Medicare and Medicaid Services……………

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Hello Everyone,
Please enjoy the information contained in this edition of Frontier Focus. Please be sure to share it with your members, colleagues, providers and office billing staff. Thank you for your continued efforts to broadcast Medicare information to the providers in Region VIII.

Table of Contents

1. CMS Caregiver Events

2. CMS Caregivers Initiative Invitation

3. CMS – NFI September 17, 2008 Broadcast Website: Innovative Employer Caregiving Programs

4. Urgent News Regarding the Medicare Learning Network

5. NPPES User Maintenance Tips

6. 2009 Competitive Acquisition Program (CAP) Postponement Announcement

7. Medicare Part B Drug Competitive Acquisition Program (CAP): “Ask-the-Contractor” Teleconference – CAP Postponement for 2009

8. Medicare Part B Drug Competitive Acquisition Program (CAP): “CAP Physician Billing Tips” Handout for Submitting CAP Claims Now Available

9. Medicare Part B Competitive Acquisition Program (CAP) for Drugs and Biologicals: October 2008 CAP Drug List Update

10. Announcement of New Fee-for-Service Provider Partnership Email Archive System

11. Third Quarter 2008 Hospital OPPS Pricer Downloads

12. Response to FQHC Question Raised on the 9/3/08 Special Open Door Forum on DMEPOS Accreditation – MIPPA 2008 Guidance

13. Flu Shot Reminder (yes, it’s that time of the year again!)

14. New From the Medicare Learning Network

15. Extra Help for Beneficiaries Paying for Prescription Drugs

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1. CMS Caregiver Events

There are two very important caregiver events that CMS is hosting the week of September 15.
On September 17, CMS will host a satellite broadcast entitled “Innovative Employer Caregiving Programs” that will provide employers, caregivers and human services professionals with information about successful programs for employed caregivers. The broadcast is from 1:00-2:00 pm ET. To register and find out more about the broadcast, go to: http://www.blsmeetings.net/caregivers/
On September 18, CMS will launch the Caregiver initiative with an e-launch at 12:00 pm ET. Following the live webcast, the webpage will go live on medicare.gov. To register for this event and sign up for the newsletter (and please encourage partners and caregivers to register as well), please go to www.medicare.gov/caregivers
Please help us to broaden the community of caring, and share information about both of these broadcasts with partners, members, and those who are caregivers.
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2. CMS Caregivers Initiative Invitation

Below you will find your invtation to the e-launch of the CMS Caregiver Initiative: Ask Medicare. This launch will be a webcast on September 18, and 12 p.m. ET. We’re asking you to do three things:
Click on the link in the invitation below and register for the e-launch. You can watch from your computer.
Forward the invitation (don’t cut/paste) to your association members and invite them to also register, and to likewise push out the invitation.
Consider submitting a question to be answered during the launch, and encourage your partners and their constituents to do so as well.
Thanks to everyone – we’re building a community of caring, and each of you are part of the conversation.

View this email in your browser

Connecting Caregivers to Medicare ResourcesThursday, September 18, 200812:00 – 1:00 pm ETLive Webcast*
· Learn about new online resources for caregivers
· Post questions to CMS Acting Administrator Kerry Weems and a panel of experts online
· Sign up for the Ask Medicare bi–monthly e–newsletter
Broadcast from The Newseum in Washington, DC*This event is only accessible via the Webcast

Once you RSVP, you will receive details for accessing the Webcast.
Please share the news about this exciting event by sending this link to colleagues and friends.

Please contact us atcaregiver@cms.hhs.gov
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3. CMS – NFI September 17, 2008 Broadcast Website: Innovative Employer Caregiving Programs

The next Caregiving broadcast sponsored by the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services New Freedom Initiative Subcommittee (NFI) is scheduled for September 17, 2008, from 1:00 p.m.—2:00 p.m. (Eastern Time).

The broadcast will focus on Innovative Employer Caregiving Programs and include presentations from employers and other organizations that have developed and conducted successful programs for employed caregivers. Presenters will discuss their experience with these programs and how they can be replicated by others to help employed caregivers.

If you are an Employer looking to expand or create services and programs to support your employed caregivers, a Caregiver working full or part-time and caring for a loved one, an Organization that provides caregiver services, or any one else with an interest in Caregiving, please make plans now to join us on September 17th.

To learn more about the broadcast or to register as an individual viewer or as a host viewing site, please go to: http://www.blsmeetings.net/caregivers/ .

