Low-Income Health Access Open Door Forum

**Updated August 13, 2010- August is National Immunization Awareness Month. This annual health observance is a great opportunity to educate seniors and other people with Medicare about the importance of disease control and prevention through immunization. Vaccine-preventable disease levels are at or near record lows. Yet, many adults remain under-immunized, missing opportunities to protect themselves against diseases such as hepatitis B, seasonal influenza, and pneumococcal disease. The Centers for Medicare & Medicaid Services (CMS) ask all health care providers who provide care to Medicare patients to join us during National Immunization Awareness Month to help protect your Medicare patients from vaccine-preventable diseases by checking to make sure their immunizations are up-to-date and encouraging utilization of Medicare-covered immunizations that are appropriate for them.
Medicare Part B Immunization Benefits
Medicare provides coverage for seasonal influenza, pneumococcal, and hepatitis B vaccines and their administration, under Medicare Part B, for qualified beneficiaries as preventive immunizations. Providers who accept the Medicare-approved payment amount for these services are reimbursed under Medicare Part B.
• Seasonal Influenza Immunization
Medicare provides payment for the seasonal influenza vaccine and its administration for all people with Medicare, once per influenza season, in the fall or winter. Medicare may cover additional influenza vaccinations, if medically necessary. (Note: According to the Centers for Disease Control and Prevention, the 2010 – 2011 influenza vaccine will protect against the 2009 H1N1, and two other influenza viruses http://www.cdc.gov/flu/about/disease/.)
• Pneumococcal Immunization
Medicare provides payment for the pneumococcal vaccine and its administration for all beneficiaries, generally once in a lifetime. Medicare may cover additional vaccinations based on risk.
• Hepatitis B Immunization
Medicare provides payment for the hepatitis B vaccine and its administration for beneficiaries at medium to high risk of contracting hepatitis B.
For More Information: CMS Adult Immunizations Web Page http://www.cms.gov/AdultImmunizations/ (Please Note: The "Immunizers' Question & Answer Guide to Medicare Coverage of Seasonal Influenza and Pneumococcal Vaccinations", which provides administration and flu vaccine payment rates for use by mass immunizers and physician practices, will be updated and posted to this site sometime in early October, 2010.)

CMS Medicare Learning Network (MLN) Preventive Services Educational Products Web Page http://www.cms.gov/MLNProducts/35_PreventiveServices.asp#TopOfPage – This site provides access to MLN educational resources developed by CMS for fee-for-service providers related to Medicare-covered preventive services, including adult immunizations.

For information about National Immunization Awareness Month, please visit the Centers for Disease Control and Prevention website at http://www.cdc.gov/vaccines/events/niam/default.htm .

**Updated August 10, 2010- Ninth National Education Call on Medicare Fee-For-Service (FFS) Implementation of HIPAA Version 5010 and D.0 Transactions, Medicare FFS 5010 Program: Taking EDI to the Next Level- August 25, 2010, 2:00pm To 3:30pm ET. The Centers for Medicare & Medicaid Services (CMS) will host its ninth national education call regarding Medicare FFS's implementation of HIPAA Version 5010 and D.0 transaction standards on August 25, 2010. This session will focus on the 835 Electronic Remittance Advice transaction. Subject matter experts will review Medicare FFS specific changes as well as general information to help the audience prepare for the transition; the presentation will be followed by a Q&A session. The presentation will be available on the CMS website by clicking on the following link: http://www.cms.gov/Versions5010andD0/V50/list.asp - Please bookmark this new "5010 National Calls" web page. Registration will close at 2:00 p.m. EST on August 24, 2010, or when available space has been filled. Target Audience: Vendors, clearinghouses, and providers who will need to make Medicare FFS specific changes in compliance with HIPAA version 5010 requirements.

Medicare Fee-For-Service (FFS) Implementation of HIPAA Version 5010 835 Electronic Remittance Advice Transaction Agenda: General Overview, Medicare Specific Changes, Timelines and Deadlines. What you need to do to prepare, Transaction Specific Issues, Q & A

In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. Registration will close at 2:00 p.m. ET on August 24, 2010, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. 

