s Congressionally mandated report on privacy and security requirements for non-Covered Entities (non-CEs), with a focus on personal health records (PHRs) and related service providers (Section 13424 of the HITECH Act) .
The roundtable will include four panels of prominent researchers, legal scholars, and representatives of consumer, patient, and industry organizations. It will address the current state and evolving nature of PHRs and related technologies (including mobile technologies and social networking), consumer and industry expectations and attitudes toward privacy and security practices, and the pros and cons of different approaches to the requirements that should apply to non-CE PHRs and related technologies.
Mark your calendars now—registration and additional conference information will be available in October at http://healthit.hhs.gov/PHRroundtable
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5. 2009 Electronic Prescribing (eRx) Incentive Program Update
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that incentive payments for the 2009 Electronic Prescribing (eRx) Incentive Program are being made to eligible professionals who met the criteria for successful reporting. The 2009 eRx incentive payments are currently being processed and distributed by Carriers and Medicare Administrative Contractors (MACs). Distribution of the 2009 eRx incentive payments are scheduled to be completed by October 22, 2010.
E-prescribing incentives earned by individual participating physicians and other eligible professionals are paid as a lump-sum to the Taxpayer Identification Number (TIN) under which the EP’s claims were submitted. It is then up to the TIN to decide how to distribute the incentive within the practice.
Effective January 2010, CMS revised the manner in which incentive payment information is communicated to eligible professionals receiving electronic remittance advices. CMS has instructed Medicare contractors to use a new indicator of LE to indicate incentive payments instead of LS. LE will appear on the electronic remittance advice. Additionally the paper remittance advice will read “This is an eRx incentive payment.” It will not include the year and indicator LE in the paper remittance. In an effort to further clarify the type of incentive payment issued (either PQRI or eRx incentive), CMS created a 4-digit code to indicate the type of incentive and reporting year. For the 2009 eRx incentive payments, the 4-digit code is RX09. This code will be displayed on the electronic remittance advice along with the LE indicator. For example, eligible professionals will see LE to indicate an incentive payment, along with RX09 to identify that payment as the 2009 eRx incentive payment.
2009 Electronic Prescribing (eRx) Incentive Program Feedback Reports: The 2009 eRx feedback reports will be available on the Physician and Other Health Care Professionals Quality Reporting Portal at http://www.qualitynet.org/pqri on the internet, starting the second week of November. TIN-level reports on the Portal require an Individuals Authorized Access to CMS Computer Services (IACS) account. Participants may also contact their Carrier or MAC to request individual NPI-level reports via an alternate feedback report fulfillment process, please visit http://www.cms.gov/MLNMattersArticles/downloads/SE0922.pdf on the CMS website.
If you have questions about the status of your eRx incentive payment (during the distribution timeframe), please contact your Provider Contact Center. The Contact Center Directory is available at http://www.cms.gov/MLNProducts/Downloads/CallCenterTollNumDirectory.zip on the CMS website.
Feel free to contact the QualityNet Help Desk with any of the following:
§ Physician Quality Reporting Initiative (PQRI) Portal password issues
§ PQRI/eRx feedback report availability and access
§ PQRI-IACS registration questions
§ PQRI-IACS login issues
The QualityNet Help Desk is available Monday through Friday from 7am-7pm CST at 866-288-8912 or via qnetsupport@sdps.org on the internet. The QualityNet Help Desk is also available to assist with PQRI and eRx measure-specific questions.
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6. Special Open-Door Forum: Medicare Provider & Supplier Enrollment – Pharmacy Focused (Wed Oct 13)
Wed Oct 13, 3:30-5pm ET (rescheduled from Tue Sep 28)
Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss Medicare supplier enrollment issues. During this call, CMS staff will discuss:
§ Review how CMS plans to implement Section 3109 of the Affordable Care Act for pharmacies;
§ Review the recent instructions given to our contractor;
§ Answer questions related to those pharmacies who voluntarily disenrolled last year; and
§ Next steps required by the pharmacy.
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 3:15pm ET.
§ Dial: 1-800-837-1935
§ Reference Conference ID 98955726
§ Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
An audio recording and transcript of this Special Forum will be posted to the Special ODF website at http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading on or around Fri Oct 22 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.gov/OpenDoorForums.
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7. Updates from the Medicare Learning Network
Special Edition MLN Matters Article #SE1029: 5010 Requirement for Ambulance Services
Effective for claims submitted in the version 5010 837P electronic claim format on and after January 1, 2011, ambulance suppliers will have three options for complying with the new diagnosis reporting requirement. The Medicare Learning Network® (MLN) has released Special Edition MLN Matters Article #SE1029 to advise ambulance suppliers how to submit their claims electronically in light of this new requirement. This article is information in nature and supports existing policy. For more details, please read the article at http://www.cms.gov/MLNMattersArticles/downloads/SE1029.pdf on the Centers for Medicare & Medicaid Services (CMS) website.
# # # # # #
“What’s New for the 2010 eRx Incentive Program” Fact Sheet
The 2010 Electronic Prescribing Incentive Program (E-Prescribing) Fact Sheet “What’s New for the 2010 eRx Incentive Program” (revised July 2010) is now available in hardcopy and downloadable format from the Medicare Learning Network®. This resource provides an overview of the 2010 E-Prescribing Incentive Program, as well as highlighted changes from the 2009 E-Prescribing program. To order your copy, free of charge, please visit the MLN Products page at http://www.cms.gov/MLNProducts/01_Overview.asp on the Internet. From this page, scroll down to the “Related Links Inside CMS” section and select the “MLN Product Ordering Page” link. To view the online version, please visit http://www.cms.gov/MLNProducts/downloads/Whats_New_2010_eRx_Fact_Sheet.pdf
on the Internet.
