College Graduate - How does health reform help me?

Uploaded by eHealthInsurance on Jun 1, 2010
This video outlines how health reform helps people who are graduating college. Starting in 2014, health reform will require everyone to buy health insurance and provide tax subsidies to help people with qualifying low-incomes cover the cost of health insurance. Beginning in the Fall of 2010, young people under the age of 26 will have the option to stay on their parents health insurance plan, or to take advantage of new consumer protections in the non-group / individual health insurance market. Although these types of plans already exist in many states, starting in 2014, young people will also have the option to buy additional new, low-cost, catastrophic health coverage with high deductibles to cover the cost of a major illness or injury.




____________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!

Click for more information: https://www.sendoutcards.com/129125/


Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

MMSEA 111 What's New

This section will provide an at-a-glance listing of new information, updates and changes to the MMSEA111 web page.

Important Note: To comment or make inquiry regarding a Mandatory Insurer Reporting document and/or posting, please utilize the designated mailbox only. PL110-173SEC111-comments@cms.hhs.gov.



August 9, 2011

Please note the following information for the August 10, 2011 Policy & Technical and Health Reimbursement Accounts (HRA)Teleconference:

•The call in number for the August 10, 2011 Policy & Technical Call is: (800) 603-1774; The pass code is: SECTION 111
This information will also be posted on the GHP section page.

August 1, 2011

The following town hall teleconferences have been scheduled. The notice and agenda containing the call in information will be posted ont he GHP and NGHP section pages.

•August: GHP Technical/Policy – 8/10; NGHP Policy – 8/24
GHP Unsolicited Alerts coming in September

•September: GHP HRA – 9/7; NGHP Technical – 9/21
GHP and NGHP TIN Validation coming in October

•October: GHP Technical/Policy –10/5; NGHP Policy – 10/19
GHP and NGHP Tin Validation requirements are now operational
___________________________________________________________
How To Get All The Patient Referrals You Can Handle!!! As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.


How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!


Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Reporting a WC case and Obtaining Conditional Payment Information

All Workers' Compensation (WC) occurrences that involve a Medicare beneficiary should be reported to the Coordination of Benefits (COB) Contractor. If you would like to report a WC case, obtain conditional payment information, or have a general WC question, please contact the COB Contractor by phone or mail. Customer Service Representatives are available to provide you with quality service Monday through Friday, from 8:00 a.m. to 8:00 p.m., Eastern Time, except holidays. The COB Contractor's toll free number is 1 (800) 999-1118 or TTY/TDD: 1 (800) 318-8782 for the hearing and speech impaired.
Written reports of WC occurrences should be addressed to:

Medicare—Coordination of Benefits
MSP Claims Investigation Project
P.O. Box 33847
Detroit, MI 48232

NOTE: This mailing address is for reporting a WC occurrence, not for the submission of Workers' Compensation Medicare Set-aside Arrangement (WCMSA) proposals.  WC settlements that include a proposed WCMSA for review should be sent to CMS C/OCoordination of Benefits Contractor, P.O. Box 33849, Detroit, MI 48232-5849.
When contacting the COB Contractor to report a new WC occurrence by phone or by mail, please be sure to have the following information available:

• Your client's name
• Your client's Medicare Health Insurance Claim Number (HICN) or SSN
• Date of incident
• Nature of illness/injury
• Name and address of the WC insurance carrier
• Name and address of the legal representatives
• Name of insured
• Policy/claim number

Once this information is received, the COB Contractor will apply it to the claimant's Medicare record, assign the case to a Medicare contractor, and inform you and your client of the applicability of the MSP program and Medicare's recovery rights. You will receive a notice advising you of the Medicare contractor assigned to handle the specifics of the case for recovery, Medicare's right of recovery and a beneficiary consent to release form. Once this process is completed, all further inquiries must be made through the assigned Medicare contractor. Please note that Medicare's interests cannot be determined until the claimant's record has been annotated with the specifics of the WC occurrence.
____________________________________________________________
How To Get All The Patient Referrals You Can Handle!!! As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.


How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!


Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Medicare Provides Assistance to Help Low-Income Beneficiar​ies Get Big Savings on Prescripti​on Drug Costs

Some Medicare beneficiaries could qualify for assistance with their prescription drug costs, and be eligible this year to pay no more than $2.50 for generic drugs and $6.30 for each brand name drug. The steps and requirements beneficiaries can take to check if they qualify for the Medicare Low-Income Subsidy Program (also known as LIS or “Extra Help”) are simple and may be done by phone or online.

The Centers for Medicare & Medicaid Services estimates that more than 2 million people with Medicare may be eligible for the subsidy, but are not currently enrolled to take advantage of these savings.

Changes resulting from the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 made it easier for Medicare beneficiaries to qualify for “Extra Help” by changing the way income and assets are counted. As of last year, the Social Security Administration, which determines eligibility for the program, does not count life insurance policies as a resource for eligibility purposes. In addition, help received from family and friends to pay for household expenses like food, mortgage, rent and utilities does not count as income.

