Guidance from KDOA on Level II Assessments

KDOA has issued a current guidance to nursing facilities regarding the MDS 3.0 A1500 instructing the facility staff to contact KDOA when there is a significant change for a resident with a Level II assessment in the absence of additional guidance from their state. 

CMS has allowed the states to give facilities guidance as to when they should contact KDOA for a resident review.   This is KDOA's current guidance to the facilities. Click here for a copy of this guidance.

Nursing facilities will want to document any contact with their program with regard to this issue.

This will also be posted on the KDOA Provider website and will be included in the next SunFlower Connection.

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  Kansas Area Agency on Aging and Interhab Anncounce Webinar

Aging & Mental Illness: 
An exploration of dementia, schizophrenia & depression in aging persons

November 18, 2010  10:00am to 12:00pm - Webinar

Join Professor Ronald Lucchino Ph.D. for an in-depth exploration of multiple mental health issues that affect elderly persons—including depression & suicide. This session will examine the physical changes that can take place in the brain as we grow older as well as changes in affective behavior.

About the Speaker:
Ronald Lucchino Ph.D., is the Professor of Biology at Utica College of Syracuse University & is the Director of the Institute of Gerontology. He has served as a professor & Director for 28 years. Professor Lucchino has been involved with the New York State Office for the Aging and the New York State Department of Developmental Disabilities. He has developed and chaired Oneida County’s Aging & DD Council as well as their Alzheimer’s Disease Assistant Coalition. 

This training is brought to you by the Kansas Area Agencies on Aging Association in partnership with InterHab’s Department of Professional Development.

For registration information, contact:

Craig Kaberline, MSW
Executive Director
Kansas Area Agencies on Aging Association
2910 SW Topeka Blvd, Topeka, KS 66611
(785) 267-1336

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  Heart of America Hospice Becomes Grace Hospice

Heart of America Hospice with Topeka and Lawrence offices has adopted the name of their sister company Grace Hospice of Kansas City. They will continue to provide the same services with the same teams throughout Northeast Kansas. Visit the website at gracehospicellc.com for more information.

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  New report shows Affordable Care Act savings of $3,500 for Medicare beneficiaries

Lower prescription drug costs, reduced waste, fraud, and abuse, and improvements to care quality and increased system-wide efficiency will reduce costs in traditional Medicare

A new analysis issued today by the U.S. Department of Health and Human Services estimates that under the Affordable Care Act, average savings for those enrolled in traditional Medicare will amount to more than $3,500 over the next 10 years.  Savings will be even higher - as much as $12,300 over the next 10 years - for seniors and people with disabilities who have high prescription drug costs.

"The Affordable Care Act makes Medicare stronger and reduces the burden of health care costs on some of our most vulnerable citizens," said Secretary Kathleen Sebelius.  "The law improves benefits for seniors and people with beneficiaries who rely on Medicare and ensures that Medicare will be there for current and future generations by extending the life of the Medicare Trust Fund.  These benefits and savings are only possible with the continued implementation of the Affordable Care Act."

The analysis, released by the Office of the Assistant Secretary for Planning and Evaluation (ASPE), shows that the Affordable Care Act helps lower costs for those on Medicare by slowing the growth of cost-sharing in Medicare.  Closing the Part D coverage gap known as the "donut hole"
will produce the greatest cost savings.  Already, more than 1.8 million seniors and people with disabilities who have reached the donut hole in 2010 received a one-time $250 rebate check, and checks will continue to be distributed to those who enter the donut hole this year. Next year, people in the donut hole will receive 50 percent discounts on covered brand name Part D prescription drugs. Also starting next year, seniors and people with disabilities on Medicare will have access to a number of recommended preventive services and annual wellness visits at no additional cost. 

Although all seniors and people with disabilities in Medicare are likely to see savings, the savings will be greatest for those with costly medical conditions or high prescription drug costs.  Total savings per beneficiary enrolled in traditional Medicare are estimated to be $86 in
2011, rising to $649 in 2020.   For a beneficiary with spending in the
donut hole, estimated savings increase from $553 in 2011 to $2,217 in 2020.

"The savings that seniors and people with disabilities on Medicare are seeing are due to critical improvements the Affordable Care Act makes to Medicare," said Assistant Secretary for Planning and Evaluation, Sherry Glied.  "Reducing waste, fraud and abuse, improving the quality of care beneficiaries receive, and making the program more efficient all contribute to lower cost increases across the system."