# # # # # #
Special Edition MLN Matters Articles regarding Recovery Audit Contractor Demonstration-Identified Vulnerabilities
The Medicare Learning Network® (MLN) has released the next in a series of Special Edition MLN Matters articles designed to educate providers about Recovery Audit Contractor (RAC) demonstration-identified vulnerabilities. With the expansion of the RAC Program and the initiation of complex coding review in all four RAC regions, it is essential that providers understand the lessons learned from the demonstration and implement appropriate corrective actions. These two new articles are informational in nature and support existing policy:
§ MLN Matters Article #SE1027, entitled “RAC Demonstration High-Risk Medical Necessity Vulnerabilities for Inpatient Hospitals,” advises inpatient hospitals about 17 RAC demonstration-identified medical necessity vulnerabilities, and is available at http://www.cms.gov/MLNMattersArticles/downloads/SE1027.pdf on the Centers for Medicare & Medicaid (CMS) website.
MLN Matters Article #SE1028, entitled “RAC Demonstration High-Risk Diagnosis Related Group (DRG) Coding Vulnerabilities for Inpatient Hospitals,” provides information about four RAC demonstration-identified inpatient hospital coding vulnerabilities, and is available at http://www.cms.gov/MLNMattersArticles/downloads/SE1028.pdf on the CMS website.
# # # # # #
October is National Breast Cancer Awareness Month
The Centers for Medicare & Medicaid Services (CMS) is asking the provider community to keep their patients with Medicare healthy by encouraging them to take advantage of Medicare-covered screening mammograms and other preventive services covered by Medicare. Medicare provides coverage for an annual screening mammogram for all female beneficiaries age 40 or older. Medicare also provides coverage for one baseline mammogram for female beneficiaries between the ages of 35 and 39.
What Can You Do? As a health care professional who provides care to patients with Medicare, you can help protect the health of your Medicare patients by encouraging them to take advantage of Medicare-covered screenings, including screening mammograms that are appropriate for them.
For More Information: CMS has developed several educational products related to Medicare-covered screening mammograms. They are all available, free of charge, from the Medicare Learning Network®:
§ The MLN Preventive Services Educational Products Web Page – provides descriptions and ordering information for Medicare Learning Network® (MLN) educational products for health care professionals related to Medicare-covered preventive services, including screening mammograms. http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp
§ The Guide to Medicare Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals – provides coverage and coding information on Medicare-covered preventive services and screenings, including screening mammograms. http://www.cms.hhs.gov/MLNProducts/downloads/mps_guide_web-061305.pdf
§ Quick Reference Information: Medicare Preventive Services – this chart provides coverage and coding information on Medicare-covered preventive services, including screening mammograms. http://www.cms.hhs.gov/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf
§ The Medicare Preventive Services Series: Part 3 Web-Based-Training (WBT) course – this WBT includes lessons on coverage, coding, and billing for Medicare-covered preventive services, including screening mammograms. To access the course, please visit the MLN home page at http://www.cms.gov/mlngeninfo on the internet. Scroll down to “Related Links Inside CMS” and click on “Web Based Training (WBT) Modules.”
§ The Cancer Screenings brochure – this brochure provides information on coverage for Medicare-covered cancer screenings, including screening mammograms. http://www.cms.hhs.gov/MLNProducts/downloads/cancer_screening.pdf
Please visit the Medicare Learning Network at http://www.cms.hhs.gov/MLNGenInfo for more information on these and other Medicare fee-for-service educational products. For more information on National Breast Cancer Awareness Month, please visit the official website at http://www.nbcam.org on the internet.
# # # # # #
New Enrollment Fact Sheets from the Medicare Learning Network
If you are a Fee-For-Service (FFS) provider or supplier who is currently enrolled or required to enroll in the Medicare Program, the Medicare Learning Network® (MLN) can help you understand and follow the Medicare enrollment process! The MLN has released the next in a series of fact sheets designed to educate FFS providers about important Medicare enrollment information, including how to use Internet-based Provider Enrollment, Chain and Ownership System (PECOS) to enroll in the Medicare Program and maintain your enrollment information. These fact sheets are available in downloadable format on the Centers for Medicare & Medicaid Services (CMS) website at the URLs listed below.
The Basics of Medicare Enrollment for Physicians Who Infrequently Receive Medicare Reimbursement
Provides general Medicare enrollment information to those physicians who are required to enroll in Medicare for the sole purpose of certifying or ordering services for Medicare beneficiaries and therefore, are not required to send claims to Medicare contractors for the services they furnish. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_Phys_Infreq_Reimb_FactSheet_ICN006881.pdf on the CMS website.
The Basics of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for Physicians and Non-Physician Practitioners
Advises physicians and non-physician practitioners on how to enroll in the Medicare Program and maintain their enrollment information using Internet-based PECOS. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_PhysNonPhys_FactSheet_ICN903764.pdf on the CMS website.
