April 2018
Mailing schedule for new Medicare card; Colorado scheduled for after June 2018

Beginning in April 2018, the Centers for Medicare & Medicaid Services will mail new Medicare cards to all people with Medicare on a flow basis by geographic location and other factors. Additional details on timing will be available as the mailings progress.

Mailing Schedule

April - June 2018
Jurisdiction L - Pennsylvania, Maryland, Delaware and the Washington D.C. Metro Area (Arlington and Fairfax counties in Virginia, the city of Alexandria, VA, the District of Columbia, and Montgomery and Prince George's counties in Maryland)

After June 2018
Jurisdiction L - New Jersey; Jurisdiction H - Colorado, Oklahoma, New Mexico, Texas, Arkansas, Louisiana, Mississippi, Indian Health Service (IHS) and Veterans Affairs (VA).

For more information, please reference this article.

Prior authorization: A threat to medicine; opportunity to comment

To most practice managers, the words "prior authorization" conjures up wasted time spent jumping through unnecessary hoops imposed by insurers to ensure that patients get the medications the physicians prescribe and patients need.

A   recent survey   found that physicians complete an average of 29 prior authorizations per week, spending the equivalent of approximately two business days (14.6 hours)* on administrative hassles to receive approvals from health insurance companies and pharmacy benefit managers (PBMs).

If an insurance plan covers a treatment that would benefit your patient, you shouldn't have to waste time ensuring access to it. That's why the Physicians' Grassroots Network recently launched a new page dedicated to   prior authorization .  As you navigate the page, you'll learn how prior authorization is driving a wedge between physicians and patients. If you have personal experience with this issue, please consider joining the thousands who have already shared their voice on this issue.

Help us get the word out about this flawed process and how it threatens patient care and your ability to practice medicine. Together, we can make prior authorization a thing of the past.    Share your story now!
HCPF update: Temporary timely filing extension

The Department of Health Care Policy & Financing (the Department) has recognized that some providers have had difficulties submitting claims during the transition to the new claims payment system, the Colorado interChange. In an effort to ensure providers are appropriately paid for services, the department is extending the temporary timely filing extension.

Though HCPF previously stated that the 240-day timely filing extension would expire on May 1, 2018, the department announced on April 12 that they will continue applying the 240 calendar day timely filing limit after May 1, 2018, until further notice.

Further information on filing can be found in the General Provider Information Billing Manual.
COQPP Fast Facts in 5 Minutes - April

1. Important info: The federal CMS releases 2018 MIPS Eligibility Tool!
Do you know if you're eligible for 2018 MIPS Participation? Check out the MIPS Participation Lookup Tool that has been updated with 2018 eligibility status for the first determination period. Changes to Low-Volume Threshold (LVT) status incorporated into this status. You are excluded from 2018 MIPS if:
  • Billed $90,000 or less Medicare Part B allowed charges OR
  • Furnished covered professional services under PFS to 200 or fewer beneficiaries
2. MIPS Final Score Status
The federal CMS is in the process of calculating the MIPS Final Score and payment adjustment based on your last submission or submission update.

Final score and feedback report with the payment adjustment will be available on July 1 through the Quality Payment Program website

Sign in to view your preliminary feedback between now and June 30. This is not your final score and may change based on the following:
  • Special Status Scoring Considerations (ex. Hospital-based Clinicians)
  • All-Cause Readmission Measure for the Quality Category
  • Claims Measures to include the 60-day run out period
  • CAHPS for MIPS Survey Results
  • Advancing Care Information Hardship Application status
  • Creation of performance period benchmarks for Quality measures that didn't have a historical benchmark
3. CMS Web Interface and CAHPS for MIPS Survey Group Registration opened
Registration will be open 4/1 - 6/30/2018. The CMS Web Interface is available to groups of 25 or more eligible clinicians. We anticipate a CMS Web Interface Submission fact sheet soon. Stay tuned!

4. 2018 Fact Sheets have been released! 
Check out the CMS Resource Library to see them!

5. Want to know what the 2018 Approved Alternative Payment Models are? 
Learn more here
New medical staff resource for identifying disruptive behavior

In response to a directive from the House of Delegates (Resolution 012, A-17), the American Medical Association (AMA) has created a new resource to help medical staffs address disruptive physician behavior.  Now available in the AMA Education Center, this free 30-minute learning module  shows physicians how to define appropriate, inappropriate, and disruptive behavior, presents guidelines for dealing with these behaviors in a fair manner, and provides users with their own downloadable copy of the AMA Model Medical Staff Code of Conduct that they can integrate into their medical staff bylaws.
National Drug Take Back Day - April 28 

National Prescription Drug Take Back Days, organized by the Drug Enforcement Administration (DEA)   can be an easy, collaborative activity to join. Many Americans are not aware that medicines that linger in home cabinets are highly susceptible to diversion, misuse, and abuse --  with more than 50 percent of people who misuse prescription painkillers gaining access to them through a friend or relative . Help support this event by promoting it to your patients. 

Take Back Day will happen nationally on April 28 from 10 a.m. to 2 p.m., and many Colorado communities have permanent take-back drop boxes for prescription medications. Find more information and drop box locations at TakeMedsBack.org. 
Free resources to reduce opioid risk - National Security Council  

The National Security Council has created warn-me labels and prescription drug disposal envelopes to limit the risk from opioids. To find out more, please visit  www.stopeverydaykillers.org . The Stericycle Seal&Send Envelope are DEA-compliant 8"x12" envelopes designed to hold up to 8 oz. of medication, of which 4 oz. may be liquid in a sealed container.

Stericycle will destroy the medication using a process that is secure and safe for the environment. Envelopes are U.S. postage-paid, pre-addressed and include complete instructions.  
Telligen webinar series: Practical Strategies to Combat Opioid Harm

Join Telligen on Thursdays in April at 11 a.m. MT to explore resources to combat opioid harm. Topics will include opioid prescribing, treatment, education, tools, Prescription Drug Monitoring Programs (PDMP), risk screening and more.
 
Telligen QIN-QIO Medication Safety Program Manager Katy Brown, PharmD, will discuss how each topic applies to various clinicians, patients, community members and caregivers and show participants where to access these resources, what they look like, how to use them and offer suggestions for their use. You must register individually for each event. Register here!
 
April 19, 2018
Part 3: Prescription Drug Management Programs (PDMPs), Health Information Exchanges (HIEs), Electronic Health Records (EHRs), Urine Drug Testing & Pain Contracts
 
April 26, 2018
Part 4: Skilled Nursing Facility Readmission Measure (SNFRM), Quality Payment Program (QPP), Medication Management and Opioid Initiative (MMO), Quality Improvement (QI) Tools, Stigma, Harm Reduction & Alternatives, Wrap-Up 
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