“The eligibility requirements are more flexible than they were a couple of years ago, ‘Extra Help’ can be lifesaving for someone who needs prescription drugs and needs help with the cost,” said Dr. Don Berwick, CMS Administrator. “If you were turned down for ‘Extra Help’ in the past due to income or resource levels, you should reapply. If you qualify, you will receive help paying for Medicare prescription drug coverage premiums, copayments and deductibles.”

To qualify, Medicare beneficiaries’ incomes must be less than $16,335 a year (or $22,065 for married couples) and have resources limited to $12,640 (or $25,260 for married couples). Resources include bank accounts, stocks, and bonds, but do not include a beneficiary’s house, car, or life insurance policy.

There is no cost to apply for “Extra Help.” Medicare beneficiaries, family members, trusted counselors or caregivers can apply online in English and Spanish at www.socialsecurity.gov/prescriptionhelp. Beneficiaries may also call the Social Security Administration at 1-800-772-1213 (TTY users should call 1-800-325-0778) and ask for the Application for Medicare’s Part D Extra Help.

Medicare beneficiaries can also receive assistance in their local communities from their State Health Insurance Assistance Program (SHIP), Area Agencies on Aging (AAA), the Aging and Disability Resource Centers (ADRC) and many tribal organizations. For information about contacting your AAA, ADRC or SHIP go to www.eldercare.gov. Local SHIP contact information can be found online at www.medicare.gov/contacts/organization-search-criteria.aspx. All information provided is confidential.

To learn more about Medicare prescription drug coverage, visit www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

___________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/


Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Health care reform some important changes for children and young adults

Uploaded by HighmarkHealthy on Feb 14, 2011
This video outlines health care coverage changes for children and young adults resulting from the Patient Protection and Affordable Care Act, also known as health care reform.


____________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!

Click for more information: https://www.sendoutcards.com/129125/


Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

2010-2011 Influenza Season Week 30 ending July 30, 2011

U.S. Virologic Surveillance:

WHO and NREVSS collaborating laboratories located in all 50 states and Washington, D.C. report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza type and subtype.

http://www.cdc.gov/flu/weekly/?source=govdelivery
_____________________________________________________________
How To Get All The Patient Referrals You Can Handle!!! As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!


Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

CMS launches tools and initiatives to help improve American health care quality

Efforts give consumers information to inform their care The Centers for Medicare & Medicaid Services (CMS) announced a new tool for patients and caregivers and other enhanced initiatives today to empower consumers to make informed choices about their health care, and to help improve the quality of care in America’s hospitals, nursing homes, physician offices, and other health care settings.

“These tools are new ways CMS is making sure consumers have information about health care quality and important information they need to make the best decisions about where to receive high-quality care,” said Dr. Don Berwick, the CMS Administrator. “These efforts are designed to also encourage providers to deliver safe, patient-centered care that consumers can rely on and will motivate improvement across our health care system.”
The steps announced today include:

· A Quality Care Finder to provide consumers with one online destination to access all of Medicare’s Compare tools -- comparison information on hospitals, nursing homes and plans: www.Medicare.gov/QualityCareFinder.

· An updated Hospital Compare website, which now includes data about how well hospitals protect outpatients from surgical infections and whether hospitals care for outpatients who are treated for suspected heart attacks with proven therapies that reduce death: www.hospitalcompare.hhs.gov

· An enhanced Quality Improvement Organization (QIO) program under which QIOs provide technical assistance and resources to health care providers across the country to assist them in changing how care is delivered in hospitals, nursing homes, physician offices, and across care settings.
CMS has also updated data for outcomes of inpatient hospital care on Hospital Compare. Today’s update includes new 30-day mortality rates and 30-day readmissions rates for inpatients admitted with heart attack, heart failure, and pneumonia. These rates encompass three full years of claims data (from July 1, 2007 to June 30, 2010).

This year, the national 30-day mortality rates for heart attack have continued to decline, falling by 0.3 percent from the 2006 through 2009 rate of 16.2 percent to the more recent 2007 through 2010 rate of 15.9 percent. Mortality rates for heart failure and pneumonia increased slightly over the same period, showing an increase from 11.2 to 11.3 percent for heart failure and 11.6 to 11.9 percent for pneumonia, respectively.

Also this year, national 30-day readmissions rates for heart attack, heart failure, and pneumonia showed small changes in their updated rates. The new 2007 through 2010 rates for these three conditions are 19.8 percent, 24.8 percent, and 18.4 percent, respectively. These rates were slightly higher for heart attack in 2006 through 2009, at 19.9 percent, and slightly lower for pneumonia, at 18.2 percent, and heart failure, at 24.5 percent.

“Both sets of inpatient measures are risk-adjusted, taking health conditions into account to ‘level the playing field’ among hospitals and to help ensure accuracy in performance reporting,” Dr. Berwick said.

