Booze Cruisin’ This Summer? — Fun with ICD–10
F10.982 — Alcohol use with other alcohol-induced disordernnT75.3XXA — Motion sickness, initial encounternnY93.18 — Activity, water skiing and wake boarding
Spring Cleaning Fever! — Fun with ICD–10
S93.411A — Sprain of calcaneofibular ligament of right ankle, initial encounternnY93.E5 — Activity, floor mopping and cleaningnnY92.010 — Kitchen of single-family (private) house as the place of occurrence of the external cause
Novitasphere Portal: Impending Multi-factor Authentication Deadline
Make sure you are prepared for the new MFA login authentication!nnThe CMS Enterprise Identity Management System (EIDM) is implementing a Multi-Factor Authentication (MFA) requirement to help improve CMS’ ability to ensure system security.nnAs of June 19, 2016, all Novitasphere Portal users will need to use MFA when logging into both EIDM and the Novitasphere website.nnTo prepare for this new level of security and avoid log in issues on June 19, we are strongly encouraging customers to set up their MFA device NOW. Once your device is registered, you will be required to enter a security code from your device each time you log in to Novitasphere and EIDM.nnWhat is MFA?n
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- MFA is a type of login authentication that, in addition to a User ID and Password, requires another “factor” such as a PIN. To comply with the CMS Policy, Novitasphere users will need to establish a second login “factor” to meet this level of security.
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nWho does this affect?nNovitasphere Portal customers who:n
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- Have a Novitasphere role that was approved before May 8, 2016
- Do not have any EIDM roles which already require MFA
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nNovitasphere customers who are approved after May 8, 2016:n
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- You will be able to set up your MFA device as of the Friday following your Novitasphere role approval.n
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- Example: For a customer whose Novitasphere role is approved on May 31, 2016, they will be able to set up MFA starting on June 3, 2016.
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How do I add an MFA device?nFor your reference, a document titled “Existing Novitasphere Portal Users Adding Multi-Factor Authentication (MFA)” has been added to the Novitasphere Center, with detailed instructions for an existing user to add an MFA device. If you have questions on the MFA process and registering a device, please review the guide to learn more.nnYou may also wish to view CMS’s EIDM Training Video: MFA Registration and Use. (This video is hosted by YouTube, a 3rd party vendor not affiliated with Novitas Solutions, Inc. In order to view YouTube videos, your company must allow this. If you receive a message that the video is blocked, please contact your network administrator to request an exception. YouTube videos are also accessible via mobile devices, which is an alternate method you may choose to view these.)nnWe strongly encourage you to register more than one type of device, with one of them being the IVR option. Due to known latency issues with the e-mail option, we do not suggest having this as your sole MFA device.nnCustomers who have a role which already requires the use of MFA should follow the instructions here:n
Medicaid Revalidation: Frequently Asked Questions
MCO/BHO Provider Enrollment/Revalidation FAQ
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Learn the answers to frequently asked questions about MedicaidnnImportant Notes:nnRevalidation is required for all currently enrolled Medicaid providers (those with a Medicaid ID). MCO/BHO providers that are enrolled in Medicaid as well as credentialed into a plan network must complete the revalidation process.nnMCO/BHO and CHP+ network providers who are currently not enrolled in Medicaid must complete enrollment no later than October 31, 2016. Although the Centers for Medicare and Medicaid (CMS) has extended its deadline for provider revalidation to September 24, 2016, it is critical that Colorado providers complete revalidation and/or enrollment as soon as possible. The Department is launching its new enrollment and claims management system, the Colorado interChange, on November 1, 2016. Starting on that date, claims and encounters submitted by providers who have not enrolled and/or revalidated will be denied. Questions regarding provider revalidation and enrollment should be addressed to Provider.Questions@state.co.us. Please be patient, as response time may run 10-14 days.nnFrequently Asked Questionsnn[vc_toggle title=”1. What is the purpose of this initiative?” size=”sm” el_id=””]New federal regulations established by the Centers for Medicare and Medicaid Services (CMS) require enhanced screening and revalidation of all Medicare, Medicaid, and CHP+ providers. Beginning Sept. 15, 2015, all Colorado providers who want to continue, or begin, providing services to Medicaid and CHP+ members after March 31, 2016, will be required to enroll and revalidate their licensure and business information under new federal enrollment screening criteria. The Department of Health Care Policy and Financing (HCPF) has posted more information on the provider screening rule on their website; click on the Federal Provider Screening Regulations link.