The full analysis is available at
http://www.healthcare.gov/center/reports/affordablecareact.html.

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  Clarification Issued for F441 - Infestion Control Standards

The attached Survey & Certification Memorandum was issued by CMS and relates to a modification in surveyor guidance for F441 – Infection Control Standards.  This memo clarifies that:

·    Reusing a fingerstick device for more than one resident should be treated as an Immediate Jeopardy deficiency.

·    Using a blood glucose meter (or other point-of-care device) for more than one resident without cleaning and disinfecting it after use should warrant further investigation following the interpretive guidelines, investigative protocol, and severity determination at F441 to determine level of severity. 

This memorandum modifies previous surveyor guidance that was resulting in Immediate Jeopardy deficiency citations for either situation.  Also, there are links in the memorandum to CDC and FDA websites for additional reference materials. Click here for a link to the actual memo.

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  CMS announces 2011 Copay Amounts

The Centers for Medicare and Medicaid Services (CMS) has set the Medicare premiums, deductibles and coinsurance amounts to be paid by Medicare beneficiaries in 2011.  For beneficiaries in skilled nursing facilities, the daily co-insurance for days 21 through 100 in a benefit period will be $141.50 in 2011, compared to $137.50 in 2010. The following is the CMS Fact Sheet.

 
MEDICARE FACT SHEET
 

For Immediate release                                                        Contact: CMS Office of Media Relations

November 4, 2010                                                                                    (202) 690-6145

MEDICARE PREMIUMS, DEDUCTIBLES FOR 2011

The Centers for Medicare and Medicaid Services (CMS) has set the Medicare premiums, deductibles and coinsurance amounts to be paid by Medicare beneficiaries in 2011.

For Medicare Part A, which pays for inpatient hospital, skilled nursing facility, and some home health care, the deductible paid by the beneficiary when admitted as a hospital inpatient will be $1,132 in 2011, an increase of $32 from this year's $1,100 deductible. The Part A deductible is the beneficiary's cost for up to 60 days of Medicare-covered inpatient hospital care in a benefit period. Beneficiaries must pay an additional $283 per day for days 61 through 90 in 2011, and $566 per day for hospital stays beyond the 90th day in a benefit period. For 2010, the per-day payment for days 61 through 90 was $275, and $550 for beyond 90 days. For beneficiaries in skilled nursing facilities, the daily co-insurance for days 21 through 100 in a benefit period will be $141.50 in 2011, compared to $137.50 in 2010. Those who enroll in Medicare Advantage plans may have different cost-sharing arrangements. All of these Part A program payment changes are determined in accordance with a statutory formula.

About 99 percent of Medicare beneficiaries do not pay a premium for Medicare Part A services since they have at least 40 quarters of Medicare-covered employment. However, some enrollees age 65 and over and certain persons with disabilities who have fewer than 30 quarters of coverage obtain Part A coverage by paying a monthly premium established according to a statutory formula. This premium will be $450 for 2011, a decrease of $11 from 2010. Individuals who have between 30 and 39 “quarters of coverage” may buy into Part A at a reduced monthly premium rate of $248 in 2011.

The monthly premium paid by beneficiaries enrolled in Medicare Part B covers a portion of the cost of physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and other items.  The standard Medicare Part B monthly premium will be $115.40 in 2011, a $4.90 increase (or 4.4-percent) over the 2010 premium.  However, the majority of Medicare beneficiaries will continue to pay the same $96.40 premium amount they have paid since 2008.

Part A premiums are decreasing because spending in 2010 was lower than expected and the Affordable Care Act implemented policies that lower Part A spending due to payment efficiencies and efforts related to waste, fraud and abuse.  Part B premiums are increasing because of growth in the use of services like outpatient hospital care, home health and physician-administered drugs.  In addition, the premium accounts for a likely Congressional action to avert a precipitous decrease in physician payments, which the Administration supports, and has occurred every year since 2003.  The Administration is committed to permanent reform of the physician payment formula.

For more information read the entire CMS fact sheet issued (11/4) at:  http://www.cms.hhs.gov/apps/media/fact_sheets.asp

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  ACCESSING MDS 3.0 VALIDATION REPORTS

MDS 3.0 Validation Reports can be obtained in CASPER when you log in with your MDS INDIVIDUAL ID (The State assigned facility ID cannot retrieve Validation Reports). 

