A final rule released today (Oct. 14, 2016) by the Centers for Medicare and Medicaid Services (CMS) details the final regulations for implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), the historic Medicare reform law that repealed the Sustainable Growth Rate (SGR) formula last year.
Colorado’s mail voting system means that the first ballots of the 2016 election will reach voters’ mailboxes in just one week. That means we’re almost out of time to make sure every voter has the FACTS about Amendment 69 and the untested experimental health care debacle that it would enshrine in our state’s constitution. We need your strong support during this final sprint toward Election Day.nnYou already know that Amendment 69 would likely mean employers fleeing Colorado, a huge tax increase on workers and a completely untested health care system. ColoradoCare would mean a panel of unaccountable politicians deciding treatment options and raising taxes without TABOR limitations. The dangers of Amendment 69 are clear. There isn’t much time to defeat this dangerous amendment. Colorado voters deserve to know the truth about Amendment 69 before they vote.nnBigger is not always better and Amendment 69 is too BIG for Colorado! Opposition to Amendment 69 continues to grow!nn
nnHere are the facts:n
n
n
n
n
n
nWith Amendment 69, it actually feels good to say NO.nn
Professional Liability InsurancennThe latest release for CAQH ProView includes improvements to the Professional Liability Insurance (PLI) screen. Based on feedback from practice managers and participating organizations, changes to this section will help providers enter PLI information accurately, reducing follow-up and making the credentialing process smoother and faster.nnChanges to this section will include:n
n
n
n
n
n
nStandardizing Practice Location AddressesnnCAQH ProView is making additional improvements to ensure that provider data entered is accurate. The United States Postal Service standardized format will be applied to ensure practice addresses are accurate and complete per USPS address standards. This feature will prompt providers to review, and correct if necessary, their practice location addresses prior to attestation. Per the USPS format, all addresses will appear IN ALL CAPITAL LETTERS.nnSystem Improvements Released August 1nnThe Employment Information screens within CAQH ProView have been updated, making them easier to use. Additionally, some fields that were previously optional are now required, enabling healthcare providers to submit more complete profiles that require less follow-up work and reducing requests for additional information from health plans and other organizations. Healthcare providers may wish to allow additional time during the next re-attestation to complete these fields. These changes to CAQH ProView do NOT affect a provider’s status in CAQH ProView or the ability for authorized participating organizations to view data.n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
n
nnNew Plan InformationnOn October 31, 2016, Hewlett Packard Enterprises (HPE) will assume fiscal agent operations on behalf of Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+). These operations include the transition to the Colorado interChange (a new claims payment system) and a new provider Web Portal.nnClaims Payment DelaysnDuring the transition to the new Colorado interChange, there will be a delay in payments for ALL providers. The length of delay will depend on the type of claim you’re submitting. The Department recognizes that payment delays can create challenges for providers, which is why we’re providing this information now so you can plan accordingly. Unfortunately, these delays are unavoidable and no exceptions can be made.nnFind more detail about these dates on the Provider Resources web page.nnPaper pharmacy or medical claims (i.e. all paper claims)n
n
n
n
n
nElectronic medical claims (and encounters)n
n
n
n
n
nElectronic pharmacy claims (and encounters)n
n
n
n
n
n
nProvider IDs and Portal LoginsnYour Provider ID number will be changing. Starting on October 31, 2016, claims must be submitted using your new provider ID number. Your new provider ID number will be sent out via email on October 15, 2016.nnYour provider Web Portal login information will be changing. The new provider Web Portal will be launching on October 31, 2016. You will receive additional instructions for Web Portal registration when you receive your new Provider ID on October 15, 2016.nnNote: You will NOT need the password you used to submit your application for revalidation/enrollment or your 5-digit application tracking number.nnYour batch claims submitter MUST apply for a new Trading Partner ID (TPID). To avoid any delay in claims submission, ensure your submitter starts their Trading Partner enrollment soon. Your submitter can learn more information about applying for a new TPID on the EDI Support web page.nnImportant Dates and Training OpportunitiesnPlease visit the Provider Resources web page for a list of important dates, training availability for the new provider Web Portal, and additional information.
Demigods…nWe want and seek the best in ourselves and in others. nnOur own demigodery often clouds our vision.nStay tuned for more Todd’s Tips!nn
nn
About R. Todd Welter • MS, CPCnFounder and President of Welter Healthcare PartnersnMr. Welter has over 25 years of healthcare industry experience assisting physicians and other providers, hospitals and other facilities with the business side of medicine. Through strategic planning and analysis, Mr. Welter’s main focus is to strategically increase revenues and profitability in this radically changing health care environment. Mr. Welter has a Masters Degree in Organizational Leadership from Regis University in Denver where he has had an appointment as affiliate faculty in the School for Professional Studies for over ten years. In addition, Mr. Welter holds a faculty appointment at the University of Denver’s University College. In the Health Care Leadership program he teaches Macro Economics in Health Care and Innovative Strategies and Change in Health Care to graduate students.
Amendment 69 will create a first-of-its-kind, untested, government run health care system that will not work as intended.nnNo other state in the country has a health care system in place like the one proposed in Amendment 69 so there is no model to look to for how this will play out in Colorado. Vermont explored a similar plan but its governor, a single payer champion, ultimately pulled the plug on his own proposal stating, “In my judgment, the potential economic disruption and risks would be too great to small businesses, working families and the state’s economy.”n
nOf course not!nnIt’s clear to anyone who has studied the bill that Amendment 69 is not only not free — it would cost Colorado’s economy way too much!nnThe measure would give Colorado the highest income tax rate in the country, would sacrifice our health care coverage to a panel of politicians and would DOUBLE the size of state government!nnColorado cannot afford the risks associated with Amendment 69!nnThis article originally posted on ColoradansforColoradans.com.