Hospital Compare also includes 10 measures that capture patient experience with hospital care. After two years of reporting these patient experience measures, hospitals have shown modest but meaningful improvement on most experience measures. The degree of this improvement has been relatively uniform across most measures and hospitals.

The website also contains 25 process-of-care measures and three children’s asthma care measures. The site also features information about the volume of certain hospital procedures performed and conditions treated for Medicare patients and what Medicare pays for those services.

Consumers have relied on Hospital Compare since 2005 to provide information about the quality of care provided in over 4,700 of America’s acute-care, critical access and children’s hospitals. So far this year, Hospital Compare has received about 1 million page views each month. More information about Hospital Compare is online at www.hospitalcompare.hhs.govse 


The QIOs will integrate and coordinate care across settings within communities, improve community health by promoting preventive services, and make health care costs sustainable in the long term by supporting care that keeps patients safe from costly and dangerous complications and harm. The works supports the administration’s National Quality Strategy and its Partnership for Patients, designed to build collaborative models to improve health care quality, reduce hospital-acquired conditions and lower hospital readmissions.

“Patient-centeredness means that every decision that’s made and every program that’s established is focused on patients and their families,” said Patrick Conway, M.D., M.Sc., CMS chief medical officer and director of the agency’s Office of Clinical Standards and Quality. “QIOs will promote this concept by including beneficiaries and front line clinicians in quality improvement initiatives, learning and action networks and communications. Listening to the voices of patients and staying focused on their outcomes and experiences are essential to achieve care centered on the patient.”

More information about the QIO Program is on the CMS website at www.cms.gov/qualityimprovementorgs.
_______________________________________________________
How To Get All The Patient Referrals You Can Handle!!! As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.


How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

MMSEA 111 What's New

This section will provide an at-a-glance listing of new information, updates and changes to the MMSEA111 web page.

Important Note: To comment or make inquiry regarding a Mandatory Insurer Reporting document and/or posting, please utilize the designated mailbox only. PL110-173SEC111-comments@cms.hhs.gov.

August 1, 2011

The following town hall teleconferences have been scheduled.  The notice and agenda containing the call in information will be posted ont he GHP and NGHP section pages.

• August:                GHP Technical/Policy – 8/10; NGHP Policy – 8/24

                                             GHP Unsolicited Alerts coming in September

• September:        GHP HRA – 9/7; NGHP Technical – 9/21

                                             GHP and NGHP TIN Validation coming in October

• October:              GHP Technical/Policy –10/5; NGHP Policy – 10/19

                                             GHP and NGHP Tin Validation requirements are now operational
_____________________________________________________________
How To Get All The Patient Referrals You Can Handle!!! As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!


Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Professional vs. Self Administration of WCMSAs

A WCMSA should be placed in an interest bearing account.  WCMSAs should also be administered by a competent administrator (the representative payee, a professional administrator, etc.).  When a claimant designates a representative payee, appointed guardian/conservator, or has otherwise been declared incompetent by a court; the settling parties must include that information in their Medicare set-aside arrangement proposal to CMS.(Ref: 10/15/04 Memo Q2)
In addition, the claimant may self-administer his or her own WCMSA, if permitted under State law.  Claimant should submit an annual self-attestation form when monies have been exhausted. (Ref:4/21/03 Memo Q8)
In professional administrative situations, the administrator of the set-aside arrangement must forward annual accounting summaries concerning the expenditures of the arrangement to the CMS Medicare contractor responsible for monitoring the individual's case. Additionally, the Medicare contractor is responsible for verifying that no payments from Medicare are made for medical expenses related to the injury or illness/disease until the WCMSA is exhausted. (Ref: 7/23/01 Memo Q3)

Administrative Fees/Expenses and/or Attorney Costs

(Ref: 5/7/04 Memo)

Administrative fees/expenses for administration of the WCMSA and/or attorney costs specifically associated with establishing the WCMSA cannot be charged to the set-aside arrangement. The CMS will no longer be evaluating the reasonableness of any of these costs because the payment of these costs must come from some other payment source that is completely separate from the WCMSA funds.
For example, if the settling parties submit a WCMSA proposal to CMS that claims that the claimant will need $50,000 worth of work-related medical expenses that would otherwise be reimbursable under Medicare and the settling parties claim that it will cost $10,000 in administrative and attorney fees in order to both administer and establish the Medicare set-aside arrangement proposal of $50,000, then CMS will only review the reasonableness of the $50,000 figure.
The CMS will not review whether or not the $10,000 in administrative and attorney fees are reasonable nor will CMS permit the settling parties to add that $10,000 amount to the $50,000 WCMSA amount. Therefore, if CMS approves that proposal for a $50,000 WCMSA, the settling parties $10,000 in administrative and attorney fees cannot be charged to/against the WCMSA of $50,000 because CMS considers those costs to be a separate issue for the settling parties to negotiate.