Internet-based Provider Enrollment, Chain and Ownership System (PECOS) Contact Information
Provides contact information for technical assistance with Internet-based PECOS. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_Contact_FactSheet_ICN903766.pdf on the CMS website.
The Basics of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for Provider and Supplier Organizations
Advises provider and supplier organizations on how to enroll in the Medicare Program and maintain their enrollment information using Internet-based PECOS. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_ProviderSup_FactSheet_ICN903767.pdf on the CMS website.
The Basics of Medicare Enrollment for Physicians and Other Part B Suppliers
Explains general Medicare enrollment information specific to physicians and other Part B suppliers, except Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PhysOther_FactSheet_ICN903768.pdf on the CMS website.
The Basics of Medicare Enrollment for Institutional Providers
Provides general Medicare enrollment information specific to institutional providers, such as community mental health centers (CMHCs), home health agencies (HHAs), hospitals, skilled nursing facilities (SNFs), and hospices. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_InstProv_FactSheet_ICN903783.pdf on the CMS website.
The Basics of Internet-based PECOS for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
Educates DMEPOS suppliers on how to enroll in the Medicare Program and maintain their enrollment information using Internet-based PECOS. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_DMEPOS_FactSheet_ICN904283.pdf on the CMS website.
In addition, the Medicare Learning Network previously released two fact sheets concerning privacy and protection of Medicare enrollment records that may also be of interest:
Medicare Fee-For-Service (FFS) Physicians and Non-Physician Practitioners: Protecting Your Privacy - Protecting Your Medicare Enrollment Record
Advises Fee-For-Service (FFS) physicians and non-physician practitioners on how to ensure their enrollment records are up-to-date and secure. This fact sheet is available at
http://www.cms.gov/MLNProducts/downloads/MedEnrollPrivcy_FactSheet_ICN903765.pdf
on the CMS website.
How to Protect Your Identity Using the Provider Enrollment, Chain and Ownership System (PECOS)
Provides step-by-step instructions to help FFS providers protect their identity while using Internet-based PECOS. This fact sheet is available at
http://www.cms.gov/MLNProducts/downloads/MedEnroll_ProtID_FactSheet_ICN905103.pdf
on the CMS website.
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8. Medicare Self-Referral Disclosure Protocol
Section 6409(a) of the Affordable Care Act (ACA) ACA requires the Secretary of the Department of Health and Human Services, in cooperation with the Inspector General of the Department of Health and Human Services, to establish a Medicare self-referral disclosure protocol (“SRDP”) that sets forth a process to enable providers of services and suppliers to self-disclose actual or potential violations of Section 1877 of the Social Security Act (the Act).
The SRDP requires health care providers of services or suppliers to submit all information necessary for CMS, on behalf of the Secretary, to analyze the actual or potential violation of Section 1877 of the Act. Section 6409(b) of the ACA, gives the Secretary of HHS the authority to reduce the amount due and owing for violations of Section 1877. The SRDP is located on the CMS website at http://www.cms.gov/PhysicianSelfReferral.
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9. October Flu Shot Reminder
Vaccination is the Best Protection Against the Flu. This year, the Centers for Disease Control and Prevention (CDC) is encouraging everyone 6 months of age and older to get vaccinated against the seasonal flu. The risks for complications, hospitalizations and deaths from the flu are higher among individuals aged 65 years and older. Medicare pays for the seasonal flu vaccine and its administration for seniors and others with Medicare with no co-pay or deductible. And remember, vaccination is particularly important for health care workers, who may spread the flu to high risk patients. Don’t forget to immunize yourself and your staff. Protect your patients. Protect your family. Protect yourself. Get Your Flu Vaccine - Not the Flu.
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 influenza vaccine and its administration, as well as related educational resources for health care professionals and their staff, please visit http://www.cms.gov/AdultImmunizations.
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10. Clinician Outreach and Communication Activities (COCA) from the Centers for Disease Control
2010 Gulf of Mexico Oil Spill: Update: What’s Coming Ashore from the Oil Spill
This page has information about what light crude oil does when it reaches shore: http://emergency.cdc.gov/gulfoilspill2010/coming_ashore.asp. For more information and additional Healthcare Professionals resources visit: http://emergency.cdc.gov/gulfoilspill2010/health_professionals.asp.