      1.     You can find the automatically generated Validation Reports on the Folders page in the folder that ends with "VR". 

OR

      2.     You can open the Reports page and select the "MDS 3.0 Submitter's Final Validation Report or MDS 3.0 NH Final Validation Report" category and request a report using the Submission ID or Submission Date range.

 Please see the MDS 3.0 Provider User's Guide found on QTSO.com at the bottom of the MDS 3.0 page

            https://www.qtso.com/mds30.html      ß    Copy and paste into your browser’s address bar.

How to retrieve Validation Reports: MDS 3.0 Provider User's Guide, Section 4 – Reports

Validation Report errors:  MDS 3.0 Provider User's Guide, Section 5 - Error Messages

The ASAP (MDS 3.0 Submission) system will not create or save the automatically generated Final Validation Report if certain errors are encountered during processing.  When these errors occur, processing ceases.  For a list of errors that cause file or record processing to cease, please refer to Section 5 - Error Messages, on pages 3 & 4 of the MDS 3.0 Provider User's Guide.  Click here for additional information on submission reports.

QIES Technical Support Office
BCSSI, West Des Moines, IA
Monday - Friday
7:00 a.m. - 7:00 p.m.
800-339-9313
Help@qtso.com

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  DMEPOS Round 1 Rebid Contract Suppliers Announced!

The Centers for Medicare & Medicaid Services (CMS) has announced the contract suppliers for the Round 1 Rebid of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program. 

Click here for a list of contract suppliers serving the Kansas City area.

The list of all contract suppliers is now available at http://www.cms.gov/DMEPOSCompetitiveBid/01A2_Contract_Supplier_Lists.asp. 

Visit the CMS web site at http://www.cms.gov/DMEPOSCompetitiveBid  for additional information. 

View the Press Release at http://www.cms.gov/apps/media/press_releases.asp.

View the Fact Sheet at http://www.cms.gov/apps/media/fact_sheets.asp.

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  Medicare Update November 2010

The CMS Regional office in Kansas City has provided the following  Medicare information for the providers in Region VII.  Please feel free to distribute this important information to all members of your team.                                                              

Meetings & Calls… 

National Education Call for Non-Contract Suppliers in the DMEPOS Competitive Bidding Program  [Mon,  Nov 8]
National Education Call for Referral Agents for the DMEPOS Competitive Bidding Program
[Tue, Nov 16]

Skilled Nursing Facility Prospective Payment System Resource Utilization Group-Version 4 (RUG-IV) National Provider Call with Q&A [Tue Nov 9]
2010 Physician Quality Reporting Initiative & Electronic Prescribing Incentive Program National Provider Call with Question & Answer Session [Wed Nov 10]
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]
Registration for ONC Personal Health Records Roundtable Now Open [Fri Dec 3]
 

Announcements and Reminders… 

X12 Announces Deadline for Requests for Modifications to the ASC X12 005010 Health Care Implementation Guides
EHR Incentive Program:  Certified Health IT Product List
ONC Reaches Out to Vendor Community to Help Reduce Health Disparities
October Flu Shot Reminder 

Updates from the Medicare Learning Network…

Two New Fact Sheets Regarding Walker Exceptions to the DMEPOS Competitive Bidding Program
“The DMEPOS Competitive Bidding Program Traveling Beneficiary Fact Sheet”
“Comprehensive Outpatient Rehabilitation Facility”
“Rural Health Clinic” Publication Revised
Revised MLN Matters Article #SE1028 – Recovery Audit Contractor (RAC) Demonstration High-Risk Diagnosis Related Group (DRG) Coding Vulnerabilities for Inpatient Hospitals
MLN Matters Article #MM7133:  “Counseling to Prevent Tobacco Use”                                                                    

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. 

2.  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.

3.  Skilled Nursing Facility Prospective Payment System Resource Utilization Group-Version 4 (RUG-IV) National Provider Call with Q&A 

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. 

4.  2010 Physician Quality Reporting Initiative & Electronic Prescribing Incentive Program National Provider Call with Question & Answer Session 

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. 

5.  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, 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. 

6.  Registration for ONC Personal Health Records Roundtable Now Open 

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.

7.  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. 

8.  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.

9.  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. 

10.  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.

 11.  From the Medicare Learning Network:  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. 

12.  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. 