We ask that you help publicize this event and hope you can join us for what promises to be a very informative discussion.
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4. Urgent News Regarding the Medicare Learning Network

The Medicare Learning Network’s (MLN) Learning Management System (LMS) that hosts our web-based training courses and product ordering page will be unavailable for a period of approximately 7 to 10 days starting the week of September 22, 2008 while we perform system maintenance and upgrades. If you need MLN products or need to complete a web-based training course within this time frame, it is recommended that you do so before September 17, 2008.Thank you for your interest in the Medicare Learning Network. If you have any questions, please send them to MLN@cms.hhs.gov .
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5. NPPES User Maintenance Tips

NPPES – Keeping It Safe and Keeping it Updated
This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES). The Centers for Medicare & Medicaid Services (CMS) recommends that each health care provider, including individual physicians and non-physician practitioners:

Know and maintain their NPPES User Ids and passwords.

Reset their NPPES passwords at least once a year. See the NPPES Application Help page regarding the ‘Reset Password’ rules. Those rules indicate the length, format, content and requirements of NPPES passwords.

Review their NPPES records in order to ensure that the information reflects current and correct information.

Maintaining NPPES Account Information for Safety and Accessibility
Health care providers, including physicians and non-physician practitioners, should maintain their own NPPES account information (i.e., User ID, Password, and Secret Question/Answer) for safety and accessibility purposes.

Viewing NPPES Information
Health care providers, including physicians and non-physician practitioners, can view their NPPES information in one of two ways:

(1) By accessing the NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created. *

* If the health care provider has forgotten the password, enter the User ID and click the “Reset Forgotten Password” button to navigate to the Reset Password Page. If the health care provider enters an incorrect User ID and Password combination three times, the User ID will be disabled. Please contact the NPI Enumerator at 1-800-465-3203 if the account is disabled or if the health care provider has forgotten the User ID.

OR

(2) By accessing the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do. The NPI Registry gives the health care provider an online view of Freedom of Information Act (FOIA)-disclosable NPPES data. The health care provider can search for its information using the name or NPI as the criterion.

Updating NPPES Information
Health care providers, including physicians and non-physician practitioners, can correct, add, or delete information in their NPPES records by accessing their NPPES records at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.

Please note: Required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information. Certain information is inaccessible via the web, thus requiring the change/update to be made via paper application. The paper NPI Application/Update Form can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.

Need More Information?
Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. Having trouble viewing any of the URLs in this message? If so, try to cut and paste any URL in this message into your web browser to view the intended information.

Note: All current and past CMS NPI communications are available by clicking “CMS Communications” in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage.
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6. 2009 Competitive Acquisition Program (CAP) Postponement Announcement

The Centers for Medicare & Medicaid Services (CMS) today announced the postponement of the 2009 Medicare Part B Competitive Acquisition Program (CAP). The program will continue through December 31, 2008.

Earlier this year, CMS accepted bids for vendor contracts for the 2009-11 CAP. While CMS received several qualified bids, contractual issues with the successful bidders resulted in CMS postponing the 2009 program. As a result, CAP physician election for participation in the CAP in 2009 will not be held, and CAP drugs will not be available from an approved CAP vendor for dates of service after December 31, 2008.

Later this fall, CMS will provide additional guidance for participating CAP physicians on how to transition out of the program. This information will be posted on the CMS CAP physician’s page at: http://www.cms.hhs.gov/CompetitiveAcquisforBios/02_infophys.asp

CMS also plans to seek feedback on the CAP from participating physicians, potential vendors, and other interested parties. CMS will assess the information and consider implementing changes to the CAP before proceeding with another bid solicitation. As part of the process, CMS is interested in hearing from the public about a range of issues, including, but not limited to, the categories of drugs provided under the CAP, the distribution of areas that are served by the CAP, and procedural changes that may increase the program’s flexibility and appeal to potential vendors and physicians.

Information about how to submit comments will be available at: http://www.cms.hhs.gov/CompetitiveAcquisforBios/
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7. Medicare Part B Drug Competitive Acquisition Program (CAP): “Ask-the-Contractor” Teleconference – CAP Postponement for 2009

On September 10, 2008, the Centers for Medicare & Medicaid Services (CMS) announced the postponement of the 2009 Medicare Part B Competitive Acquisition Program (CAP). As a result, CAP physician election for participation in the CAP in 2009 will not be held, and CAP drugs will not be available from an approved CAP vendor for dates of service after December 31, 2008.
To discuss this major change to the CAP for 2009 and assist participating CAP physicians in planning for the transition out of the CAP, an “Ask-The-Contractor” teleconference for participating CAP physicians will be hosted by the CAP designated carrier, Noridian Administrative Services (NAS). NAS staff will be available to respond to inquiries during a question and answer session after the presentation. This call is intended for all interested providers and their staff.
Use the following information to participate on the call:
Date: September 18, 2008 at 2:00PM CST
Domestic U.S. Dial In Number: 800-230-1085
U.S. Territories Dial In Number: 612-332-0923
A PowerPoint slide presentation to accompany the “Ask-the-Contractor” teleconference will be posted on the NAS website at: (https://www.noridianmedicare.com/cap_drug/train/act.html). The slides will be available at least one day prior to the teleconference.
Additional information about the postponement is available on the CMS CAP website (http://www.cms.hhs.gov/CompetitiveAcquisforBios/.)
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8. Medicare Part B Drug Competitive Acquisition Program (CAP): “CAP Physician Billing Tips” Handout for Submitting CAP Claims Now Available