Treatment of Taxable Interest Income Earned on a WCMSA

(Ref: 7/11/05 Memo Q6)

If a claimant receives a Form 1099-INT for the interest income earned on his or her WCMSA account, the claimant or his/her administrator may withdraw an amount equal to the additional tax as a "cost that is directly related to the account" to cover the additional tax liability. This assumes that there is adequate documentation for the amount of incremental tax that the claimant must pay for the interest earned on this WCMSA.  Moreover, such documentation should be submitted along with the annual accounting.

Beneficiaries that Request Termination of a WCMSA Account

(Ref: 7/11/05 Memo Q10)

The administrator of the CMS-approved WCMSA should not release set-aside funds for any purpose other than the purpose for which the WCMSA was established without review from CMS. However, if the treating physician concludes that the claimant's medical condition has substantially improved, then the claimant (or the claimant's representative) may submit a new WCMSA proposal covering future expected medical expenses. Such proposals must justify at least a 25% reduction in the outstanding WCMSA funds. In addition, such proposal may not be submitted until at least five years after a previous CMS approval letter and should be accompanied by all supporting documentation not previously submitted with the original WCMSA proposal. The CMS decision on the new proposal is final and not subject to administrative appeal. The above proposals shall be submitted to:

CMS
c/o Coordination of Benefits Contractor
P.O. Box 33849
Detroit, MI 48232-5849
Attention: WCMSA Proposal

If CMS determines that a 25% or greater reduction is justified, CMS will issue a new approval letter. After CMS issues a new approval letter, any funds in the current WCMSA in excess of the newly calculated amount may be released to the claimant.
Effective August 25, 2008, the July 11, 2005 memorandum at Question and Answer 10, entitled "Beneficiaries that Request Termination of a WCMSA Account," is rescinded.

Death of a Claimant Prior to Exhaustion of the Medicare Set-Aside Money

(Ref: 4/21/03 Memo Q21)

Once the Regional Office (RO) and the contractor responsible for monitoring the claimant's case verify that all of the claimant's claims have been paid, then any amount left over in the claimant's WCMSA may be disbursed pursuant to State law. This may involve holding the WCMSA open for some period after the date of death, as providers, physicians, and other suppliers are permitted to submit their initial bill to Medicare for a period ranging from 15-27 months after the date of service.

Transfer Mechanism for Items and Services Not Covered by Medicare

(Ref: 7/11/05 Memo Q15)

Should a WCMSA provide for items and services that are not covered by Medicare but later become covered, those funds should then be considered part of the set-aside and treated accordingly, i.e., used to pay for any services as they were designated in the non-Medicare portion of the set-aside included in the WC settlement. These funds do not have to be transferred to a separate WCMSA bank account or be included in the annual WCMSA accounting.

______________________________________________________________
How To Get All The Patient Referrals You Can Handle!!! As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

New demonstration program to help states to improve the quality of care for patients suffering from a psychiatric emergency

The Centers for Medicare & Medicaid Services (CMS) today announced a new Medicaid Emergency Psychiatric Demonstration designed to provide states with more flexibility and resources to care for Medicaid beneficiaries with mental illnesses.

This demonstration provides up to $75 million in funding to states over three years, as authorized by the Affordable Care Act, to help care for Medicaid patients (aged 21 through 64) with psychiatric emergencies, in private inpatient psychiatric facilities with 17 or more beds, also known as institutions for mental diseases (IMDs). The demonstration defines psychiatric emergencies as expressions of suicidal or homicidal thoughts or gestures resulting in a determination that the patient is dangerous to himself or to others.

As a result, in order for states to receive federal reimbursement for medical assistance to care for psychiatric emergencies warranting hospitalization, Medicaid patients must receive services in non-IMD settings such as general hospital emergency rooms, which can often result in higher cost and less appropriate care settings. This demonstration will permit federal reimbursement for treatment of psychiatric emergencies in IMD settings, providing Medicaid patients with improved access to psychiatric treatment and enabling states to ensure the provision of needed services at lower cost.

“By changing the way the federal government can partner with states in the care of those suffering from mental illness, we are giving states the resources needed to provide higher quality care,” said CMS Administrator Dr. Don Berwick. “The Affordable Care Act was clear in its charge that we must continuously strengthen our commitment to mental health parity -- which remains one of the most silent, yet pervasive conditions affecting millions of Americans.”