H1N1 & Seasonal Influenza Resources: Influenza 2010-2011: ACIP Vaccination Recommendations
In this podcast targeted to clinicians, Dr. Joe Bresee discusses who should be vaccinated against flu this year, explains who is at risk for severe illness, and discusses the benefits of vaccination. http://www2c.cdc.gov/podcasts/player.asp
H1N1 & Seasonal Influenza Resources: Guidelines and Recommendations: Prevention Strategies for Seasonal Influenza in Healthcare Settings
This guidance supersedes previous CDC guidance for both seasonal influenza and the Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, which was written to apply uniquely to the special circumstances of the 2009 H1N1 pandemic as they existed in October 2009. As stated in that document, CDC planned to update the guidance as new information became available. http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm
H1N1 & Seasonal Influenza Resources: Seasonal Influenza Vaccine Safety: A Summary for Clinicians
Seasonal influenza vaccination is the most important way of preventing seasonal influenza virus infections and potentially severe complications, including death. Seasonal influenza vaccination reduces the likelihood of becoming ill with influenza or transmitting influenza to others. The 2010-2011 seasonal influenza vaccine protects against an influenza A H3N2 virus, an influenza B virus, and the 2009 H1N1 virus that caused widespread illness last season. http://www.cdc.gov/flu/professionals/vaccination/vaccine_safety.htm
Emergency Preparedness & Response: 2010 Report: Public Health Preparedness: Strengthening the Nation’s Emergency Response State by State
A report on CDC-funded preparedness and response activities in 50 states, 4 cities, and 8 U.S. insular areas. http://emergency.cdc.gov/publications/2010phprep
Emergency Preparedness & Response: BARDA funds medical countermeasure innovation
The US Department of Health and Human Services’ Biomedical Advanced Research and Development Authority (BARDA) announced the first eight contract awards under an initiative to help modernize and improve the nation’s infrastructure for producing medical countermeasures that protect against natural and man-made biological threats. The contracts help advance innovative tools and techniques that reduce the time and cost of development, testing, and production of medical countermeasures and that improve the safety, efficacy, and ease of use of these products. These contracts total $55 million for the initial phase and up to $100 million over three years. http://www.hhs.gov/news/press/2010pres/09/20100921d.html
Emergency Preparedness & Response: BARDA awards $51 million contract for next generation anthrax vaccine
The US Department of Health and Human Services’ Biomedical Advanced Research and Development Authority (BARDA) awarded a $51 million contract to Emergent BioSolutions, Inc., of Rockville, Md., for the development of a new anthrax vaccine using the protective antigen (rPA) to stimulate a protective immune response that neutralizes the anthrax toxins. http://www.hhs.gov/news/press/2010pres/09/20100917c.html
Emergency Preparedness & Response: When Every Drop Counts: Protecting Public Health During Drought Conditions: A Guide for Public Health Professionals
CDC’s National Center for Environmental Health developed this publication to assist public health officials, practitioners, and other stakeholders in their efforts to understand and prepare for drought in their communities. The document includes information about how drought affects public health, recommends steps to help mitigate the health effects of drought, identifies future needs for research and other drought-related activities, and provides a list of helpful resources and tools. http://www.cdc.gov/nceh/ehs/Publications/Drought.htm
Emerging Infectious Diseases (EID) Journal
The Emerging Infectious Diseases (EID) journal provides recognition of new and re-emerging infections and understanding of factors involved in disease emergence, prevention, and elimination. It also represents the scientific communications component of CDC's efforts against the threat of emerging infections. See the October 2010 issue of the EID journal at http://www.cdc.gov/ncidod/eid.
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11. 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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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. Message from CMS: Electronic Health Record (EHR) Incentive Program Information
2. Thirty-Three Electronic Health Record (EHR) Products Certified
3. Two Final Awardees for the Regional Extension Center (REC) Program
4. Personal Health Records — Understanding the Evolving Landscape (December 3)
5. 2009 Electronic Prescribing (eRx) Incentive Program Update
6. Special Open-Door Forum: Medicare Provider & Supplier Enrollment – Pharmacy Focused (Wed Oct 13)
7. Updates from the Medicare Learning Network
8. Medicare Self-Referral Disclosure Protocol
9. October Flu Shot Reminder
10. Clinician Outreach and Communication Activities (COCA) from the Centers for Disease Control
11. A new "twist" in the law makes it easier to save on your prescription drug costs.
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1. Message from CMS: Electronic Health Record (EHR) Incentive Program Information
Incentive payments totaling as much as $27 billion may be made under the Medicare & Medicaid Electronic Health Record (EHR) Incentive Programs beginning in 2011. Are you eligible for an incentive? How much can an eligible professional earn? What are the key dates for these programs?
Learn more on the Centers for Medicare & Medicaid Services EHR Incentive Programs website!
Tip Sheets for Eligible Professionals:
· UPDATED: Medicare EHR Incentive Programs, PQRI, and E-Prescribing Comparison
Learn what opportunities are available to Medicare Eligible Professionals to receive incentive payments for participating in important Medicare initiatives. This fact sheet provides information on eligibility, timeframes, and maximum payments for each program.
· UPDATED: Flow Chart – Determine Eligibility for Medicare and Medicaid EHR Incentive Programs
Unsure if you are eligible to participate in the Medicare or Medicaid EHR Incentive Programs? Use this handy flow chart to find out!
· Medicare EHR Incentive Payments for Eligible Professionals
Which types of individual practitioners can participate in the Medicare EHR Incentive Program? This easy tip sheet provides information about incentive payment amounts and describes how payments are calculated for fee for service (FFS) and Medicare Advantage providers. It also describes payment adjustments beginning in 2015 for Eligible Professionals who are not meaningful users of certified EHR technology.
For the 3 tip sheets above, go to http://www.cms.gov/EHRIncentivePrograms. Select the “Medicare Eligible Professional” tab on the left, and then scroll to “Downloads.”
· NEW: Medicaid EHR Incentive Payments for Eligible Professionals
Which types of individual practitioners can participate in the Medicaid EHR Incentive Program? Learn about Medicaid patient volume requirements, payment amounts, and the timeframes for the Medicaid EHR Incentive Program.
Go to http://www.cms.gov/EHRIncentivePrograms. Select the “Medicaid Eligible Professional” tab on the left, and then scroll to “Downloads.”
Important Dates:
· NEW: EHR Incentive Program Timeline
Find it at http://www.cms.gov/EHRIncentivePrograms in the “Downloads” section of the “Overview” tab.
