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. MEDICARE REOPENS COMPETITIVE BIDDING PROGRAM FOR MEDICAL EQUIPMENT AND SUPPLIES

2. Bidding Is Now Open for the Round 1 Rebid of the DMEPOS Competitive Bidding Program!

3. New Requirements for Medicare DMEPOS Suppliers – Accreditation/Surety Bonds

4. Eighth and Final Special Open Door Forum Bidders’ Conference for the Round 1 Rebid of the Medicare DMEPOS Competitive Bidding Program

5. October 2009 Quarterly Provider Specific File Update – REVISED

6. Protect your patients and yourself from influenza: Get Vaccinated!

7. Your October Flu Message

8. New from the Medicare Learning Network®

9. Extra Help for Beneficiaries Paying for Prescription Drugs

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1. MEDICARE REOPENS COMPETITIVE BIDDING PROGRAM FOR MEDICAL EQUIPMENT AND SUPPLIES

The Centers for Medicare & Medicaid Services (CMS) today began accepting bids from accredited and bonded medical equipment suppliers after implementing a number of important modifications to the program and conducting an intensive supplier outreach and education effort.

Medicare-approved medical equipment suppliers will have 60 days in which to submit bids for the Round One Rebid of the Medicare Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) in nine communities.

Suppliers that have completed the bidder registration process may now access the on-line bidding system and begin the process of submitting their bids. Information and materials may be found at www.dmecompetitivebid.com .

For additional information about the Medicare DMEPOS Competitive Bidding Program, please visit: http://www.cms.hhs.gov/DMEPOSCompetitiveBid/.

To read the complete CMS Press release issued today (10/21/09) click here: http://www.cms.hhs.gov/apps/media/press_releases.asp

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2. Bidding Is Now Open for the Round 1 Rebid of the DMEPOS Competitive Bidding Program!

The Centers for Medicare & Medicaid Services (CMS) is now soliciting bids for the Round 1 Rebid of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. All bids must be submitted in DBidS, the on-line bidding system, by 9 p.m. prevailing Eastern Time on December 21, 2009; all required hardcopy documents that must be included as part of the bid package must be postmarked by 11:59 p.m. on December 21, 2009. The contract period for mail order diabetic supplies is January 1, 2011 – December 31, 2012. The contract period for all other Round 1 Rebid product categories is January 1, 2011 – December 31, 2013.

All bidders must submit certain required hardcopy documents as specified in the Request for Bids (RFB) instructions. CMS urges all bidders to take advantage of the new covered document review process. Under this new process we will notify suppliers that submit their hardcopy financial documents by the Covered Document Review Date (CDRD) of any missing financial documents. The CDRD for the Round 1 Rebid is November 21, 2009 – financial documents must be postmarked by 11:59 p.m. on November 21, 2009 to qualify for the covered document review process. This process only determines if there are any missing financial documents. It does not indicate if the documents are acceptable, accurate or meet applicable requirements. Suppliers that submit financial documents by the CDRD will be notified of any missing financial documents within 45 days of the CDRD. Suppliers will be required to submit the missing financial document(s) within 10 business days of the notification.

The Round 1 Rebid competitive bidding areas (CBAs), product categories, DBidS information, bidder charts, educational materials, and complete RFB instructions can be found on the Competitive Bidding Implementation Contractor (CBIC) web site, www.dmecompetitivebid.com. Suppliers should review this information prior to submitting their bid(s). CMS will send important bidding updates via e-mail, so all suppliers interested in bidding are urged to sign up for E-mail Updates on the home page of the CBIC website. If you have any questions about the bidding process, please contact the CBIC Customer Service Center at 1-877-577-5331.

The target registration dates for Authorized Officials (AOs) and Backup Authorized Officials (BAOs) to register in CMS’ Individuals Authorized Access to the CMS Computer Services (IACS) system have passed. End Users (EUs), as well as any AOs and BAOs who have not yet registered, should now be registering. Only suppliers that have registered and received a user ID and password will be able to access the on-line bidding system and submit bids. If the AO for your company has not already registered, we cannot guarantee that he or she will be able to complete the registration process before registration closes. If your AO does not register, you cannot bid and will not be eligible for a contract. In addition, suppliers whose AOs have not registered are at risk of experiencing delays in accessing the on-line bidding system to get a bidder number and thereby missing the opportunity to submit financial documents by the CDRD. Registration will close on November 4, 2009 at 9:00 p.m. EST – no AOs, BAOs, or EUs can register after registration closes. Suppliers that do not register cannot bid and are not eligible for contracts. To register, visit the CBIC web site, www.dmecompetitivebid.com.

Please note that the RFB instructions initially posted on the CBIC web site contained target bid submission deadlines, including a target midnight bid deadline. CMS has updated the RFB instructions posted on the CBIC web site to reflect the actual bid submission deadlines shown in this announcement.