The Medicaid Emergency Psychiatric Demonstration is part of the CMS’s commitment to improving the quality of care available to Medicaid beneficiaries. The demonstration is being administered by the Center for Medicare and Medicaid Innovation (the Innovation Center). Created by the Affordable Care Act, the Innovation Center is committed to achieving the three aims of better health, better health care, and reduced costs through improvement for CMS beneficiaries by testing delivery system models. CMS is now accepting applications to participate in this demonstration from interested State Medicaid Directors. States will be selected competitively based on their application proposals. More information, including the solicitation, application and fact sheet can be found at http://www.cms.gov/DemonstrProjectsEvalRepts/MDP/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=3&sortOrder=ascending&itemID=CMS1249074&intNumPerPage=10

___________________________________________________________
How To Get All The Patient Referrals You Can Handle!!! As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/




Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Advisory Opinion 11-11 (PDF)

(concerning two proposals by a supplier that furnishes medical supplies, equipment, and related services to enter into a contract with a skilled nursing facility to provide such items and services.)
http://oig.hhs.gov/fraud/docs/advisoryopinions/2011/AdvOpn11-11.pdf
__________________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.


To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

CMCS Medical Director Position

The Centers for Medicare & Medicaid Services (CMS), Center for Medicaid, CHIP and Survey & Certification (CMCS), Baltimore (Woodlawn), Maryland is seeking to hire a full-time Medical Director to serve as the senior medical advisor and medical consultant to the Director and Deputy Directors of CMCS and other key staff and managers within the Center on the Medicaid and Children’s Health Insurance Program (CHIP). This is a new, leadership position focusing on improvements in service delivery and payment and the impact of federal and state policies on the provider community and provider performance as part of the Center’s overall efforts to Improve care and population health while lowering costs through such improvements.

Duties of the position include but are not limited to the following:

· Provide medical expertise to central and regional office staff regarding clinical issues related to the design and development of strong primary care delivery systems for prevention, early diagnosis, and treatment and develops strategies for coordination of primary care and specialty care to achieve quality health outcomes.

· Lead or participate in the development of reimbursement and payment policies that support quality care, value-based health care purchasing, provides incentives to providers to improve access, efficiency, and improved health outcomes, and work to adjust payment level for preventable errors. In this regard, the Medical Director will work closely with the Federal Coordinated Health Care Office.

· Contribute to the development and implementation of nationally endorsed performance measures for transparency in assessing provider performance, informing beneficiary choices and decisions, and determining the application of payment incentives.

· Collaborate with States and localities, national organizations, advocacy groups, etc. on reducing health care disparities through the assessment of health care data and the promulgation of best practices on how to reduce such disparities.

· Advise on the development and implementation of a beneficiary-centered health information technology infrastructure and quality data collection system that supports quality reporting and the improvement in health outcomes.

Please let us know if you are interested in the position by submitting your resume to Tracey Mummert at tracey.mummert@cms.hhs.gov by August 31, 2011.

Qualification and determination of grade level will be not be made until prior to any offer of employment.
_________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!  As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Health Care Reform - Changes to Medicare

Uploaded by mcneelyfs on Apr 5, 2011

____________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!

Click for more information: https://www.sendoutcards.com/129125/


Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Physicians, Nurses and Allied Health Professionals Open Door Forum

Updated August 4, 2011- The proposed agenda for the next Physician Nurses & Allied Health Open Door Forum is scheduled for Tuesday, August 9, 2011 from 2:00pm-3:00pmET is as follows: Physician Fee Schedule NPRM; Claims Reprocessing; Primary Care Incentive Payment Program; Advanced Diagnostic Imaging Program. This agenda is subject to Change. If you wish to participate, dial 1-800-837-1935 Conference ID 68641515. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.

____________________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/


Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

CMS Updates to Coverage Pages

Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) Meetings
     Posted updated roster
http://www.cms.gov/FACA/Downloads/medcacroster_08_2011.pdf
The September 21, 2011, MEDCAC meeting has been canceled and will be rescheduled for early 2012. Please continue to check our coverage website and the Federal Register Notice for the new date.

______________________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

All participating practices to continue in 2-year PGP Transition Demonstration

Physician Group Practice Demonstration succeeds in improving quality and reducing costs

All participating practices to continue in 2-year PGP Transition Demonstration

Today the Centers for Medicare and Medicaid Services (CMS) announced results from the initial Physician Group Practice (PGP) Demonstration, a landmark partnership with physician group practices that aims to better coordinate care across different settings, leading to improved quality and cost savings. After five years, this demonstration has shown positive results, including significant progress in areas of both quality improvement and savings in Medicare expenditures. The lessons learned from this demonstration helped shape the Accountable Care Organization (ACO) model put forth by the Affordable Care Act.

CMS also announced that all ten of the physician groups will continue to participate in the new PGP Transition Demonstration, a two-year supplement to the original PGP Demonstration.

“As we work to help bring care coordination to a broader set of providers through Accountable Care Organizations, the lessons learned by this demonstration provide great insight into how to use Medicare’s payment systems to improve quality while reducing costs,” said CMS Administrator Donald M. Berwick, M.D. “We have learned to invest in sustained improvement over time, and that short-term comparisons between start-up costs and measureable results may fail to realize the long-term value of these efforts.”