Electronic Health Record Incentives – Get the Facts from CMS.
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2. Thirty-Three Electronic Health Record (EHR) Products Certified
The Certification Commission for Health Information Technology (CCHIT®) announced today that it has tested and certified 33 Electronic Health Record (EHR) products under the Commission’s ONC-ATCB program, which certifies that the EHRs are capable of meeting the 2011/2012 criteria supporting Stage 1 meaningful use as approved by the Secretary of Health and Human Services (HHS). Certification is required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA). The certifications include 19 Complete EHRs, which meet all of the 2011/2012 criteria for either eligible provider or hospital technology, and 14 EHR Modules, which meet one or more – but not all – of the criteria.
More news….. http://www.cchit.org/media/news/2010/10/commission-announces-first-onc-atcb-20112012-certifications
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3. Two Final Awardees for the Regional Extension Center (REC) Program
The Office of the National Coordinator for Health Information Technology (ONC) announced today the selection of two final awardees for the Regional Extension Center (REC) program:
CalOptima Foundation, covering Orange County, California ($4,662,426)
Massachusetts eHealth Collaborative, covering the state of New Hampshire ($5,105,495)
ONC also announced expanded coverage areas for two existing RECs in Florida:
Community Health Centers Alliances will cover additional areas in Glades and Hendry counties
Health Choice Network of Florida will cover additional areas in Indian River, Palm Beach, St. Lucie, Martin and Okeechobee counties
These additional awards complete a nationwide system of RECs that will help providers move from paper-based medical records to electronic health records (EHRs).
For more information about the awards and a complete listing of RECs, visit http://www.HealthIT.hhs.gov/programs/REC/.
Learn more about the Medicare and Medicaid EHR Incentive Programs at www.cms.gov/EHRincentiveprograms
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4. Personal Health Records — Understanding the Evolving Landscape (December 3)
On Friday, December 3, the Office of National Coordinator for Health Information Technology (ONC) will host a free day-long public roundtable on "Personal Health Records — Understanding the Evolving Landscape." The roundtable is designed to inform ONC’s Congressionally mandated report on privacy and security requirements for non-Covered Entities (non-CEs), with a focus on personal health records (PHRs) and related service providers (Section 13424 of the HITECH Act) .
The roundtable will include four panels of prominent researchers, legal scholars, and representatives of consumer, patient, and industry organizations. It will address the current state and evolving nature of PHRs and related technologies (including mobile technologies and social networking), consumer and industry expectations and attitudes toward privacy and security practices, and the pros and cons of different approaches to the requirements that should apply to non-CE PHRs and related technologies.
Mark your calendars now—registration and additional conference information will be available in October at http://healthit.hhs.gov/PHRroundtable
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5. 2009 Electronic Prescribing (eRx) Incentive Program Update
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that incentive payments for the 2009 Electronic Prescribing (eRx) Incentive Program are being made to eligible professionals who met the criteria for successful reporting. The 2009 eRx incentive payments are currently being processed and distributed by Carriers and Medicare Administrative Contractors (MACs). Distribution of the 2009 eRx incentive payments are scheduled to be completed by October 22, 2010.
E-prescribing incentives earned by individual participating physicians and other eligible professionals are paid as a lump-sum to the Taxpayer Identification Number (TIN) under which the EP’s claims were submitted. It is then up to the TIN to decide how to distribute the incentive within the practice.
Effective January 2010, CMS revised the manner in which incentive payment information is communicated to eligible professionals receiving electronic remittance advices. CMS has instructed Medicare contractors to use a new indicator of LE to indicate incentive payments instead of LS. LE will appear on the electronic remittance advice. Additionally the paper remittance advice will read “This is an eRx incentive payment.” It will not include the year and indicator LE in the paper remittance. In an effort to further clarify the type of incentive payment issued (either PQRI or eRx incentive), CMS created a 4-digit code to indicate the type of incentive and reporting year. For the 2009 eRx incentive payments, the 4-digit code is RX09. This code will be displayed on the electronic remittance advice along with the LE indicator. For example, eligible professionals will see LE to indicate an incentive payment, along with RX09 to identify that payment as the 2009 eRx incentive payment.
2009 Electronic Prescribing (eRx) Incentive Program Feedback Reports: The 2009 eRx feedback reports will be available on the Physician and Other Health Care Professionals Quality Reporting Portal at http://www.qualitynet.org/pqri on the internet, starting the second week of November. TIN-level reports on the Portal require an Individuals Authorized Access to CMS Computer Services (IACS) account. Participants may also contact their Carrier or MAC to request individual NPI-level reports via an alternate feedback report fulfillment process, please visit http://www.cms.gov/MLNMattersArticles/downloads/SE0922.pdf on the CMS website.
If you have questions about the status of your eRx incentive payment (during the distribution timeframe), please contact your Provider Contact Center. The Contact Center Directory is available at http://www.cms.gov/MLNProducts/Downloads/CallCenterTollNumDirectory.zip on the CMS website.
Feel free to contact the QualityNet Help Desk with any of the following:
§ Physician Quality Reporting Initiative (PQRI) Portal password issues
§ PQRI/eRx feedback report availability and access
§ PQRI-IACS registration questions
§ PQRI-IACS login issues
The QualityNet Help Desk is available Monday through Friday from 7am-7pm CST at 866-288-8912 or via qnetsupport@sdps.org on the internet. The QualityNet Help Desk is also available to assist with PQRI and eRx measure-specific questions.