[/vc_toggle]nn[vc_toggle title=”2. With revalidation, we understand the providers will keep their existing Medicaid IDs, but may be assigned additional IDs depending on how they’re currently set up. How will the providers and Plans be notified if the existing Medicaid ID changes?” size=”sm” el_id=””]With revalidation, we understand the providers will keep their existing Medicaid IDs, but may be assigned additional IDs depending on how they’re currently set up. How will the providers and Plans be notified if the existing Medicaid ID changes? Current providers will continue to use their Medicaid ID numbers through October 31, 2016. Starting on November 1, all Medicaid and CHP+ providers will be identified in the interChange system either by their NPI or by a system-assigned ID number (for providers not eligible for an NPI). Providers identified by a system-assigned number will be notified shortly before full implementation, hopefully by mid-October. Current/existing Medicaid ID numbers will remain in the system as legacy identifiers but will not be used to pay claims with a DOS of 11/1/16 or later.[/vc_toggle]nnn[vc_toggle title=”3. Plans have to put a process in place to identify providers that have either not revalidated or are up for revalidation (every 3-5 years). In this process, there needs to be a way the MCOs/BHOs can verify the revalidation. How will the MCO/BHO know which providers have been revalidated?” size=”sm” el_id=””]Plans have to put a process in place to identify providers that have either not revalidated or are up for revalidation (every 3-5 years). In this process, there needs to be a way the MCOs/BHOs can verify the revalidation. How will the MCO/BHO know which providers have been revalidated?” The Department is still working on an outreach plan for providers who have not revalidated within established time frames. A spreadsheet was distributed to MCOs/BHOs in mid-January 2016 that listed providers, by county, who had not started revalidation by 12/31/15. MCOs/BHOs should compare this list to their list of network providers that are currently enrolled in Medicaid. An updated list will be provided by the end of February 2016. These providers should be outreach targets. Providers will be notified by the interChange system several months prior to their next revalidation period, which will be either 3 years or 5 years, depending on provider type.[/vc_toggle]nnn[vc_toggle title=”4. Will there be a lookup on the State’s portal (or other mechanisms) similar to verifying eligibility for members, where plans can verify revalidation for providers?” size=”sm” el_id=””]Will there be a lookup on the State’s portal (or other mechanisms) similar to verifying eligibility for members, where plans can verify revalidation for providers?” Not at this time. Providers will be notified of their next required validation.[/vc_toggle]nnn[vc_toggle title=”5. Will there be a list of validated providers available to the plans?” size=”sm” el_id=””]The Department is able to pull a list of providers who have revalidated by NPI number, but cannot pull a list of providers by health plan.[/vc_toggle]nnn[vc_toggle title=”6. We understand providers will get a confirmation letter when they’re revalidated. Can the plans get a copy of this letter template?” size=”sm” el_id=””]The current letter is being revised and a new letter with additional information will be published in the near future. We will provide a copy of both letters. The date for distribution of the new letter is still pending.[/vc_toggle]nnn[vc_toggle title=”7. Can the Plans be a cc on the letter to the providers?” size=”sm” el_id=””]No. Letters are sent directly to the email address submitted by the provider in its revalidation application. A costly systems change would be required to include a cc for health plans in these letters.[/vc_toggle]n
American Medical Association Medical Liability Reforms Challenged
The American Medical Association is pursuing solutions to developed issues in medical liability reforms.
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nnMedical liability reforms are likely to be advanced and challenged in 2016, according to a report published by the American Medical Association. nnTo address existing and developing issues in medical liability, the AMA is pursuing legislative solutions at the federal and state levels. To expedite the resolution of meritorious claims, provide more consistent damage awards, and reduce defensive medicine, 3 states recently passed new bills to create early disclosure system. Other states are likely to design systems to engage in early discussion with patients following adverse health care incidents. States will also work to establish and protect existing medical liability reforms, with implementation of caps on noneconomic and total damages.nnThe report also addresses new movements underway to adopt a no-fault patient compensation system for medical liability in which patients would be compensated automatically; many, including the Physician Insurers Association of America, are not in favor of the no-fault system. Legislation that the AMA will be advocating for in 2016 includes the Sports Medicine Licensure Clarity Act, which would protect sport medicine professionals when they travel with teams across state lines, and the Good Samaritan Health Professionals Act, which will protect health care professionals who volunteer during a federally declared disaster. Lastly, physicians are also supporting medical liability reforms in the midst of legal challenges, including cases that threaten physician-patient confidentiality and cases questioning the admissibility of expert evidence and testimony.n
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This article is originally posted on Endocrinologyadvisor.com.
Stay AWAY from the Chicken Coops! — Fun with ICD–10
S01.02XA — Laceration with foreign body of scalp, initial encounternnW61.33XA — Pecked by chicken, initial encounternnY92.72 — Chicken coop as the place of occurrence of the external cause