Under the PGP Demonstration, physician groups earn incentive payments based on the quality of care they provide and the estimated savings they generate in Medicare expenditures for the patient population they serve. For each participating PGP practice, CMS established a minimum threshold (or benchmark) for each of the quality performance measures. In order to receive incentive payments, a group had to meet the quality performance benchmark.

The results from the demonstration underscore the opportunities for integrating care for patients enrolled in traditional fee-for-service Medicare. In the fifth year of the demonstration, seven groups achieved benchmark performance on all 32 performance measures; these include Billings Clinic in Billings, Montana, Everett Clinic in Everett, Washington, Forsyth Medical Group in Winston-Salem, North Carolina, Geisinger Health System in Danville, Pennsylvania, Middlesex Health System in Middletown, Connecticut, Park Nicollet Health Services in St. Louis Park, Minnesota, and St. John’s Health System in Springfield, Missouri. The remaining three groups achieved benchmark performance on at least 30 of the 32 reported measures. These results mark a significant increase from year 1, when only 2 physician groups achieved benchmark performance on all measures.
All ten physician groups achieved benchmark performance on heart failure, coronary artery, and preventive care measures. Over the five years of the demonstration, the physician groups also increased their quality scores in the following areas an average of: 11.0 percentage points on diabetes measures, 12.4 percentage points on heart failure measures, 6.0 percentage points on coronary artery disease measures, 9.2 percentage points on cancer screening measures, and 3.8 percentage points on hypertension measures.

Four of the groups will receive incentive payments of $29.4 million (out of total savings to Medicare of $36.2 million). Over the five years of the demonstration, Medicare has paid $110 million in incentives to seven of the PGP participants. These incentive payments reward the PGP participants for both the savings they have achieved for the Medicare program, as well as quality improvements that have resulted in not only better health, but also a better experience of care for patients.

The first performance year of the 2-year PGP Transition Demonstration began on January 1, 2011. The Demonstration will provide CMS with additional performance data and insight into how the successes of this type of program can be sustained, as well as offer CMS the opportunity to continue testing additional quality measures using a methodology that encourages continual improvement. The Demonstration also continues to provide incentives for improvement as the broader Medicare Shared Savings Program and the Innovation Center’s Pioneer Accountable Care Organization begin to become operational.

Under the PGP Transition Demonstration, PGPs will need to have lower growth in Medicare costs relative to a national benchmark in order to share in savings. The PGP Transition Demonstration design includes a retrospective assignment algorithm based on services provided by primary care providers, rather than all specialties as was done under the initial PGP Demonstration. This methodology underscores the important role primary care providers play in coordinating care to achieve better quality and cost outcomes. Quality performance continues to be a key aspect of the Demonstration design and the PGP Transition Demonstration includes new measures and areas of focus, including claims and chart based measures, composite measures, and patient experience measures.

“We are optimistic that these groups that participated in the both the initial PGP Demonstration and the new PGP Transition Demonstration will continue to show improved quality and generate shared savings for the Medicare program,” said Dr. Berwick. “The continued movement towards shared savings programs is beneficial for the both providers and their patients.”
For additional details on the design of the PGP Transition Demonstration, visit the Physician Group Practice Demonstration webpage at:http://www.cms.gov/demoprojectsevalrpts/md/itemdetail.asp?itemid=CMS1198992. Information about other Medicare Demonstrations can be found on the CMS Web site at: http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD.

_______________________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Rural Health Open Door Forum

**Updated July 15, 2011- The next Rural Health Open Door Forum is scheduled for Tuesday, August 23, 2011 from 2:00pm-3:00pmET. If you wish to participate, dial 1-800-837-1935 Conference ID 68647472. This call will be Conference Call Only. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums.

**Additional Updated July 6, 2011 (Corrected Web Address) - Fiscal Year (FY) 2012 IPPS Proposed Rule Wage Index and Outmigration Adjustment Corrections (For Immediate Attention)

The Centers for Medicare & Medicaid Services (CMS) has become aware that an error was made in the calculation of the wage index outmigration adjustment in Table 4J of the FY 2012 IPPS-LTCH PPS proposed rule (CMS-1518-P), posted on the CMS Web site at:http://www.cms.gov/AcuteInpatientPPS/IPPS2012/list.asp#TopOfPage. The correction of this error results in an additional 104 providers being eligible for the outmigration adjustment in the FY 2012 proposed wage index. For a provider that is newly eligible for the adjustment and is not reclassified in the proposed wage index (under sections 1886(d)(8) or (d)(10) of the Social Security Act (the Act)), the correction to the outmigration adjustment also changes the provider's FY2012 wage index value listed on Table 2.