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3. New Requirements for Medicare DMEPOS Suppliers – Accreditation/Surety Bonds

If you help people with Medicare get certain medical equipment and supplies, such as oxygen or power wheelchairs, you should know about new requirements for Medicare suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) now in effect that may change the suppliers that Medicare beneficiaries will need to use. CMS is sending notification letters to beneficiaries who may need to change suppliers in order for Medicare to pay for their equipment and supplies. The letter encourages each beneficiary to check with their supplier to make sure that the supplier meets the new requirements. The letter also provides instructions for the beneficiary to find another supplier, if necessary. A copy of the notification letter along with additional information on Medicare’s new accreditation and surety bond requirements for DMEPOS suppliers may be found at http://www.cms.hhs.gov/Partnerships/03_DMEPOS_Toolkit.asp#TopOfPage.

Please forward & distribute to your counselor networks!

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4. Eighth and Final Special Open Door Forum Bidders’ Conference for the Round 1 Rebid of the Medicare DMEPOS Competitive Bidding Program

Centers for Medicare & Medicaid Services

Special Open Door Forum:

Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Bidders’ Conference:

Open Call

Wednesday, November 4, 2009

2:00 pm-3:00 pm Eastern Time

Conference Call Only

Please join us for the eighth and final Special Open Door Forum (ODF) bidders’ conference for the Round 1 Rebid of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program. At this Special ODF, we will respond to prospective bidders’ questions about the competitive bidding process. If you have questions you would like to submit in advance of the ODF, please e-mail them to CMS at cbic.teleconference@PalmettoGBA.com by November 1, 2009.

Reminder: Bidding is open. All bids must be submitted in DBidS, the on-line bidding system, by 9 p.m. prevailing Eastern Time on December 21, 2009; all required hardcopy documents that must be included as part of the bid package must be postmarked by 11:59 p.m. on December 21, 2009. CMS urges all bidders to take advantage of the new covered document review process. Under this new process we will notify suppliers that submit their hardcopy financial documents by the Covered Document Review Date (CDRD) of any missing financial documents. The CDRD for the Round 1 Rebid is November 21, 2009 – financial documents must be postmarked by 11:59 p.m. on November 21, 2009 to qualify for the covered document review process.

Only suppliers that have registered and received a user ID and password will be able to access the on-line bidding system and submit bids. The target registration dates for Authorized Officials (AOs) and Backup Authorized Officials (BAOs) to register in CMS’ Individuals Authorized Access to the CMS Computer Services (IACS) system have passed. End Users (EUs), as well as any AOs and BAOs who have not yet registered, should now be registering. If the AO for your company has not already registered, we cannot guarantee that he or she will be able to complete the registration process before registration closes. If your AO does not register, you cannot bid and will not be eligible for a contract. In addition, suppliers whose AOs have not registered are at risk of experiencing delays in accessing the on-line bidding system to get a bidder number and thereby missing the opportunity to submit financial documents by the CDRD. Registration will close on November 4, 2009 at 9:00 p.m. EST – no AOs, BAOs, or EUs can register after registration closes. Suppliers that do not register cannot bid and are not eligible for contracts. To register and bid, visit the Competitive Bidding Implementation Contractor (CBIC) web site, www.dmecompetitivebid.com.

Background:

The Round 1 Rebid competitive bidding areas (CBAs), product categories, DBidS information, bidder charts, educational materials, and complete RFB instructions can be found on the CBIC web site, www.dmecompetitivebid.com. Suppliers should review this information prior to submitting their bid(s). CMS will send important bidding updates via e-mail, so all suppliers interested in bidding are urged to sign up for E-mail Updates on the home page of the CBIC website. If you have any questions about the bidding process, please contact the CBIC Customer Service Center at 1-877-577-5331.

We look forward to your participation.

Special Open Door Participation Instructions:

Dial: 1-800-837-1935 & Reference Conference ID: 23045924

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 of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning Monday, November 16, 2009.

For Open Door Forum schedule updates, E-Mailing list subscriptions, and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .

Thank you for your interest in CMS Open Door Forums.

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5. October 2009 Quarterly Provider Specific File Update – REVISED

It was discovered that the October 2009 quarterly Provider Specific Files (PSF) SAS data files were missing data. They have been revised and are now available on the CMS website at: http://www.cms.hhs.gov/ProspMedicareFeeSvcPmtGen/04_psf_SAS.asp in the Downloads section. If you use the Provider Specific SAS File data, please go to the page above and download the latest version of the PSF Files. Note: These are the quarterly data sets for the Provider Specific Data for Public Use in SAS Format.

It was also discovered that the October 2009 quarterly Provider Specific Files (PSF) Text data files were missing data. They have been revised and are now available on the CMS website at: http://www.cms.hhs.gov/ProspMedicareFeeSvcPmtGen/03_psf_text.asp in the Downloads section. If you use the Provider Specific Text File data, please go to the page above and download the latest versions of the PSF Files. Note: These are the quarterly data sets for the Provider Specific Data for Public Use in text format.

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6. Protect your patients and yourself from influenza: Get Vaccinated!