13.  From the Medicare Learning Network:  “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. 

14.  From the Medicare Learning Network:  “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. 

15.  From the Medicare Learning Network:  Revised MLN Matters Article #SE1028 – Recovery Audit Contractor (RAC) Demonstration High-Risk Diagnosis Related Group (DRG) Coding Vulnerabilities for Inpatient Hospitals 

The Medicare Learning Network® (MLN) has revised MLN Matters Article #SE1028 to clarify requirements for coding diagnosis codes by attending physicians.  The article provides information related to four RAC demonstration-identified inpatient coding vulnerabilities in an effort to prevent similar problems from occurring in the future.  The revised version is now available at http://www.cms.gov/MLNMattersArticles/downloads/SE1028.pdf on the CMS website. 

16.  From the Medicare Learning Network:  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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  Application Packets Available for AHCA/NCAL National Quality Awards

The 2011 AHCA/NCAL National Quality Award Bronze, Silver and Gold application packets are now available on the Quality Award website. In 2010, Kansas had 15 homes receive a Bronze Level and had one home receive a Silver Level. These homes were honored at the 61st Annual AHCA/NCAL Convention in Long Beach. Apply today to be considered for the 2011 program. 

There are some important changes to note  for the 2011 program.

New in 2011! 

Intent to Apply Requirement: Applicants for the 2011 AHCA/NCAL National Quality Award program are required to submit a non-refundable $75 Intent to Apply fee in order to be eligible to submit an application. The Intent to Apply fee will be accepted online via credit card beginning November 15, 2010. The deadline to submit the Intent to Apply fee is January 18, 2011 at 8:00pm EST. We strongly encourage applicants to submit their intent to apply fee early!

New Award Deadlines: 

• Intent to Apply Deadline for Bronze, Silver and Gold Applicants: January 18, 2011
• Bronze: February 28, 2011
• Silver: March 15, 2011
• Gold: March 15, 2011

Important Note: All award deadlines are now at 8:00pm EST (7:00pm CST, 6:00pm MST, 5:00pm PST)

Click here for the official flyer.

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  AHCA/NCAL Incoming President & CEO Presented Elder Care Award

 Kansas Governor Mark Parkinson, the incoming President & CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) was honored  by the Kansas Advocates for Better Care (KABC). Governor Parkinson received the organization’s second annual Caring Award. “Governor Mark Parkinson has intimate knowledge of the long term and post-acute care sector that has allowed him to be a dedicated champion of elder care issues both in the Kansas legislature and as Governor,” stated Bruce Yarwood, President & CEO of AHCA/NCAL. “We know that he will continue to advocate for long term care professionals when he joins AHCA/NCAL and we congratulate him on this well deserved and appropriate award.”

AHCA/NCAL is the nation’s leading association representing the long term care profession. When he assumes the role of President & CEO in January, Governor Parkinson will be the leader for 11,000 member facilities and the 1.5 million Americans they care for each day.

The KABC Caring Award is given to recognize exemplary contributions of leadership in providing quality care for frail elders and persons with disabilities in Kansas. Governor Parkinson received this award during KABC’s “Stand By Me” benefit on October 17.

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  Obama Signs Bill Replacing ‘Mental Retardation’ With ‘Intellectual Disability’
Michelle Diament

President Barack Obama signed legislation Tuesday October 2, 2010 requiring the federal government to replace the term “mental retardation” with “intellectual disability” in many areas of government.

The measure known as Rosa’s Law was approved unanimously by Congress before receiving the go-ahead from the president with little fanfare this week.

Under the law, “mental retardation” and “mentally retarded” will be stripped from federal health, education and labor policy. “Intellectual disability” and “individual with an intellectual disability” will be inserted in their place. The rights of individuals with disabilities will remain the same.

“This is a really important step, particularly for the self-advocacy community,” said Peter Berns, CEO of The Arc, which lobbied heavily for Rosa’s Law. “Self-advocates have been working for many years to remove hurtful language and this takes our community one step closer.”

Even with the new law in effect, the terms will not be swapped out immediately. That’s because the change will be implemented gradually over the next several years as laws and documents are revised so that the alteration does not incur any cost.

By moving to use the term “intellectual disability,” the federal government is following a trend. Most states and some federal agencies including the Centers for Disease Control and Prevention already use the new language.

Rosa’s Law is named for Rosa Marcellino, a Maryland girl with Down syndrome.

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