Volume 5 | May 2018
CMS Encourages Eligible Suppliers to Participate in Expanded Medicare Diabetes Prevention Program Model
Nationally expanded performance-based payment model now enrolling service suppliers

The Centers for Medicare & Medicaid Services (CMS) in April expanded the Medicare Diabetes Prevention Program (MDPP), a national performance-based payment model offering a new approach to type 2 diabetes prevention in eligible Medicare beneficiaries with an indication of pre-diabetes.

CMS Announces Agency’s First Rural Health Strategy
Today, the Centers for Medicare & Medicaid Services (CMS) released the agency’s first Rural Health Strategy intended to provide a proactive approach on healthcare issues to ensure that the nearly one in five individuals who live in rural America have access to high quality, affordable healthcare.

Medicare Beneficiary Identifier (MBI)
Look-up Tool
Medicare Beneficiary Identifier (MBI) Look-up Tool: Palmetto GBA's new Medicare Beneficiary Identifier (MBI) tool is now available in eServices for providers to obtain patients' MBI numbers. CMS offers a transition period from April 1, 2018 through December 31, 2019, during which the system will accept both HICNs and MBIs. Providers should not submit both numbers on the same transaction. For more information, please read this article.
Providers are required to determine whether Medicare is a primary or secondary payer for each inpatient admission of a Medicare beneficiary and outpatient encounter with a Medicare beneficiary prior to submitting a claim to Medicare. Providers are also required to review the Common Working File (CWF) prior to submitting a claim to Medicare. READ MORE
Multi-Factor Authentication (MFA) Codes Are Usable for up
to Eight Hours
Providers are able to use their MFA codes for up to eight hours! This allows providers to simply reuse the last valid code issued. MFA codes will expire eight hours from the time it was requested or when a new MFA code is generated.

Note: Providers will still have the ability to request a new MFA code in the event another one is needed.
Re-elect Senator Ron Stollings, MD
2018 Kanawha Blvd., E, Charleston WV 25311 (WVSMA Headquarters)

05/21/18 6:00pm - 05/21/18 8:00pm

I'll be there!
I cannot attend.
Contact me for a donation.
2018 Healthcare Summit & Annual Business Meeting at the Greenbrier! August 24-25, 2018. REGISTRATION IS OPEN

Appalachian Addiction & Prescription Drug Abuse Conference,
October 18-20, 2018 at the Embassy Suites, Charleston, WV
Dr. Barbe answers your 2018 Quality Payment Program questions
Medicare’s payment incentive program can be confusing, and what you learned in 2017 may not be transferable in 2018. The AMA’s president clears the air. READ MORE.
If you are a provider and you have a health reimbursement arrangement member, you now have the opportunity to promote efficiency and reduce your collection costs by utilizing WebAccounts. READ MORE
Did You Know?
The Health Plan has registered nurses that are certified case managers to coordinate health care services for members READ MORE
West Virginia Rx Card Helps Patients Fill Their Prescriptions
West Virginia State Medical Association (WVSMA) in partnership with West Virginia Rx Card reminds physicians that patients who are not insured or who take prescription drugs that are not covered by their health insurance plans, can use the West Virginia Rx Card to obtain discounts of up to 75 percent off the retail price for FDA-approved medications.

West Virginia Rx Card has been working closely with WVSMA, as well as numerous clinics and hospitals around the state to distribute free discount prescription cards so that all West Virginia residents will have access to this free program. The program can also be used by people that have health insurance coverage with no prescription benefits, which is common in many health savings accounts (HSA) and high deductible health plans. 

West Virginia Rx Card is a proud supporter of Children’s Miracle Network and its network of CMN hospitals across the country. A donation will be made to your local CMN Hospital each time a prescription is processed using this Rx savings program.

Please help by encouraging your patients to print a free West Virginia Rx Card at the WVSMA website or at www.westvirginiarxcard.com. West Virginia Rx Card also has an available app for your iPhone and Android phones. You can visit “ Free Rx iCard” in the app store and select “West Virginia” in the drop-down box. Any physicians who are interested in ordering free cards for their clinic/hospital can email Stacy Miller, via email at smiller@westvirginiarxcard.com or by phone at 888-808-0099.
New Highmark Provider Manual Now Available!
Locum Tenens Process Change to Take Effect June 1, 2018
Effective June 1, 2018, Highmark will no longer accept locum tenens forms. READ MORE
Effective June 12, 2018, Express Scripts®, the company that processes Highmark drug claims, will implement state prescriptive authority logic within their pharmacy claim processing system. This implementation is phase one of the three-phased initiative that will ensure all applicable Highmark regions, as well as all states, are in compliance with Federal law and applying specific prescriptive state authority.  READ MORE
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