An updated version of the “CAP Physician Billing Tips” handout is now available. This reference contains information on the claims submission requirements for the CAP such as the CAP modifiers and other necessary elements. A copy of this document is available on the ‘Information for Physicians’ page on the CMS CAP website at: http://www.cms.hhs.gov/CompetitiveAcquisforBios/02_infophys.asp
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9. Medicare Part B Competitive Acquisition Program (CAP) for Drugs and Biologicals: October 2008 CAP Drug List Update

The list of drugs available under the CAP has been updated and is now available in the ‘Downloads’ section on the CMS CAP “Information for Physicians” page at: (http://www.cms.hhs.gov/CompetitiveAcquisforBios/02_infophys.asp).

The following drug has been added to the CAP effective October 1, 2008: Vivitrol® naltrexone (J2315).
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10. Announcement of New Fee-for-Service Provider Partnership Email Archive System

Effective September 1, 2008, CMS is pleased to announce the Medicare Fee-for-Service Provider Partnership email archive has been updated to make searching for provider partnership messages easier.

To access the new Provider Partnership email archive system, visit http://www.cms.hhs.gov/FFSProvPartProg/EmailArchive/list.asp on the CMS website and click on the Provider Partnership email archive tab. Once on the provider partnership email archive page, you can search for messages by date, subject, or audience.
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11. Third Quarter 2008 Hospital OPPS Pricer Downloads

The Third Quarter 2008 Hospital OPPS Pricer Downloads have been updated. You may go to (http://www.cms.hhs.gov/PCPricer/08_OPPS.asp) to view the latest update.
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12. Response to FQHC Question Raised on the 9/3/08 Special Open Door Forum on DMEPOS Accreditation – MIPPA 2008 Guidance

DME is not covered within the Medicare Federally Qualified Health Clinic (FQHC) benefit. All FQHC’s would need to have a DMEPOS supplier number in order to bill for those separately, and go through the same process as any other DME supplier. Thus, all FQHC’s billing for the products covered under the DME quality standards would be subject to the accreditation deadline of September 30, 2009 in order to continue to bill for these supplies. If you would like a list of those supplies, please go to the website at: www.cms.hhs.gov/medicareprovidersupenroll there is a link on the upper left hand side of the page for DMEPOS Accreditation. Once in that site, you will find the 10 accreditation organizations, the quality standards and a Fact Sheet listing all of the covered items.
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13. Flu Shot Reminder (yes, it’s that time of the year again!)

Flu Season Is Coming! It’s not too early to start vaccinating as soon as you receive vaccine. Encourage your patients to get a flu shot as it is still their best defense against the influenza virus. (Medicare provides coverage of the flu vaccine without any out-of-pocket costs to the Medicare patient. No deductible or copayment/coinsurance applies.) And don’t forget, health care workers also need to protect themselves. Get Your Flu Shot. – 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 virus vaccine and its administration as well as related educational resources for health care professions and their staff, please go to http://www.cms.hhs.gov/MLNProducts/Downloads/flu_products.pdf on the CMS website. To order, free of charge, a quick reference chart on Medicare Part B Immunization Billing go to http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident=kc0001&loc=5 on the CMS website.
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14. New From the Medicare Learning Network

The CMS Form 1500 Web-based Training (WBT) course has been updated (July 2008) and is now available from the Centers for Medicare & Medicaid Services Medicare Learning Network. This WBT course provides information that will allow you to file Medicare Part B claims accurately and reduce your chances of receiving unprocessable rejections.
To access this WBT, visit http://www.cms.hhs.gov/mlngeninfo/ , scroll down to “Related Links Inside CMS” and select “Web-based training Modules”, scroll down to “Office Management Information” to select this training.
# # # # #
Just another reminder that the Medicare Learning Network’s (MLN) Learning Management System (LMS) that hosts our web-based training courses and product ordering page will be unavailable for a period of approximately 7 to 10 days starting the week of September 22, 2008 while we perform system maintenance and upgrades. If you need MLN products or need to complete a web-based training course within this time frame, it is recommended that you do so before September 17, 2008.Thank you for your interest in the Medicare Learning Network. If you have any questions, please send them to MLN@cms.hhs.gov .
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15. 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
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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