AUCH - [ Health Care News ]

COMMUNITY HEALTH CENTERS

Funding
Electronic Health Record Demonstration Project

HHS Secretary Invites Communities to Apply for An
Innovative Electronic Health Record Demonstration Project

Use of EHRs Can Improve the Quality of Health Care and Reduce Errors

Health and Human Services (HHS) Secretary Michael Leavitt called on community leaders across the country to collaborate and apply for a new demonstration project that provides Medicare incentive payments to physicians for the use of certified electronic health records to improve patient care. The project, which will be open to small- and medium-sized primary-care physician practices, is expected to reduce medical errors and improve the quality of care for an estimated 3.6 million Americans.

This initiative is also part of HHS’ bold vision for health care reform built on the four cornerstones of value-driven health care, and a major step toward the President’s goal of most Americans having access to a secure, interoperable electronic health record by 2014.

“Communities have a tremendous opportunity to help transform health care delivery starting at the local level,” Secretary Leavitt said. “Broad adoption of interoperable electronic health records has the potential not only to improve the quality of care provided, but also to change the way medicine is practiced and delivered.”

Over a five-year period, financial incentives will be provided to as many as 1,200 physician practices that use certified electronic health records to improve quality as measured by their performance on specific clinical quality measures. In addition to the incentive payments, bonus payments may be awarded based on a standardized survey measuring the number of EHR functionalities a physician group has incorporated into its practice. Total payments under the demonstration for all five years may be up to $58,000 per physician or $290,000 per practice. On average, it is expected that approximately $3.5 million in incentive payments will be made to participating physician practices in each of the 12 sites under this demonstration.

“By implementing this demonstration project in a dozen health markets across the country, we’ll help move this nation toward a system that delivers better quality health care at lower cost for more Americans,” Kerry Weems, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS) said.

The application period is open now through early May for communities interested in becoming one of the pilot program’s 12 sites. CMS expects that the demonstration will start with four communities in 2008, with the remainder beginning in 2009. Once communities have been selected, CMS will begin working with the communities to recruit physician practices for participation in the demonstration.

For more information about the EHR demonstration project, visit http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1204776

Current RESOURCES
2007-2008 Influenza Season Educational Products and Resources - this PDF document includes links to influenza-related educational products developed by CMS for provider use and links to other online resources where clinicians may find useful information and tools for the 2007-2008 flu season.

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HEALTH POLICY

Health Care Marketplace
Health Insurers Work To Address Issues Involving Retroactively Canceled Policies

Capitol Hill Watch
Democratic Governors Call on Congress To Block Bush Administration Rules That Would Make It Harder for States To Expand SCHIP

Congressional Democrats Might Use Budget Reconciliation Process To Pass Medicare Bill

Senate Approves Legislation That Would Reauthorize, Overhaul Indian Health Care Improvement Act

AdvaMed Offers Qualified Support for Bill To Require Disclosure of Payments From Medical Device Companies to Physicians

State watch
New York City Launches EHR System

Opinion
Opinion Pieces Address Issues Related to Health Care Reform

San Francisco Chronicle Opinion Pieces Discuss Issues Related to Medicare

Health Insurance Does Not Equal Health Care, Opinion Piece Writes

Reports
JAMA Commentaries Discuss Role of Costs in Overhauling U.S. Health System, Implementing Effective EHR Systems

Medicare News
Acting CMS Administrator Weems Outlines Medicare Physician Quality Reporting Program Participation Rates

Effective March 1, 2008, when required for Medicare claim submission, all 837P and CMS-1500 claims must have an NPI or NPI/legacy pair in the required primary provider fields. Failure to include an NPI will cause the claim to reject.
Visit the CMS NPI web page at http://www.cms.hhs.gov/NationalProvIdentStand/02_WhatsNew.asp
for more details.

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 call 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 call
1-800-MEDICARE.

The Medicare Billing Information for Rural Providers, Suppliers, and Physicians, which consists of charts that provide billing information for Rural Health Clinics, Federally Qualified Health Centers, Skilled Nursing Facilities, Home Health Agencies, and Critical Access Hospitals, is now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/RuralChart.pdf

New Medicare Learning Network (MLN) Products are now available on the topic of Individuals Authorized Access to CMS Computer Services - Provider Community (IACS-PC).

CMS will soon be offering the Provider Enrollment, Chain and Ownership System (PECOS) and Provider Statistical and Reimbursement Report (PS&R) online. These new online enterprise applications will allow Medicare fee-for-service providers to access, update, and submit enrollment and cost report information over the Internet. Providers and/or appropriate staff must register for access through a new CMS security system known as the Individuals Authorized Access to CMS Computer Services - Provider Community (IACS-PC). CMS urges FFS providers to read the series of MLN Matters articles on this subject and act now. They can be accessed at the following urls:

http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0747.pdf

http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0753.pdf

http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0754.pdf

There is another product available on the Medicare Learning Network website that contains Steps to Accessing CMS Enterprise Applications for Provider Organizations. The fact sheet/chart can be accessed at the following url: http://www.cms.hhs.gov/MLNProducts/downloads/IACSchart.pdf

Medicaid News
Important update - A notification came this afternoon from the HDMA outside counsel indicating NACDS/NCPA has been successful in their efforts to obtain a preliminary injunction to prevent implementation of the AMP rule. In a motion hearing in the NACDS/NCPA v. HHS et al. case, Judge Lamberth held that NACDS/NCPA established irreparable injury. All parties are to submit proposed orders by the close of business Tuesday, and Judge Lamberth is set to issue the order sometime Wednesday. It is not clear at this point whether the Government intends to appeal the order, and when it would do so (the Government has 60 days to appeal).

This is a great victory for American Pharmacist Association which has been concerned that inadequate product reimbursement and pharmacist compensation under the new rule may limit patient access to medications and pharmacist services. “The formula doesn’t work, and we need to ensure that patients don’t suffer as a result,” said APhA Executive Vice President and CEO John A. Gans, PharmD.
We will follow closely to watch for appeals over the next sixty days. Additional information will undoubtedly be coming soon.

Background - The Deficit Reduction Act of 2005 (DRA) was the impetus for CMS to change their compensation formula. The new rule would calculate the federal upper limit (FUL) at 250% of the average manufacturer price (AMP). FUL, the maximum amount the federal government will pay to states for generic drugs dispensed through Medicaid, had previously been based on the average wholesale price (AWP) of drugs.

HHS Approves Medicaid Waiver for Low-Income Indiana Residents To Use Health Savings Accounts

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