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6. Special Open-Door Forum: Medicare Provider & Supplier Enrollment – Pharmacy Focused (Wed Oct 13)
Wed Oct 13, 3:30-5pm ET (rescheduled from Tue Sep 28)
Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss Medicare supplier enrollment issues. During this call, CMS staff will discuss:
§ Review how CMS plans to implement Section 3109 of the Affordable Care Act for pharmacies;
§ Review the recent instructions given to our contractor;
§ Answer questions related to those pharmacies who voluntarily disenrolled last year; and
§ Next steps required by the pharmacy.
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 3:15pm ET.
§ Dial: 1-800-837-1935
§ Reference Conference ID 98955726
§ Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
An audio recording and transcript of this Special Forum will be posted to the Special ODF website at http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading on or around Fri Oct 22 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.gov/OpenDoorForums.
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7. Updates from the Medicare Learning Network
Special Edition MLN Matters Article #SE1029: 5010 Requirement for Ambulance Services
Effective for claims submitted in the version 5010 837P electronic claim format on and after January 1, 2011, ambulance suppliers will have three options for complying with the new diagnosis reporting requirement. The Medicare Learning Network® (MLN) has released Special Edition MLN Matters Article #SE1029 to advise ambulance suppliers how to submit their claims electronically in light of this new requirement. This article is information in nature and supports existing policy. For more details, please read the article at http://www.cms.gov/MLNMattersArticles/downloads/SE1029.pdf on the Centers for Medicare & Medicaid Services (CMS) website.
# # # # # #
“What’s New for the 2010 eRx Incentive Program” Fact Sheet
The 2010 Electronic Prescribing Incentive Program (E-Prescribing) Fact Sheet “What’s New for the 2010 eRx Incentive Program” (revised July 2010) is now available in hardcopy and downloadable format from the Medicare Learning Network®. This resource provides an overview of the 2010 E-Prescribing Incentive Program, as well as highlighted changes from the 2009 E-Prescribing program. To order your copy, free of charge, please visit the MLN Products page at http://www.cms.gov/MLNProducts/01_Overview.asp on the Internet. From this page, scroll down to the “Related Links Inside CMS” section and select the “MLN Product Ordering Page” link. To view the online version, please visit http://www.cms.gov/MLNProducts/downloads/Whats_New_2010_eRx_Fact_Sheet.pdf
on the Internet.
# # # # # #
Special Edition MLN Matters Articles regarding Recovery Audit Contractor Demonstration-Identified Vulnerabilities
The Medicare Learning Network® (MLN) has released the next in a series of Special Edition MLN Matters articles designed to educate providers about Recovery Audit Contractor (RAC) demonstration-identified vulnerabilities. With the expansion of the RAC Program and the initiation of complex coding review in all four RAC regions, it is essential that providers understand the lessons learned from the demonstration and implement appropriate corrective actions. These two new articles are informational in nature and support existing policy:
§ MLN Matters Article #SE1027, entitled “RAC Demonstration High-Risk Medical Necessity Vulnerabilities for Inpatient Hospitals,” advises inpatient hospitals about 17 RAC demonstration-identified medical necessity vulnerabilities, and is available at http://www.cms.gov/MLNMattersArticles/downloads/SE1027.pdf on the Centers for Medicare & Medicaid (CMS) website.
MLN Matters Article #SE1028, entitled “RAC Demonstration High-Risk Diagnosis Related Group (DRG) Coding Vulnerabilities for Inpatient Hospitals,” provides information about four RAC demonstration-identified inpatient hospital coding vulnerabilities, and is available at http://www.cms.gov/MLNMattersArticles/downloads/SE1028.pdf on the CMS website.
# # # # # #
October is National Breast Cancer Awareness Month
The Centers for Medicare & Medicaid Services (CMS) is asking the provider community to keep their patients with Medicare healthy by encouraging them to take advantage of Medicare-covered screening mammograms and other preventive services covered by Medicare. Medicare provides coverage for an annual screening mammogram for all female beneficiaries age 40 or older. Medicare also provides coverage for one baseline mammogram for female beneficiaries between the ages of 35 and 39.
What Can You Do? As a health care professional who provides care to patients with Medicare, you can help protect the health of your Medicare patients by encouraging them to take advantage of Medicare-covered screenings, including screening mammograms that are appropriate for them.
For More Information: CMS has developed several educational products related to Medicare-covered screening mammograms. They are all available, free of charge, from the Medicare Learning Network®:
§ The MLN Preventive Services Educational Products Web Page – provides descriptions and ordering information for Medicare Learning Network® (MLN) educational products for health care professionals related to Medicare-covered preventive services, including screening mammograms. http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp
§ The Guide to Medicare Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals – provides coverage and coding information on Medicare-covered preventive services and screenings, including screening mammograms. http://www.cms.hhs.gov/MLNProducts/downloads/mps_guide_web-061305.pdf
§ Quick Reference Information: Medicare Preventive Services – this chart provides coverage and coding information on Medicare-covered preventive services, including screening mammograms. http://www.cms.hhs.gov/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf
§ The Medicare Preventive Services Series: Part 3 Web-Based-Training (WBT) course – this WBT includes lessons on coverage, coding, and billing for Medicare-covered preventive services, including screening mammograms. To access the course, please visit the MLN home page at http://www.cms.gov/mlngeninfo on the internet. Scroll down to “Related Links Inside CMS” and click on “Web Based Training (WBT) Modules.”