Protect your patients and yourself from influenza: Get Vaccinated!

This year the CDC recommends seasonal and 2009 monovalent H1N1 influenza vaccination for all healthcare workers because of their critical role in the health care system and their increased risk of exposure to patients with influenza, as well as concern about transmission of the viruses to susceptible patients. The 2009 H1N1 monovalent influenza vaccine is made in the same way as seasonal flu vaccine, which has a very good safety track record. Preliminary data suggest that the immunogenicity and safety of these vaccines are similar to those of seasonal influenza vaccines

Seasonal influenza vaccination among healthcare personnel reduces the flu-related mortality risk among patients at highest risk of severe illness. Despite the documented benefits of healthcare worker vaccination, seasonal influenza vaccine coverage in past seasons among this group has remained low (<50%) nation-wide. Influenza outbreaks in hospitals and long-term care facilities have been associated with low vaccination rates among healthcare workers, while higher vaccination levels among staff are associated with a lower incidence of nosocomial influenza cases. More information on locating 2009 monovalent H1N1 and seasonal vaccine, priority groups for vaccination, and vaccine safety is located at www.flu.gov. The most effective way to protect yourself and your patients from flu is to be vaccinated. It’s up to you! ~~~~~~~~~~~~~~~~~~~~ 7. Your October Flu Message Flu Season is upon us! CMS encourages providers to begin taking advantage of each office visit to encourage your patients with Medicare to get seasonal flu shots. Flu shots are their best defense against combating flu this season. And don’t forget—health care workers also need to protect themselves. Medicare provides coverage of the flu vaccine without any out-of-pocket costs to the Medicare patient as a part B benefit. No deductible or copayment/coinsurance applies. Note that influenza vaccine is NOT a Part D covered Drug. For more information about Medicare’s coverage of the seasonal influenza vaccine and its administration, as well as related educational resources for health care professionals, please go to http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp on the CMS website. For information on Medicare policies related to H1N1 influenza, please go to http://www.cms.hhs.gov/H1N1 on the CMS website. Additional information can also be found in the attached “Weekly H1N1 Influenza Bulletin.” ~~~~~~~~~~~~~~~~~~~~ 8. New from the Medicare Learning Network® · The Medicare Learning Network’s Diabetes-Related Services Brochure, which provides an overview of Medicare’s coverage of diabetes screening tests, diabetes self-management training, medical nutrition therapy, and supplies and other services for Medicare beneficiaries with diabetes, has been newly revised and updated. It is now available on the Medicare Learning Network in a downloadable, printable format at the following address: http://www.cms.hhs.gov/MLNProducts/downloads/DiabetesSvcs.pdf . A printed hardcopy version will be available at a later date. For more products related to Medicare-covered preventive services, please visit our preventive services educational products website at: http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp · The following revised publications are now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network: § The Medicare Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals (October 2009) offers general information about the Medicare Program, how to become a Medicare provider or supplier, Medicare reimbursement, Medicare payment policies, evaluation and management services, protecting the Medicare Trust Fund, inquiries, overpayments, and fee-for-service appeals. This publication can be accessed at http://www.cms.hhs.gov/MLNProducts/downloads/physicianguide.pdf . § The Facilitator’s Guide: Companion to Medicare Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals (October 2009) includes all the information and instructions necessary to prepare for and present a Medicare Resident, Practicing Physician, and Other Health Care Professional Training Program including instructions for facilitators, customization guide, a PowerPoint presentation with speaker notes, pre- and post-assessments, master assessment answer keys, and a course evaluation tool. This publication can be accessed at http://www.cms.hhs.gov/MLNProducts/Downloads/facilitators_guide.zip . · Recent MLN Matters articles of particular interest: SE0922 – Alternative Process for Individual Eligible Professionals to Access Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Feedback Reports CMS has created an alternative process that individual EPs may use to request 2007 Re-Run and 2008 PQRI feedback reports based on their individual NPI. For more information, please see the article located at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0922.pdf on the CMS website. ~~~~~~~~~~~~~~~~~~~~ 9. Extra Help for Beneficiaries Paying for Prescription Drugs Do You Know Someone Who Is Having Trouble Paying For Prescription Drugs? Medicare Can Help! If an individual has limited income and resources, they may qualify for extra help from Medicare. It could be worth over $3,300 in savings on prescription drug costs per year.
Encourage people with Medicare to file for Extra Help online: https://s044a90.ssa.gov/apps6z/i1020/main.html or by calling Social Security at 1-800-772-1213 to apply over the phone.
State Health Insurance Information Program (SHIP) offices can assist with the application. Find contact information for a local SHIP Counselor at http://www.medicare.gov/contacts/static/allStateContacts.asp or by calling
1-800-MEDICARE.

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Lucretia James

Division for Medicare Health Plans Operations
Centers for Medicare & Medicaid Services
Region VIII
1600 Broadway, Suite 700
Denver, CO 80202
(303) 844-1568
lucretia.james@cms.hhs.gov

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