Since these changes could affect hospitals' geographic reclassification decisions for FY 2012, we are providing immediate notification of the corrections to Tables 2 and 4J of the FY 2012 IPPS/LTCH PPS proposed rule and a brief extension of the 45-day deadline of §412.273 (referenced at 75 FR 25881) for hospitals to terminate or withdraw 1886(d)(10) reclassifications as well as the 45-day deadline (referenced at 75 FR 25887) for a hospital to receive the out-migration adjustment rather than their section 1886(d)(8)(B) redesignation. A discussion of the corrections will be included in a Correction Notice to the FY 2012 IPPS/LTCH proposed rule (CMS-1518-CN2), which will be on display in the Federal Register sometime during the week of July 4, 2011. The corrections to Tables 2 and 4J are posted on CMS's Web site at: http://www.cms.hhs.gov/AcuteInpatientPPS/01_overview.asp. Hospitals that wish to request (or to revise a previous request) to terminate or withdraw an 1886(d)(10) reclassification, or to receive the out-migration adjustment rather than their section 1886(d)(8)(B) redesignation, must submit their request by no later than 7-days from the actual date of display of the Federal Register Correction Notice.

A detailed instructional letter (TDL-11384, 6-28-11, ATTACHMENT) has also been distributed to (or posted for) hospitals through their Medicare contractors and is available on CMS's Web site, also at: http://www.cms.gov/AcuteInpatientPPS/01_overview.asp, in the "Downloads" section. For questions, contact Brian Slater (410-786-5229) or Valerie Miller (410-786-4535).

******

Rural Health Open Door Forum Overview

The Rural Health ODF addresses Rural Health Clinic (RHC), Critical Access Hospital (CAH) and Federally Qualified Health Center (FQHC) issues, as well as some inclusion of other questions and concerns that occur in clinical practice pertaining to other CMS payment systems that also extend into these settings. Topics that frequently arise on this forum often deal with payment & billing for services subject to Health Professional Shortage Area (HPSA) and/or Physician Shortage Area (PSA) status, cost report clarifications, classifications for & qualifications of rural provider types, and the many special provisions being implemented for improving rural health in the Medicare Modernization Act of 2003. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the Forums.

_________________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!
Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Health Care Reform - A Timeline of Benefits and Provisions

Uploaded by mcneelyfs on Apr 5, 2011

____________________________________________________________

How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.

How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!

Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.

Physicians, Nurses and Allied Health Professionals Open Door Forum

**Updated August 4, 2011- The proposed agenda for the next Physician Nurses & Allied Health Open Door Forum is scheduled for Tuesday, August 9, 2011 from 2:00pm-3:00pmET is as follows: Physician Fee Schedule NPRM; Claims Reprocessing; Primary Care Incentive Payment Program; Advanced Diagnostic Imaging Program. This agenda is subject to Change. If you wish to participate, dial 1-800-837-1935 begin_of_the_skype_highlighting            1-800-837-1935      end_of_the_skype_highlighting Conference ID 68641515. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.

**Updated July 15, 2011- Special Open Door Forum: Providing an overview of the Quality Care Finder online resource - Wednesday, July 20, 2011 2:00 p.m.-3:00 p.m. ET. This Special Open Door Forum will focus will be to introduce the newest of the CMS Medicare.gov resources: the Quality Care Finder. Participants will be given a brief overview of the CMS quality commitment followed by a guided tour of the Quality Care Finder landing page and the many tools that are accessible through this online resource. Participants will also learn how CMS is working with partners to get the word out about this important new resource. This is Audio Only Web-Based. If you wish to participate: Go to: http://www.cms.gov/apps/events/event.asp?id=637 to register by midnight July 19, 2011. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forum.

******

Physicians Nurses & Allied Health Professionals Open Door Forum Overview

The Physicians, Nurses, and Allied Health Professionals Open Door Forum addresses the concerns and issues of Medicare and Medicaid physicians, non-physician practitioners, nurses, and other allied health care specialists. This diverse group of providers serves Medicare and Medicaid beneficiaries in almost all service settings, ranging from independent physician offices to specialized departments within larger facilities. The types of issues that come up during this forum are as varied as the providers who participate, but some frequent topics include the Physician Fee Schedule, Stark regulations, care plan oversight, payment and documentation rules, Provider Enrollment Chain Ownership System (PECOS), as well as the roles and responsibilities of different allied health professional staff under CMS regulations. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the forums.
____________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.
How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!


Click for more information:  https://www.sendoutcards.com/129125/




Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.

To learn more about Atlantic Financial Consulting you may visit their website at

http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555 begin_of_the_skype_highlighting            1 888-428-2555      end_of_the_skype_highlighting, Ext. 200.

Details for Electronic Health Records Demonstration

This demonstration aimed to reward delivery of high-quality care supported by the adoption and use of electronic health records in physician practices. This initiative expands upon the foundation created by the Medicare Care Management Performance (MCMP) Demonstration. The goal of this 5-year demonstration was to foster the implementation and adoption of EHRs and health information technology (HIT) more broadly as effective vehicles not only to improve the quality of care provided, but also to transform the way medicine is practiced and delivered.
UPDATE:

• On August 1, 2011, CMS announced that the demonstration would be ended early.