§ The Cancer Screenings brochure – this brochure provides information on coverage for Medicare-covered cancer screenings, including screening mammograms. http://www.cms.hhs.gov/MLNProducts/downloads/cancer_screening.pdf
Please visit the Medicare Learning Network at http://www.cms.hhs.gov/MLNGenInfo for more information on these and other Medicare fee-for-service educational products. For more information on National Breast Cancer Awareness Month, please visit the official website at http://www.nbcam.org on the internet.
# # # # # #
New Enrollment Fact Sheets from the Medicare Learning Network
If you are a Fee-For-Service (FFS) provider or supplier who is currently enrolled or required to enroll in the Medicare Program, the Medicare Learning Network® (MLN) can help you understand and follow the Medicare enrollment process! The MLN has released the next in a series of fact sheets designed to educate FFS providers about important Medicare enrollment information, including how to use Internet-based Provider Enrollment, Chain and Ownership System (PECOS) to enroll in the Medicare Program and maintain your enrollment information. These fact sheets are available in downloadable format on the Centers for Medicare & Medicaid Services (CMS) website at the URLs listed below.
The Basics of Medicare Enrollment for Physicians Who Infrequently Receive Medicare Reimbursement
Provides general Medicare enrollment information to those physicians who are required to enroll in Medicare for the sole purpose of certifying or ordering services for Medicare beneficiaries and therefore, are not required to send claims to Medicare contractors for the services they furnish. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_Phys_Infreq_Reimb_FactSheet_ICN006881.pdf on the CMS website.
The Basics of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for Physicians and Non-Physician Practitioners
Advises physicians and non-physician practitioners on how to enroll in the Medicare Program and maintain their enrollment information using Internet-based PECOS. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_PhysNonPhys_FactSheet_ICN903764.pdf on the CMS website.
Internet-based Provider Enrollment, Chain and Ownership System (PECOS) Contact Information
Provides contact information for technical assistance with Internet-based PECOS. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_Contact_FactSheet_ICN903766.pdf on the CMS website.
The Basics of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for Provider and Supplier Organizations
Advises provider and supplier organizations on how to enroll in the Medicare Program and maintain their enrollment information using Internet-based PECOS. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_ProviderSup_FactSheet_ICN903767.pdf on the CMS website.
The Basics of Medicare Enrollment for Physicians and Other Part B Suppliers
Explains general Medicare enrollment information specific to physicians and other Part B suppliers, except Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PhysOther_FactSheet_ICN903768.pdf on the CMS website.
The Basics of Medicare Enrollment for Institutional Providers
Provides general Medicare enrollment information specific to institutional providers, such as community mental health centers (CMHCs), home health agencies (HHAs), hospitals, skilled nursing facilities (SNFs), and hospices. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_InstProv_FactSheet_ICN903783.pdf on the CMS website.
The Basics of Internet-based PECOS for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
Educates DMEPOS suppliers on how to enroll in the Medicare Program and maintain their enrollment information using Internet-based PECOS. This fact sheet is available at http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_DMEPOS_FactSheet_ICN904283.pdf on the CMS website.
In addition, the Medicare Learning Network previously released two fact sheets concerning privacy and protection of Medicare enrollment records that may also be of interest:
Medicare Fee-For-Service (FFS) Physicians and Non-Physician Practitioners: Protecting Your Privacy - Protecting Your Medicare Enrollment Record
Advises Fee-For-Service (FFS) physicians and non-physician practitioners on how to ensure their enrollment records are up-to-date and secure. This fact sheet is available at
http://www.cms.gov/MLNProducts/downloads/MedEnrollPrivcy_FactSheet_ICN903765.pdf
on the CMS website.
How to Protect Your Identity Using the Provider Enrollment, Chain and Ownership System (PECOS)
Provides step-by-step instructions to help FFS providers protect their identity while using Internet-based PECOS. This fact sheet is available at
http://www.cms.gov/MLNProducts/downloads/MedEnroll_ProtID_FactSheet_ICN905103.pdf
on the CMS website.
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8. Medicare Self-Referral Disclosure Protocol
Section 6409(a) of the Affordable Care Act (ACA) ACA requires the Secretary of the Department of Health and Human Services, in cooperation with the Inspector General of the Department of Health and Human Services, to establish a Medicare self-referral disclosure protocol (“SRDP”) that sets forth a process to enable providers of services and suppliers to self-disclose actual or potential violations of Section 1877 of the Social Security Act (the Act).
The SRDP requires health care providers of services or suppliers to submit all information necessary for CMS, on behalf of the Secretary, to analyze the actual or potential violation of Section 1877 of the Act. Section 6409(b) of the ACA, gives the Secretary of HHS the authority to reduce the amount due and owing for violations of Section 1877. The SRDP is located on the CMS website at http://www.cms.gov/PhysicianSelfReferral.