1. To register for the call participants need to go to:
http://www.eventsvc.com/palmettogba/082510

2. Fill in all required data.

3. Verify your time zone is displayed correctly the drop down box.

4. Click "Register".

5. You will be taken to the "Thank you for registering" page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.

6. If assistance for hearing impaired services is needed the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event.

**Updated July 26, 2010- CMS is hosting a Payment Error Rate Measurement (PERM) Provider Education Conference Call to provide an opportunity for live dialogue between CMS and the Medicaid provider community in the States of New Hampshire, Vermont., West Virginia, and Utah. Provider forum participants will learn from PERM related presentations such as: An overview of the PERM program, the PERM process and what you may be required to do during a PERM review; The documentation request letter/what are your responsibilities when the documentation request letter is received; The follow up schedule and the requirements; Frequent mistakes and best practices. The PERM 101 for Medicaid Providers and Sample document request letter materials will be discussed and are available at the PERM Providers page of the CMS Website, http://www.cms.gov/PERM/ . There will be time available for Q&A's however; CMS encourages your questions to be submitted in advance to our designated PERM provider email address at: PERMProviders@cms.hhs.gov or, you may also contact your State PERM Representatives with any questions and for information about educational and training events in your area. For New Hampshire Providers: George.C.Cummings@dhhs.state.nh.us; For Vermont Providers: Mary.Grovers@ahs.state.vt.us; For West Virginia Providers: ScottWinterfeld@wvdhhr.org; For Utah Providers: jslade@utah.gov . 

The call will be held Wednesday, August, 4, 2010 at 2:00pm to 3:30pm. Participant Dial-In Number: (800) 603-1774 Your conference ID # is 87754610. To view the entire announcement please see: http://www.cms.gov/PERM/Downloads/Invite_Aug_4.pdf .

**Updated June 15, 2010- The proposed agenda for the Low Income Health Access Open Door Forum scheduled for Tuesday, June 15, 2010 from 2pm-3:30pmET is as follows: Health Care Reform Update, HRSA Cross-Agency Collaborations, Redeeming and Reassignment. This agenda is subject to change. If you still wish to participate, dial 800-837-1935 and Conference ID 76349201. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums. 

**Updated May 18, 2010- The next Low Income Health Access Open Door Forum is scheduled for Tuesday, June 15, 2010 from 2pm-3:30pmET. If you wish to participate, dial 800-837-1935 and Conference ID 76349201. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums. 

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Low Income Health Access ODF Overview

The Low Income Health Access ODF addresses the concerns of the beneficiary advocates, providers, and information intermediaries throughout the country interested in improving access to Medicare and Medicaid for lower income Americans. Generally, CMS addresses are new guidance or initiatives in programs for people with low-incomes, such as the Medicaid and SCHIP programs.  Also, CMS provides information on the  Medicare Prescription Drug Benefit, as well as the low-income subsidy.  Services settings such as Federally Qualified Health Centers (FQHCs), Community Health Centers (CHCs) and 340(b) Hospitals and other providers are also often discussed. CMS co-hosts this forum with the Health Resources & Services Administration (HRSA). Timely announcements and clarifications regarding important rulemaking, agency program initiatives, and other related areas impacting the lower income beneficiaries are also included in the Forums.

Downloads
Wednesday, June 16, 2010- Payment Error Rate Measurement (PERM) Provider Education Call (PDF, 24KB) Tuesday, June 15, 2010- Low Income Health Access Open Door Forum (PDF, 34KB) Tuesday, March 23, 2010- Low Income Health Access CHIPRA Demonstration Grants Presentation Material (PDF, 107KB) December 15, 2009- Follow Up Resources and Weblinks- Low Income Health Access ODF (PDF, 24KB)
Related Links Inside CMS
Low Income Health Access Open Door Forum Mailing List Sign-Up State Medicaid Director Letters Assuring Access to Community Living for the Disabled Fact Sheet CHIP
Related Links Outside CMS
Government Printing Office Federal Register HRSA Patient Safety & Clinical Pharmacy Services Collaborative (added 03/25/10) Health Disparities (added 03/25/10) HRSAs FY 2009 Grant Opportunities in the Health Center Program (added 12/12/08) HRSAs General Health Center Program Information (added 12/12/08) School Health Program National Assembly On School-Based Health Care CMS Survey and Certification Group Training Site

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