Electronic Health Records Demonstration Summary
In 2007, the Secretary of the Department of Health and Human Services directed the Centers for Medicare & Medicaid Services to develop a new demonstration initiative using Medicare waiver authority to reward the delivery of high-quality care supported by the adoption and use of electronic health records (EHR). The goal of this demonstration was to foster the implementation and adoption of EHRs and health information technology (HIT) more broadly as effective vehicles to improve the quality of care provided and transform the way medicine is practiced and delivered. Adoption of HIT has the potential to provide significant savings to the Medicare program and improve the quality of care rendered to Medicare beneficiaries. This demonstration is designed to leverage the combined forces of private and public payers to drive physician practices to widespread adoption and use of EHRs.
As part of this new demonstration, all participating primary care physician practices were required to have a certified EHR by the end of the second year.  Physician practices must, as part of the demonstration, be utilizing the EHR to perform specific minimum core functionalities that can positively impact patient care processes, (e.g., clinical documentation, ordering of lab tests, recording lab tests, and recording of prescriptions). However, the core incentive payment was to be based on performance on the quality measures, with an enhanced bonus based on the degree of HIT functionality used to manage care.
The Electronic Health Record demonstration was planned to be operational for a 5-year period. The first operational year of the demonstration provided payments to participating practices based on use of a certified EHR to manage the care of patients, with higher payment for more sophisticated HIT use (e.g., use of the EHR to facilitate care management activities, sharing of records among providers of care, etc.). Payments were determined by a practice's score on an Office Systems Survey (OSS) administered annually to track the status of EHR implementation at the practice level, and the specific EHR functions employed by each participating practice to support the delivery of care. Higher scores on the OSS result in increased incentive payments to participating practices.
During the second operational year of the demonstration, payments were to be made to participating physician practices that are using certified EHRs and reporting clinical quality measures, again with additional payments based on EHR functionalities employed by the practice. During years 3 to 5 of the demonstration, payments to participating practices were to be based on performance on the designated clinical quality measures, with an added bonus each year based on the degree to which the practice has used the EHR to change and improve the way it operates.
The Centers for Medicare & Medicaid Services (CMS) solicited partners interested in working with CMS to implement the Electronic Health Records (EHR) Demonstration in their communities. The role of the community partner is to assist CMS with outreach activities, education and recruitment of eligible primary care physician practices in their defined communities. Community partners will also collaborate with CMS on an ongoing basis in an effort to assist us in achieving our goal of leveraging the combined forces of private and public payers to drive physician practices to widespread adoption and use of EHRs. CMS sought strong organizational entities that have the necessary infrastructure and a clear commitment to advancing the adoption of EHRs and are capable of supporting CMS in these activities
Status
On June 10, 2008 CMS announced the selection of 12 community partners in defined sites to help CMS implement this demonstration. The approved community partners in each site represent diverse collaborations of organizations including, but not limited to: varied HIT stakeholder collaborations, medical societies, primary care professional organizations and health departments. The demonstration was initially planned to be implemented in two phases. Phase I includes the following 4 sites: Louisiana, Southwest Pennsylvania, South Dakota (and some counties in bordering states), and Maryland and the District of Columbia. Phase 2 included 8 additional sites and was scheduled to follow one year later. Recruitment of physician practices in the four Phase I sites was initiated on September 2, 2008, and the enrollment period closed on November 26, 2008. Over 800 eligible applications were received from interested practices in the four Phase I sites.
On April 7, 2009 CMS announced that, as a result of the incentive provisions for physicians to encourage the adoption of health information technology in the American Recovery and Reinvestment Act 0f 2009 (ARRA), CMS would change its plans for implementing the EHR Demonstration. Specifically, we decided to continue implementation of Phase I of the EHR Demonstration but discontinue Phase II of the EHR demonstration, which originally was planned to begin operations in mid-2010. Phase 1 of the demonstration began as scheduled on June 1, 2009 and will continue through May 31, 2014.
On August 1, 2011, CMS announced the decision to end this demonstration early. As a result of a greater decrease than projected in the number of participating treatment group practices since the start of the Demonstration and the expected attrition over the next three years, CMS has concluded that the final participation numbers will likely be insufficient for the demonstration evaluation to support any definitive conclusions about the Demonstration's impact. Therefore, given the financial and staff resources necessary to continue this Demonstration and the limited potential for definitive results, CMS has made the difficult decision to terminate this Demonstration effective August 1, 2011.
Contact
For additional information, please contact the following mailbox resource: EHR_Demo@cms.hhs.gov

__________________________________________________________________________
How To Get All The Patient Referrals You Can Handle!!!As a health care provider you know that the majority of your new patients come from referrals from existing patients and other physician practices.

How would you like to be able to send cards like these to your patients and referrals sources automatically with the click of a button? Just think how much that would grow your patient base and increase your revenue!!!


Click for more information:  https://www.sendoutcards.com/129125/

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us  or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.