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9. October Flu Shot Reminder
Vaccination is the Best Protection Against the Flu. This year, the Centers for Disease Control and Prevention (CDC) is encouraging everyone 6 months of age and older to get vaccinated against the seasonal flu. The risks for complications, hospitalizations and deaths from the flu are higher among individuals aged 65 years and older. Medicare pays for the seasonal flu vaccine and its administration for seniors and others with Medicare with no co-pay or deductible. And remember, vaccination is particularly important for health care workers, who may spread the flu to high risk patients. Don’t forget to immunize yourself and your staff. Protect your patients. Protect your family. Protect yourself. Get Your Flu Vaccine - Not the Flu.
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 influenza vaccine and its administration, as well as related educational resources for health care professionals and their staff, please visit http://www.cms.gov/AdultImmunizations.
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10. Clinician Outreach and Communication Activities (COCA) from the Centers for Disease Control
2010 Gulf of Mexico Oil Spill: Update: What’s Coming Ashore from the Oil Spill
This page has information about what light crude oil does when it reaches shore: http://emergency.cdc.gov/gulfoilspill2010/coming_ashore.asp. For more information and additional Healthcare Professionals resources visit: http://emergency.cdc.gov/gulfoilspill2010/health_professionals.asp.
H1N1 & Seasonal Influenza Resources: Influenza 2010-2011: ACIP Vaccination Recommendations
In this podcast targeted to clinicians, Dr. Joe Bresee discusses who should be vaccinated against flu this year, explains who is at risk for severe illness, and discusses the benefits of vaccination. http://www2c.cdc.gov/podcasts/player.asp
H1N1 & Seasonal Influenza Resources: Guidelines and Recommendations: Prevention Strategies for Seasonal Influenza in Healthcare Settings
This guidance supersedes previous CDC guidance for both seasonal influenza and the Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, which was written to apply uniquely to the special circumstances of the 2009 H1N1 pandemic as they existed in October 2009. As stated in that document, CDC planned to update the guidance as new information became available. http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm
H1N1 & Seasonal Influenza Resources: Seasonal Influenza Vaccine Safety: A Summary for Clinicians
Seasonal influenza vaccination is the most important way of preventing seasonal influenza virus infections and potentially severe complications, including death. Seasonal influenza vaccination reduces the likelihood of becoming ill with influenza or transmitting influenza to others. The 2010-2011 seasonal influenza vaccine protects against an influenza A H3N2 virus, an influenza B virus, and the 2009 H1N1 virus that caused widespread illness last season. http://www.cdc.gov/flu/professionals/vaccination/vaccine_safety.htm
Emergency Preparedness & Response: 2010 Report: Public Health Preparedness: Strengthening the Nation’s Emergency Response State by State
A report on CDC-funded preparedness and response activities in 50 states, 4 cities, and 8 U.S. insular areas. http://emergency.cdc.gov/publications/2010phprep
Emergency Preparedness & Response: BARDA funds medical countermeasure innovation
The US Department of Health and Human Services’ Biomedical Advanced Research and Development Authority (BARDA) announced the first eight contract awards under an initiative to help modernize and improve the nation’s infrastructure for producing medical countermeasures that protect against natural and man-made biological threats. The contracts help advance innovative tools and techniques that reduce the time and cost of development, testing, and production of medical countermeasures and that improve the safety, efficacy, and ease of use of these products. These contracts total $55 million for the initial phase and up to $100 million over three years. http://www.hhs.gov/news/press/2010pres/09/20100921d.html
Emergency Preparedness & Response: BARDA awards $51 million contract for next generation anthrax vaccine
The US Department of Health and Human Services’ Biomedical Advanced Research and Development Authority (BARDA) awarded a $51 million contract to Emergent BioSolutions, Inc., of Rockville, Md., for the development of a new anthrax vaccine using the protective antigen (rPA) to stimulate a protective immune response that neutralizes the anthrax toxins. http://www.hhs.gov/news/press/2010pres/09/20100917c.html
Emergency Preparedness & Response: When Every Drop Counts: Protecting Public Health During Drought Conditions: A Guide for Public Health Professionals
CDC’s National Center for Environmental Health developed this publication to assist public health officials, practitioners, and other stakeholders in their efforts to understand and prepare for drought in their communities. The document includes information about how drought affects public health, recommends steps to help mitigate the health effects of drought, identifies future needs for research and other drought-related activities, and provides a list of helpful resources and tools. http://www.cdc.gov/nceh/ehs/Publications/Drought.htm
Emerging Infectious Diseases (EID) Journal
The Emerging Infectious Diseases (EID) journal provides recognition of new and re-emerging infections and understanding of factors involved in disease emergence, prevention, and elimination. It also represents the scientific communications component of CDC's efforts against the threat of emerging infections. See the October 2010 issue of the EID journal at http://www.cdc.gov/ncidod/eid.
~~~~~~~~~~~~~~~~~~~~
11. 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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Saturday, October 2, 2010
North Dakota Legislative Higher Education Committee Meeting in Bismarck on October 13
October 13 Legislative Higher Education Committee Meeting in Bismarck
http://www.legis.nd.gov/assembly/61-2009/interim-info/agenda/HE101310agenda.pdf
http://www.legis.nd.gov/assembly/61-2009/interim-info/agenda/HE101310agenda.pdf
North Dakota October Legislative Calendar
North Dakota Legislative Calendar
http://www.legis.nd.gov/docs/pdf/eventsnews.pdf
http://www.legis.nd.gov/docs/pdf/eventsnews.pdf
Friday, October 1, 2010
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