CMS asks that you share this important information with all of your association members and State and local chapters. Thanks! Hi everyone! A few of these items are time sensitive so I thought I'd go ahead and send you what I have so far this week, including information on: New From the Medicare Learning Network Home Health PPS Grouper Update Medicare Part B Drugs Average Sales Price Files " October 2008 Clarification of MIPPA Guidance for DME Accreditation Open Door Forum Updates News of Benefit to Medicare Beneficiaries New from the Medicare Learning Network The revised Guidelines for Teaching Physicians, Interns, and Residents (July 2008), which provides information about payment for physician services in teaching settings, general documentation guidelines, and evaluation and management documentation guidelines, is now available in downloadable format from the Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/gdelinesteachgresfctsht.pdf. Just a reminder that the Medicare Learning Network web-based training courses and product ordering web page are currently unavailable on the CMS website while we perform system maintenance and upgrades. We expect the system will be available again around 10/1/2008. Thank you for your interest in the Medicare Learning Network. If you have any questions, please send them to MLN@cms.hhs.gov. Home Health PPS Grouper Update The Centers for Medicare & Medicaid Services (CMS) has updated the Home Health (HH) PPS Grouper due to changes in ICD-9-CM coding (effective October 1, 2008). CMS is providing an updated HH PPS Grouper Software Package (Version 2.03). The package includes the updated GROUPER.DLL software module, an updated version of the grouper logic (pseudocode) and associated tables, and updated test cases to be used by those who are developing their own software to implement the grouper logic. The changes to the grouper are described in the README file (READM203.PDF) which is also included. This package is available at http://www.cms.hhs.gov/HomeHealthPPS/05_CaseMixGrouperSoftware.asp in the Downloads section. Medicare Part B Drugs Average Sales Price Files -- October 2008 The Centers for Medicare & Medicaid Services (CMS) has made available the Medicare Part B Drug and Biological Average Sales Price (ASP) Payment Amounts for October 1, 2008 to December 31, 2008 on the CMS website at http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a_2008aspfiles.asp The files are located in the "Downloads" section of this web page. CMS Clarifies MIPPA Guidance for DME Accreditation On September 3, 2008, CMS announced those DMEPOS providers that are exempt from meeting the quality standards for DMEPOS accreditation. CMS, at that time, stated that Orthotists, Prosthetists, and Pedorthotists are included in that exemption. CMS will issue a notice of proposed rulemaking in 2009 that will define quality standards designed specifically for anyone furnishing or providing orthotics and prosthetics in order to be reimbursed for such supplies and services under Medicare Part B. Open Door Forum Updates Due to a technical malfunction in the recording system, we have experienced a delay in making accessible the Encore audio recording service for the September 18, 2008 CMS End Stage Renal Disease Open Door Forum. The issues have been resolved and the recording is now available. To access, dial 1-800-642-1687 and key in the conference ID 58370205 followed by the pound key. This recording will be available until Friday, September 26, 2008. Thank you for your patience. The next CMS Physicians, Nurses & Allied Health Professionals Open Door Forum is scheduled for: Date: October 7, 2008 Start Time: 2:00 PM Eastern Daylight Time (EDT) [Please dial in at least 15 minutes before call start time.] Conference Leader(s): Jeffrey Rich, M.D./Bill Rogers, M.D./Mark Gilbert/Natalie Highsmith Open Door Participation Instructions: There are 2 ways to participate, by phone or onsite. 1. To participate by phone: Dial: 1-800-837-1935 & Reference Conference ID 58370420 **Persons participating by phone do not need to RSVP. ** Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html. A Relay Communications Assistant will help. 2. To participate onsite: Your RSVP is required. Please send a reply to CMS PHYSICIANODF-L@cms.hhs.gov, by 2:00 PM EDT, October 3, 2008. Be sure to include the title of the forum "Physician ODF" in the subject line of your message, and send us the following information: - Your first & last name
- Your organization or representation
- Your telephone number
Please arrive no later than 1:30 p.m. ADDRESS: Hubert H. Humphrey Bldg. 200 Independence Avenue S.W. Washington, D.C. 20201 Map & Directions: http://www.hhs.gov/about/hhhmap.html ENCORE: 1-800-642-1687; Conf. ID# 58370420 Encore is a recording of this call that can be accessed by dialing 1-800-642-1687 and entering the Conf. ID., beginning 2 hours after the call had ended. The recording will be available for 3 business days. For Forum updates, Mailing List subscription and Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums. News of Benefit to Medicare Beneficiaries The next presentation in the My Health. My Medicare. series of audio-conference training sessions sponsored by the Centers for Medicare & Medicaid Services (CMS) will be held: When: Thursday, September 25, 2008 Time: 3:00-4:00 p.m. EST Subject: Medicare Advantage Updates from the "Medicare Improvements for Patients and Providers Act of 2008" (MIPPA), including prohibitions on marketing activities for certain types of Medicare Advantage and Prescription Drug Plans. These sessions are designed to give Medicare partners, professionals and volunteers who assist people with Medicare the most up-to-date information on the Medicare program. Calls feature CMS policy experts who provide in-depth information and answer questions from callers on topics of current interest impacting people with Medicare. Call-in procedures: Dial toll free: 800-857-9674 (Please call in 15 minutes before the session begins) Pass Code: NMTP State Health Insurance Assistance Program Receives Performance Award The Centers for Medicare & Medicaid Services (CMS) recently announced that State Health Insurance Assistance Program (SHIPs) will receive a $1.5 million in additional funding to be awarded based on their performance during the prior year. SHIP Performance Award based on the SHIPs' outstanding achievements the prior year in serving Medicare beneficiaries, CMS is providing these additional funds to expand their services. The SHIPs provide Medicare beneficiaries counseling and benefits information at the state and local level. SHIP counselors can help answer beneficiaries' questions related to Medicare, Medicare Supplement Insurance, Medicare Advantage, prescription coverage, and low-income assistance. SHIPs can provide tools and information to help beneficiaries make decisions regarding their health care. CMS works with a network of staff and volunteers to help SHIPs provide services to improve the health care of people with Medicare. For more information about SHIP local activities in your area, visit http://www.SHIPTalk.org. CMS EXPANDS PERSONAL HEALTH RECORD PILOT IN SOUTH CAROLINA TO INCLUDE DATA FROM TRICARE The Centers for Medicare & Medicaid Services (CMS) recently announced an expansion of the South Carolina Personal Health Record pilot (MyPHRSC) to include TRICARE health data. An interagency agreement between CMS and the Department of Defense (DoD) will enable beneficiaries who have original Medicare and also receive TRICARE benefits to be offered the option of adding TRICARE health data to their MyPHRSC personal health records (PHRs). This data has only been available to the beneficiary through the DoD Medical Information Technology systems until this point. "This exciting pilot expansion will be a major step forward for Medicare and DoD. We believe that collaborations of this sort will provide more complete information and better tools to empower consumers to manage their health," CMS Acting Administrator Kerry Weems said. "We expect this pilot, which brings data together from multiple sources, can be combined successfully to provide the beneficiary with access to more complete personal health records." The PHR tool selected for the MyPHRSC was created by HealthTrio, which currently offers PHRs to thousands of individuals through employer contracts. The Medicare data is provided through Palmetto GBA, a Medicare contractor serving the region that includes South Carolina. The pilot is being managed by QSSI, a company that specializes in information technology solution development and headquartered in Gaithersburg, Md. The pilot is accepting enrollment online at http://www.MyPHRSC.com.
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